- Reference Manager
- Simple TEXT file
People also looked at
Original research article, chaos, care, and critique: performing the contemporary academy during the covid-19 pandemic.
- Department of Science and Technology Studies, University of Vienna, Vienna, Austria
The starting point for this article is that the COVID-19 global pandemic has brought normally invisible, taken-for-granted aspects of contemporary societies into sharp relief. I explore the analytical affordances of this moment through a focus on the nature of the contemporary academy, asking how this was performed on “academic Twitter” in the early months of the 2020 COVID-19 pandemic, therefore contributing to work that has characterized contemporary university, research practice, and social media discussion of this. I draw on a dataset of tweets from academic Twitter, systematically downloaded between 1 March and 24 July 2020, that are concerned with the pandemic, analyzing these through a qualitative, multimodal, and practice-oriented approach. I identify themes of the disruption of academic work, of care and care practices, and of critiques of injustice and inequity within academia, but also argue that the ways in which these topics are instantiated—through distinctive repertoires of humor and of emotional honesty, positivity, and gratitude—are central to performances of academic life. The analysis thus further contributes to studies of communication to and by other publics, and in particular, the ways in which the content and form of social media communication are intertwined.
Introduction
I would like to start, if I may, with an anecdote from my own experiences during the early days of the pandemic in Europe. In Austria a hard lockdown came rather quickly into force: we went, it seemed, from vague concerns about other countries to a dramatic curtailment of movement in the space of a few days. In common with many others, my memory of those first days is of uncertainty, of rules and recommendations changing almost by the hour, and of a desperate search for new information. Those early hours, days, and weeks were marked by a dedication to media both new and old. Never before had I sat down deliberately to watch a government press conference; now, it was an event I planned my day around.
I was, both then and now, struck by the extent to which (my) sense-making was taking place through social media. This was a year in which the term “doomscrolling” ( Markham, 2020 ) rose to prominence, and the notion perfectly captures my memory of obsessive scrolling through feeds in an effort to garner more knowledge, more certainty more collective meaning. Social media delivered local information (from the numbers of cases in my city to how to support local businesses), but it also showed how the global communities of which I am a part were making sense of the pandemic. Within my personal filter bubble ( Pariser, 2011 ), academic jokes, stories, and debates were one aspect of this. Social media showed me how (some versions and parts of) academia were experiencing and defining this moment of crisis and change.
It was these experiences that led, in part, to this research, in that I became fascinated by what social media responses to the pandemic were revealing about academic cultures more generally. But the starting point for this article is not only my sense of social media as central to pandemic sense-making, but also a wider appreciation of the analytical affordances of moments of crisis or infrastructure breakdown. “The normally invisible quality of working infrastructure becomes visible when it breaks,” write Leigh Star and Ruhleder (1996) , 113: “the server is down, the bridge washes out, and there is a power blackout. Even when there are back-up mechanisms or procedures, their existence further highlights the now-visible infrastructure.” Indeed, the COVID-19 global pandemic has brought normally invisible, taken-for-granted aspects of contemporary societies into sharp relief. In all its horror, the pandemic, its management in specific contexts, and public discourse on and responses to it have acted as analytical lenses through which the attitudes, practices, and values that underpin particular collectives—from nation states to specific institutions—can be rendered visible and therefore debatable. As many commentators have argued, the pandemic offers an opportunity to observe what is present and to suggest what might, and perhaps should, be otherwise.
In this article, I am specifically concerned with academic communities. In taking the pandemic as a moment of crisis in which taken-for-granted norms, assumptions, and ways of living are disrupted and therefore made visible, I seek to explore the nature of the contemporary academy as it was performed on “academic Twitter” in the early months of 2020. I therefore examine social media practices as a way of exploring the experiences of one particular public, that of academic researchers and teachers. In doing so, I build on previous scholarship in Science and Technology Studies (STS) and Higher Education Studies (HES) that has critically examined the ways in which academia is done in contemporary societies, from trends of marketization, massification, or internationalization to increased competition and precarity within academic careers. I am concerned with the following questions: How do scholars know and live in universities today? How are academia and the “good academic” performed, and how are these performances contested? What dynamics shape experiences of academia?
In what follows, I reflect on these questions through a qualitative, multimodal study of tweets from “academic Twitter.” I begin by outlining the literatures and conceptual sensitivities that frame the research, before describing the methodological approach taken. An extended empirical section describes three key aspects of the performances of academic life found within the data. I close by drawing my arguments together and reflecting on the wider implications of the analysis. What does it suggest more generally about academia, social media, and the COVID-19 crisis?
Literatures and Sensibilities
Life and work in the contemporary academy.
At the broadest level the question that animates this research concerns the nature of the contemporary academy, and what it is to live and work within it. It thus builds upon, and speaks to, a now extensive body of multidisciplinary work that has sought to characterize university and research practice today. Key themes within this have included the “projectification” of research ( Ylijoki, 2014 ; Fowler et al., 2015 ), an increase in precarity ( Courtois and O’Keefe, 2015 ; Sigl, 2016 ; Bataille et al., 2017 ; Roumbanis, 2019 ), the implementation of entrepreneurial or capitalistic logics to academic practice ( Slaughter and Leslie, 1997 ; Fochler, 2016 ; Reitz, 2017 ; Rushforth et al., 2018 ), the rise of narratives of “excellence” as one way of auditing academic practice ( Lund, 2015 ; Watermeyer and Olssen, 2016 ), and demands for international mobility and other often punitive ways of living the “ideal academic” ( Lund, 2015 ; Balaban, 2018 ). Much of this literature has thus been concerned, explicitly or implicitly, with questions of equity and diversity ( Ackers, 2008 ; Leemann, 2010 ; Heijstra et al., 2017 ; Angervall and Beach, 2018 ), as it suggests that only some people can afford—financially, emotionally, or intellectually—to maintain an existence within academia as it is currently instantiated. Relatedly, it has been argued that the emotional tenor of academic life has become skewed toward anxiety and a sense of insecurity, and away from practices of care or support ( Cardozo, 2017 ; Lorenz-Meyer, 2018 ; Ivancheva et al., 2019 ).
This is now a substantial and diverse literature, and one in which there are key disagreements (for instance, concerning the extent to which “neoliberalism” is a helpful framing of the changes that are taking place: Amsler and Shore, 2017 ; Ball, 2015 ; Cannizzo, 2018 ). I do not attempt to review it further here, instead highlighting one aspect that will be particularly pertinent to my discussion: that of the ways in which “living” and “working” are increasingly entangled within academic identities ( Felt, 2009 ). Felt and others have argued that academics exist within “epistemic living spaces” in which the epistemic is mingled with, and enacted through, diverse social, symbolic, and material practices ( Felt and Fochler, 2012 ; Linkova, 2013 ). Knowledge production, the crafting of a career or professional identity, and other ways of living are thus entangled. Similarly, accounts of academic careers have described the quite stringent work that is required to craft and protect an academic identity, from avoiding imposter syndrome ( Taylor and Breeze, 2020 ) to successfully inhabiting an academic role ( Campbell, 2003 ; Winkler, 2013 ; Schönbauer, 2020 ), while discussion of international mobility or of “jetsetter” academics have emphasized the all-encompassing nature of what is required of individuals ( Zippel, 2017 ; Balaban, 2018 ). Living and working in the contemporary academy appear on the one hand to draw on well-established notions of a “vocation” or “calling” ( Shapin, 2009 ; Berthoin Antal and Rogge, 2020 ), while, on the other, merging these with more recent expectations of entrepreneurialism, self-reliance, and individual responsibility ( Hakala, 2009 ; Loveday, 2017 ). Academic identities are therefore performed in ways that mingle knowledge production with informal relationships, the personal with the professional, and the material with the symbolic ( Davies, 2020 ).
Networked Scholarship and Academic Twitter
If the starting point for this research is the question of how life and work in the academy are currently articulated, then a second frame is studies of how these academic lives are performed on social media. A growing body of work explores how academics make use of digital tools and platforms, from the use of online learning tools to academic social networks such as Academia.edu (e.g., Delfanti, 2020 ; Lupton et al., 2017 ). Within this, the work of George Veletsianos ( Veletsianos, 2016 ; Veletsianos and Kimmons, 2012 ) on “networked participatory scholarship” has proven particularly influential. Veletsianos and Kimmons (2012) , in the article that introduces the term, suggest that scholarship is changing through the emergence of digital tools; specifically, they write, “Networked Participatory Scholarship is the emergent practice of scholars’ use of participatory technologies and online social networks to share, reflect upon, critique, improve, validate, and further their scholarship” (p.768). This is not simply an amplification or development of existing practices. Rather, their contention is that academic practice is undergoing qualitative changes in ways that are entangled with digital technologies, including the emergence of new kinds of networks and of greater engagement with different kinds of audiences in and outside the academy. Thus, Veletsianos suggests, “paradigmatic shifts in and evaluation of our identity as scholars, the purposes of education and scholarship, and the academic preparation of scholars” (2016, 26) are underway.
One central aspect of this networked scholarship is the use of social media, and a number of studies have addressed the use of Twitter, in particular, by academics ( Brantner et al., 2020 ; Gregory and Singh, 2018 ; Kimmons and Veletsianos, 2016 ). Stewart (2016) , in an ethnographic study of academic Twitter users, argued that the platform “enables a collapsed space of engagement, wherein the analytic and text-based content of scholarship is shared via often-casual, participatory, and dialogic forms of exchange” (p.72). She charts the use of the platform not only for network-creation but for interactions involving intimacy, vulnerability, and care; as such, the now well-established notion of “context collapse” ( Marwick and Boyd, 2011 ), where scholars may be subject to “unanticipated audiences and attention” ( Stewart, 2016 , 77), is a key risk. Other studies have shown, however, that academic users of Twitter are alert to these dangers and carefully manage their online presence. Self-disclosure, while potentially involving deeply intimate topics such as mental health or personal and professional challenges within the academy, is selective and tactical ( Veletsianos and Stewart, 2016 ), while online identities are both “authentic” and “fragmented” (ibid; Jordan, 2020 ): social media users seek to present genuine expressions of the self, but spread across multiple platforms and designed for different audiences. While this work supports the notion of a sea change in academic practice—as Veletsianos and Stewart write, “scholars’ personal lives are often an integral part of online participation and as such mediate emergent forms of scholarship” (2016, 8)—more recent research has pointed out that opportunities to participate in such networked participatory scholarship are not distributed or experienced equally ( Gregory and Singh, 2018 ). “Building an online academic presence,” argued Taylor and Breeze (2020) , “is conditioned by the politics of class, race, and gender” (p.3). While Twitter appears to be a key site in which academics can perform identity work, for instance by rendering underrepresented identities within the academy more visible ( Veletsianos and Stewart, 2016 ), not everyone is able to (safely) do this in the same way.
Memes, Communities, and “Folkloric Expression”
While the work described above has explored, in some detail, how scholars use social media, there has been less systematic attention to the content of what they post, with the emphasis largely having been on individual negotiations and performances of academic experience. 1 In the context of this study, and of my interest in how academia is enacted, it is therefore important to draw on an adjacent body of work: that which has looked at the content of social media more generally, and specifically the “emerging patterns in public conversations” ( Milner, 2018 , 1) that can be identified within the rise of “mimetic media”: memes. Memes, Milner suggests, exist “in the space between individual texts and broader conversations, between individual citizens, and broader cultural discourses” (ibid, 2). They therefore offer an opportunity to explore the shared meanings held by (and sometimes contested within) particular communities.
Internet memes have been subject to academic study since at least 2014, when Limor Shifman defined the form as
(a) a group of digital items sharing common characteristics of content, form, and/or stance, which
(b) were created with awareness of each other, and
(c) were circulated, imitated, and/or transformed via the Internet by many users ( Shifman, 2014 , 41)
As Shifman suggests, memes are both multiple—involving many versions of, for instance, an original image or text—and intertextual, in that they refer to other (online) content. Shifman and others distinguish memes (which are constantly tweaked, for instance, through mimicry or adaption) from virals (a single piece of content with high circulation); memes, then, are inherently communal, forming part of a wider conversation that implies a collective of people “in the know” ( Philips and Milner, 2017 ). The slipperiness of memes is exactly that they travel outside of these implied communities, such that context collapse ( Marwick and Boyd, 2011 ) is inevitable, their meanings are unclear, and the intention of their authors ambiguous. As Dynel notes, “online users’ voices behind their humorous memetic produce [sic] can never be established beyond any doubt” (2021, 191). Philips and Milner (2017) situat such communication as a form of “folkloric expression,” arguing that rather than being something dramatically new, memes, trolling, and other forms of internet ambiguity have many of the same features of folklore (the “lore” of any group with at least one thing in common; p. 25). As with folklore, mimetic expression is vernacular, informal, and simultaneously stable and conservative (referring to “tradition” and widely shared meanings) and dynamic and creative (constantly adapted and remade by individuals). This perspective thus takes us again to understanding such communication as a set of practices that connect shared meanings with individual interpretations of these.
One further aspect of memetic media will be important for my discussion. Memes—like much of the rest of the internet environment—are multimodal, involving diverse communicative modes such as “word, image, audio, video, and hypertext” ( Milner, 2018 , 24). This, of course, renders them even more complex, as intertextual referencing, remixing, and adaptation can happen in one or several of the modes that they include (an image that tweaks another, or text that quotes or adapts lyrics or phrases; see Figure 1 ). It is important to note that this multimodality has also become important to virality: even text-only tweets are often captured with screenshots so that they can be circulated as images on other platforms. As I describe further below, I will primarily be focusing on textual content in my analysis, but will seek to pay attention to the ways in which this is situated and extended through other communicative modes.
FIGURE 1 . Examples of memes; captured using the search term “You should be writing meme” and showing how both images and text are remixed in multiple combinations. “You should be writing” memes circulate within academically oriented social media but also in communities oriented to writing or study.
Materials and Methods
In describing work that explores the nature of the contemporary academy, networked scholarship, and memetic expression I have uncovered a number of conceptual sensitivities that will shape my analysis. I will, first, be interested in the ways in which contemporary academic life is performed, and particularly in the ways that these performances combine multiple facets of life, knowledge production, and work. Second, I am concerned with how such performances are done on Twitter, viewing academia-oriented tweets as the products of strategic and selective self-presentations. Finally, I treat this social media material as a form of mimetic expression that both references wider community (ies) and shared meanings and involves individual creativity. While I am, as noted, interested in a set of general questions concerning contemporary academic experience (including how scholars know and live in universities today, how academia and the “good academic” are performed, and how these performances are contested), the specific question that structures the following discussion is: how was the contemporary academy performed on “academic Twitter” in the early months of the 2020 COVID-19 pandemic ? In line with my interest in performativity and the enactment of community, I take an approach that is ethnographically oriented and qualitative ( Marwick, 2013 ; Hine, 2015 ), viewing social media material as records of digital practices ( Hepp et al., 2017 ) and thereby constitutive of what they describe. I therefore adapt techniques used for big data analysis of Twitter corpuses, such as bulk download of tweets (e.g., Brantner et al., 2020 ; Graham and Smith, 2016 ), in order to create a dataset that is suitable for in-depth qualitative analysis. As described below, the focus of this adaptation was on tightly delimiting the dataset ( Dynel, 2021 ), an approach that allows for an in-depth but inevitably highly specific analysis.
I explore Twitter rather than other social media platforms for two reasons. First, academic Twitter offers perhaps the most consolidated online academic community, and is certainly the most studied ( Brantner et al., 2020 ; Gregory and singh, 2018 ; Kimmons and Veletsianos, 2016 ; Stewart, 2016 ; Veletsianos and Stewart, 2016 ). Second, it enables the collection of a coherent and clearly delimited dataset via the hashtags #AcademicTwitter and #AcademicChatter (in contrast to, for instance, Facebook, where there would be many relevant groups and users). The material I am concerned with thus consists of 1) tweets that 2) use the hashtags #AcademicTwitter or #AcademicChatter and were 3) published in the period March–July 2020, and 4) contain content (whether in the form of further hashtags or in the topics discussed) relating to the pandemic. This material has been gathered and curated in a number of steps. First, at the end of March 2020, I used Twitter’s search function to find tweets with the relevant hashtags, published in that month, which had been “favourited” 500 times or more. 2 Tweets that mentioned or related to the COVID-19 crisis were saved as screenshots. Second, using the tool Twitter Archiver, 3 I set up an automated download of all tweets with the hashtags #AcademicTwitter or #AcademicChatter from 4 April 2020 onward. 4 Of this material, I have incorporated tweets from the first month (4 April–4 May) with 25 or more favorites into the dataset, along with tweets from the next three months (4 May–24 July) with 500 or more favorites. The result is a corpus of tweets with hashtags #AcademicTwitter or #AcademicChatter from March (17), April (326), May to July (204), or 547 tweets in total across 5 months.
As the preceding description suggests, the dataset has been hand-curated to ensure both a quantity of material that lends itself to in-depth qualitative analysis (hence the decision to largely work with tweets with 500+ favorites, which are limited in number) and the capacity to capture key moments within the pandemic (the choice to include all tweets with 25+ favorites in April). In all cases, by working with tweets with 25+ favorites, the material has achieved some level of virality— here understood as being due to its reflecting shared experiences or opinions within the community of academic Twitter users, with high numbers of favorites seen as a sign of community approval ( Graham and Smith, 2016 ). This process of curation was, of course, imperfect on multiple levels. The aim has been to create a corpus that captures widely appreciated tweets over the early months of the pandemic in numbers suitable for qualitative analysis ( Dynel, 2021 ), but it can be problematized in multiple ways: by excluding hashtags such as #blackintheivory, #pandemicpedagogy, #PhdChat, and #PhDlife, for instance, key constituencies are partially excluded or rendered less visible in the material. It also misses academia-oriented content that used no hashtags at all. Similarly, the balance between producing a dataset that is manageable (focusing on more frequently favourited tweets) and capturing more of the discussion (including less popular tweets) over the course of the pandemic has been a difficult one. Ultimately, the material I work with cannot be seen as straightforwardly representative of online articulations of experiences of academia during the pandemic; rather, it captures key aspects of discussion between users of Twitter (a rather select population within academia more generally) who specifically identify or engage with the communities associated with the hashtags #AcademicTwitter and #AcademicChatter.
Once compiled, the corpus was subject to two forms of analysis. I first carried out a thematic analysis ( Rivas, 2018 ) of the material in order to identify repeated patterns and concerns, using the software MaxQDA as a means of organizing the material and developing a code scheme based on its content. I have, second, combined this thematic analysis with more focused exploration of multimodality ( Machin, 2013 ) and with the conceptual sensitivities mentioned above, paying particular attention to how academia is (articulated as) lived in and embodied. In the discussion that follows, I use this second approach to explore particular tweets or aspects of the content in more detail, and to assess how particular themes are instantiated through social media practices.
It is important to note that working with Twitter data in this way raises issues relating to public space and ethical research. While early social media research embraced discourse on platforms such as Twitter as “public” and therefore as not being subject to the need for informed consent ( Marwick, 2013 ), more recent scholarship has problematized this notion, pointing out that, while services such as Twitter explicitly state that “posts that are public will be made available to third parties,” many users assume some level of privacy or that their consent will be sought before tweets are used in research ( Williams et al., 2017 , 1150). Researchers have dealt with this in different ways, from following a decision flowchart where factors such as whether the tweeter is a “public figure” or deals with sensitive content shape the approach taken ( Williams et al., 2017 ) to avoiding quotation entirely and instead crafting “autoethnographic fictions” that recreate how tweets might have been rendered ( Taylor and Breeze, 2020 ). In this text, I use a variety of strategies. I avoid direct quotation as much as possible, instead discussing emergent themes and shared features of the corpus. I also paraphrase tweet content and describe, rather than including screenshots of, images and memes. Where I do quote directly, I do so from content that has been favourited thousands of times as well as frequently retweeted and replied to; such content, in my view, has become public by virtue of its popularity and reach. In all cases, I anonymize content and do not refer to specific users by name.
The next section presents the results of this analysis, describing and discussing three key themes that emerged from the data as central to depictions of academic life during this period: disruption, care, and critique.
Performing the Academy on Academic Twitter
To say that experiences of disruption, crisis, and chaos were a key feature of tweets about the pandemic risks banality. Notions of a break from normality and of dramatic differences from the expected or mundane were common across mainstream media and in political and policy discussion; indeed, as noted above, this disruption is what allows underlying assumptions to be identified. In this section, I thus explore not only tweet content concerning a sense of chaos and crisis but also what this tells us about “normal” life in the academy.
Particularly during the early stages of the pandemic in March, tweets frequently noted or alluded to the “unprecedented” nature of the current moment. This was, as one tweeter wrote, a “GLOBAL PANDEMIC” (caps in the original) and therefore an entirely new situation. Not only was this moment unprecedented but it was also “trying,” “tough,” or “difficult” in multiple ways. Themes of struggling and of the need to endure repeatedly emerged within the dataset, with, for instance, stories of students with close family members ill with COVID, the “emotional toll” of the situation, the challenge of dealing with constant uncertainty, or the sadness of defending one’s thesis at a time of social distancing. Tweeters spoke of struggling to concentrate, feeling despair or demoralization, or of mental health issues triggered by the crisis.
Such emotions and experiences were certainly not unique to academics. What was it, exactly, that academic tweeters described as being disrupted? Here key themes concerned the interruption of “normal” academic life through home-working, home-schooling, and care responsibilities, but also through the sudden removal of conferences and other face-to-face events such as defenses, the demand for online teaching, and ubiquitous Zoom meetings. Thus, on the one hand, some tweeters talked about the pleasures or affordances of quarantine and lockdown: one might use the time to finally finish the PhD thesis, or to catch up on reading. On the other hand, tweeters also asked for advice concerning disrupted fieldwork and the need to move to digital formats, made jokes about missing the lab, and worried about students who had “disappeared” since the move to online teaching. Much of this discussion was oriented to the need to the need to produce – particularly text, in the form of theses or articles, but also CVs, datasets, or good student evaluations. Concerns about an inability to concentrate, disrupted work days (for instance due to home-schooling), or a desire to “stay in my pyjamas all day,” “eat ice cream,” and “cry” all relate to an imagination of academic life as oriented to productivity. What was being disrupted by the pandemic, and the changed work practices it entailed, was the steady production of text and the capacity to “get more writing done.”
If the academy is enacted as oriented to productivity and the creation of text (in particular) within these tweets, it is also framed as being simultaneously solitary and social. It is this dynamic that lies behind the dual acknowledgment that much research (and more specifically, writing) is carried out alone (and that academics might therefore be somehow better prepared for the pandemic), but that it also involves important communal occasions (conferences, group meetings, and defenses). The pandemic was therefore described as simultaneously involving continuities with mundane academic life and as dramatically different from it. Tweeters joked about the PhD experience—limited human contact, the need for self-discipline, and digital communication—as being good preparation for lockdown, while also telling stories of efforts to replicate, via Zoom or other tools, social encounters such as discussions over coffee or conference attendance. The opportunity to participate in communal celebration—at the conclusion of a PhD or course, for instance—was particularly missed. Here, as in other aspects of the material, there was a sense that face-to-face copresence was something intrinsic to academic life.
This material from academic Twitter thus enacts academic life as productivity-oriented and as simultaneously solitary and social. It is these features that were disrupted so violently by the pandemic: much of the anxiety and struggles that are described within the data come from interruptions of productivity–through additional care responsibilities, anxiety, or extra work connected to the pandemic, for instance—and from enforced changes in rhythms of solitude and copresence. Merely describing these themes, however, gives little sense of how they were enacted within tweets, and in particular the degree to which the use of humor to tell stories of disruption is key to these accounts. The themes described above were articulated in the form of jokes, humorous stories, and remixed memes as much as through straightforwardly descriptive text. The challenges of working from home, for instance, might be conveyed by a story about a child running in and asking to take their clothes off in the middle of a lecture, while disrupted rhythms are implied by joking questions about what day it is. Importantly, ideas about (lost) productivity were also conveyed in this way. One tweeter wrote that while they were impressed by people who were managing to finish articles or develop analyses during lockdown, all they had managed was a small-scale study of the relation between pandemics and wine consumption; another noted that with classes being canceled and university buildings closed, they would be forced to actually work on their dissertation. Such humor is an important feature both of the platform generally ( Philips and Milner, 2017 ) and of this particular dataset. In referencing challenges in a lighthearted way, it reinforces particular imaginations of academic life—that productivity and professional demeanor are important, for instance—whilst also gently subverting them (showing that ideals are rarely lived up to, or that procrastination is as much an issue as lack of time).
Performances of the contemporary academy are thus instantiated through a humorous tone that does complex work in both reinforcing and subverting ideals concerning what academic life should look like. This point can be further illustrated by one popular meme, an academia-oriented adaptation of the “unfinished horse drawing” meme 5 which was circulated in mid-March. This appears in this dataset as a screengrab of another tweet, and has been favourited almost 1500 times, but the meme also traveled to other platforms, rapidly losing its original attribution. As shown in Figure 2 , it uses the “unfinished horse drawing” image (used in multiple other memes) as a basis for a depiction of teaching in 2020 and, in particular, the move to online teaching. The online meme encyclopedia Know Your Meme notes that memes based on this image convey “the feeling of being rushed through a task and express the feeling that something's quality has diminished over time.” As such, its adaptation in the context of academic life and “pandemic pedagogy” communicates the disruption that has taken place and the drop in teaching quality that has occurred. It does so, however, in a manner that is humorous, highly visual, and self-mocking in the contrast between what is planned and what is actually carried out. The use of wry irony is typical of the humor that is deployed within discussion of pandemic disruption in this dataset, and of the ways in which even chaos and disruption are communicated through self-aware reflection.
FIGURE 2 . Unfinished horse drawing “teaching in 2020” meme, captured from Twitter but widely circulated without attribution.
If a first key theme within this material is of articulations of chaos and disruption that are frequently conveyed through humor and ironic self-reflection, a second relates to care and care practices. Tweets in this dataset are not only oriented to funny stories about disrupted working practices. Just as frequently, the content seeks to express compassion, care, and emotional honesty, and to offer (or request) support, empathy, or advice. Tweeters thus frame themselves as being part of particular groups (faculty, PhD students, supervisors, and academics generally), offering mutual support to those communities and giving guidance for supporting others outside of them.
Students are one frequent object of these care practices. Many tweeters expressed concern or gratitude for their students, or advised others about how to look out for them. One tweet, from Mrach favourited several thousand times, asked readers to “check in regularly on your PhD students … Many (perhaps most) live alone with no family nearby. We supervisors are the closest they have to a family.” Others focused more on junior students, advising others to drop penalties for late assignments, be cautious that using COVID-19 in teaching might be triggering for some individuals, or find ways to maintain relationships with students despite the move to remote teaching. Students were thus viewed as a key population which was suffering from the effects of the pandemic and which users of academic Twitter had the possibility to influence or support, whether by showing “kindness” or by trying to understand how to help individuals with little or no digital connectivity.
Tweeters also sought to care for “each other” and for “ourselves.” Articulations of care were directed within and between a community of academic Twitter users, with this community framed as being in need of compassion and care during the pandemic. Such articulations took different forms. Tweets might express offers of support (“we are here to support you”), discuss what it means in practice to “be kind to yourself,” remind people to check in on their friends and colleagues, ask for advice or for a “Zoom happy hour” because the tweeter was struggling, discuss the systems and structures in place at institutions to support well-being and mental resilience, or talk about how one was “staying sane” during such a difficult time (for instance, by painting or taking time off work). Such messages foregrounded the emotions tied to experiences of the pandemic, disclosing information about one’s own struggles and repeatedly emphasizing that it was normal to be finding the situation difficult. Tweeters thus both acknowledged negative emotions associated with the disruption described above, and affirmed that readers are “amazing and resilient” if they are managing to “survive.”
Care, in this material, is thus enacted as being vital to academia, but as often missing within it (cf. Cardozo, 2017 ; Ivancheva et al., 2019 ). The fact that so many of these tweets call for compassion and for care practices implies a backdrop where these are lacking or undervalued. Indeed, this is explicit within some tweets. One frequently favourited tweet discussed “the countless academics whose lack of compassion has consistently torn others down in the past few months,” and noted that this was more disappointing to them than their own, very natural, struggles. Similarly, the advice given—to check in on students or colleagues, to advise students that their mental health should be their priority, and to find things that help you “stay calm”—suggests that these practices are currently largely missing, and therefore need to be encouraged. Academic life is framed as requiring an influx of care through the mutual and self-supporting activities and practices the tweets promote.
Just as stories of disruption often came bundled with jokes and irony, expressions of care were instantiated through a distinctive affective repertoire. Here, memes and images were less important; instead, text (and sometimes Tweet threads, where several tweets are used to tell a longer story) was used to convey advice and support. The emotional tone of this content featured not only expressions of struggles or suffering and articulations of care and compassion in response to this but also gratitude, celebration, and motivational language. Thus, a thread of positivity ran through much of this content: tweeters wrote “props to other grads” who were similarly enduring difficult situations, that one needs to “survive to thrive” in “HARD” times, said “thank you” publically to colleagues or students, or gave “shout outs” to key individuals and groups. Similarly, academic Twitter was used as a key site to celebrate achievements (such as finishing or defending the PhD) or just enduring (even if one had not achieved anything, or were not pleased with your work, you should still consider yourself “excellent,” wrote one tweeter). As Veletsianos and others have suggested, then, disclosure is a central feature of how academic Twitter is used ( Stewart, 2016 ; Veletsianos and Stewart, 2016 ; Jordan, 2020 ). In this material, tweeters rarely complained about their situations, although they might express that they were finding them hard in particular ways. Instead, they expressed gratitude, gave themselves and others advice, shared encouragement or motivation, and asked for support. I discuss the one key exception to this in the section below.
While tweeters in this material rarely discussed injustice or unfairness at a personal level, 6 or complained about their individual situations (though they might disclose that they were finding these challenging), a thread of critique did run through the dataset. This critique was rarely aimed at individuals; instead, tweeters drew attention to inequity and injustice within academia, and criticized the institutions, structures, or systems seen as responsible for these. Academic Twitter, in this dataset, was thus not only concerned with personal struggles or with care practices within a community of academic Twitter users, but with wider questions of equity and with academia’s place within these.
The objects of this critique were institutions or groups such as “universities,” “faculty,” “this administration” (the Trump presidency in the United States), and “educators,” but also “us” and the “academic twittersphere.” Criticism or comment might also not be directed at any particular actor, but reflect on inequity without localizing blame to any specific site. The subject was, broadly, fairness or equity within the academy. Tweeters discussed, for instance, the different access students had to the technology that they now needed to access teaching, and their different home situations; the gendered challenges of working and teaching from home; cases where mainstream media focused on scientific work against COVID-19 by men, ignoring contributions by women; unfairness in how universities were treating their students and staff; and the ways in which casual or temporary academic staff were particularly badly affected by the situation. The discussion thus focused on the ways in which challenges (and opportunities) are differently experienced by those with different backgrounds and identities. As one tweeter wrote, “unearned privilege” was a central dynamic that structured how academics were able to deal with the pandemic and the demands it put on them.
This is well illustrated by a discussion that arose in response to a tweet by the celebrity scientist Neil deGrasse Tyson ( Fahy, 2015 ). In a 1 April tweet that has been favourited 113,000 times (and which did not reference #AcademicTwitter or #AcademicChatter, and therefore does not form part of this dataset), deGrasse Tyson wrote that “When Isaac Newton stayed at home to avoid the 1665 plague, he discovered the laws of gravity, optics, and he invented calculus”: the point was, implicitly, that others stuck in lockdown situations might use the time productively. The tweet appears in this dataset as a screenshot alongside the comment that Newton did not have to deal with online teaching, home-schooling, shortages of essential supplies, and other aspects of daily life in the pandemic for many academics. By suggesting that “staying home” was straightforward, resulting in empty time that could be filled with scientific work, deGrasse Tyson was ignoring the diverse and often difficult situations that people found themselves in, and the degree to which having such empty time was a product of resources (family members who might care for one’s children, for instance, or a low teaching load). Other critique in this dataset was similarly focused on notions of productivity, which was seen as a key site where inequity became apparent. One tweeter wrote, addressing those anxious about their levels of productivity, that the pandemic “accentuates privileges” and that not everyone was able to be productive to the same extent, while another talked about the “duplicitous bullshit” of rewarding people who were managing to be particularly productive at a time of global crisis. Such comments relate to my earlier discussion of productivity—understood as the efficient and speedy creation of text or analysis—as central to enactments of the academy, but nuance and complicate this emphasis by pointing out that the ability to achieve this is in fact structured by unevenly shared privilege and opportunity.
By incorporating a thread of critique and attention to social justice, this Twitter material thus performs the academy as flawed not only through a deficit of care but also through its entanglements with and reflections of wider societal inequality. Particularly subject to criticism are university administrations and other institutional structures that demand productivity, a rapid switch to online teaching, or strict student attendance without acknowledging the barriers that some individuals and groups face in achieving this (from a lack of digital infrastructure to care responsibilities). While academics are themselves sometimes framed as complicit within this (hence the calls for “we,” the “twittersphere,” or “fellow researchers” to take heed of critique), the emphasis is on systemic factors that perpetuate historical privilege and on (flawed) university leadership. The academy is enacted as a place where an emphasis on productivity can all too easily be connected with a refusal to acknowledge unequal opportunities; this, in this material, leads to normative calls for institutions to act in more just ways, and for academics themselves—in the shape of the community that coalesces around #AcademicTwitter and #AcademicChatter—to be aware of injustice, show solidarity, and act in reflective and caring ways that seek to remedy or counter inequity.
To summarize, analysis of this dataset from academic Twitter during the COVID-19 pandemic has led to the identification of themes of the disruption of academic work, frequently instantiated through ironic humor and memes; of care and care practices, generally discussed in a language of emotional honesty, positivity, and gratitude; and of critiques of injustice and inequity within academia, including (self-imposed) demands for productivity that ignore structural inequalities around who can achieve this. In this section, I want both to return to my research question—how was the contemporary academy performed on “academic Twitter” in the early months of the 2020 COVID-19 pandemic?—and to offer some more general reflections on the implications of these findings in the context of the literatures discussed at the start of the article.
How, then, was the academy performed within this material? As I have already started to sketch out, the version of academic life that is enacted within these Twitter discussions is one in which notions of “productivity” are contested but key. “Normal,” or perhaps rather “ideal,” academic life is one where it is possible to write, analyze, create datasets, read, or otherwise create knowledge products in effective and focused ways. Productivity is something that is constantly sought and that was disrupted by the pandemic. But this emphasis on production is neither taken for granted nor beyond criticism; indeed, a central focus of the critique that runs as a thread throughout the material is of the ability to produce being prioritized above well-being, mental health, or care for one’s community, and of unequal access to the possibility of such productivity. In this respect there are parallels with the literature that has analyzed the rise of “excellence” narratives within academia ( Lund, 2015 ), discussed expectations of entrepreneurialism, self-reliance, and individual responsibility ( Hakala, 2009 ; Loveday, 2017 ), or discussed current affective regimes of academic practice ( Lorenz-Meyer, 2018 ). In such accounts, as in the material analyzed here, academics are expected to take personal responsibility for their careers, prioritizing the production of “excellent” research in order to ensure access to stable, long-term positions. Similarly, such work has also problematized ever-increasing demands to perform more and to perform better, and charted how these demands are being resisted or subverted by academics ( Cannizzo, 2018 ; Rushforth et al., 2018 ). In this material, such resistance is done in part by an emphasis on care and care practices, an emphasis that has been hinted at in prior research ( Cardozo, 2017 ; Heijstra et al., 2017 ; Ivancheva et al., 2019 ). By seeking to encourage care and “kindness,” these data enact the academy as fundamentally lacking in these things—a lack that is, at times, explicitly related to the emphasis on (personal) productivity. Similarly, the structural and institutional critique that appears on academic Twitter implies an academy that is unjust along multiple lines, and that demands intervention. The contemporary academy is performed as fundamentally flawed, both in its absence of equity and of care.
While this story of shortcoming and critique is certainly a key feature of this material, and one that is in line with other discussion of contemporary academia ( Ball, 2015 ; Amsler and Shore, 2017 ), there are some complicating aspects. These emerge in particular from the ways in which these themes of productivity, deficiency, and critique are instantiated in the data, and the precise social media practices through which the academy is done. It matters, in other words, that the themes I have described are enacted through distinctive multimodal formats and through particular repertoires. It also matters that the academy is performed within stories of disruption as not only oriented to productivity but also involving rhythms of social interaction and solitude. Opportunities for celebration and togetherness are framed as key to academic life, and as deeply missed when the pandemic renders them impossible. The academy, then, is communal as much as being about writing and producing. Similarly, themes of productivity are often conveyed through ironic humor or memes (such as the unfinished horse drawing meme discussed above, or the joke about a study of pandemics and wine consumption) that both reference and distance oneself from the practices or priorities described. Efficient production of knowledge products might be an ideal, but it is one that is rarely achieved, and this lack of achievement is a key feature of self-aware humor. Wry joking becomes a way of enacting both what is demanded and resistance to it, in the form of highlighting the impossibility of these demands. More than this, however, such humor itself performs a shared community, one that participates in the production and circulation of particular forms of mimetic expression, sharing “in-jokes” and thereby crafting a shared identity. What is being done on academic Twitter, through these practices, is the enactment not only of a specific version of the academy but of a community that reflects upon this academy, at times critiques it, and mobilizes a specific repertoire and style within its communications (humor, but also emotional honesty, gratitude, and positivity). Academic Twitter, we might say, performs not only the academy but also a counterpublic ( Graham and Smith, 2016 ) that sits both inside (in that it is a part of it) and outside (in that it offers distance and critique) of it.
While this study adds weight to previous work that has outlined an increasingly pressured and precarious academy, then, it also adds new dimensions to this by suggesting something of the style by which academics inhabit this space. On this platform, at least, humor, articulations of care, and the crafting of communities of solidarity were central to life and work in the academy during the pandemic. It is these dynamics which could be particularly valuable lines for future research, enabling investigations which seek to nuance accounts of experiences of precarity or injustice (for instance) through examination of the tools and practices through which these are rendered meaningful and bearable.
In examining how the contemporary academy was performed on “academic Twitter” in the early months of the 2020 COVID-19 pandemic, I have argued that academic life is enacted in this material not only as oriented to productivity but also as involving rhythms of solitude and sociality, as lacking in care, and as often operating in unjust or unequal ways. At the same time, I have suggested that such a bald account misses much of the richness of the ways in which these performances are done. The use of humor, of registers of affect and solidarity, and of memes and other forms of multimodal expression all allow complex negotiations between acknowledgment of what one should be doing, and commentary on how things “really are.” Similarly, an emphasis on encouraging and enabling care practices and on social justice assists in the production of (a shared imagination of) an academic community that exists within academe, but that seeks to counter toxic features of it.
How does this relate to COVID-19 itself? Certainly, my account has richly illustrated the ways in which institutions such as academia have had their values laid bare by the pandemic, and how accounts of disruption can allow us to identify norms and practices that are being disrupted. While academic Twitter is not, of course, representative of all experiences of the academy, the analysis nonetheless provides us with insight into the nature of life and work in contemporary universities. It also shows us how one particular community used social media to discuss, reflect on, and share experiences of the pandemic. Academics—specifically those who use #AcademicTwitter and #AcademicChatter on Twitter—are certainly not alone in using the platform to build community, share and seek advice, and articulate struggles during ongoing experiences of COVID-19. I therefore hope that this analysis can contribute to studies of communication to and by other publics, and of the ways in which the content and form of social media communication are intertwined.
Data Availability Statement
The original contributions presented in the study are included in the article/Supplementary Material; further inquiries can be directed to the corresponding author.
Author Contribution
The author confirms being the sole contributor of this work and has approved it for publication.
Conflict of Interest
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
1 See Veletsianos and Stewart, 2016 for one study of key themes within scholars’ “disclosures.”
2 Twitter users “show their agreement with or appreciation for a tweet by giving it an endorsement and ‘favoriting’ it” ( Graham and Smith, 2016 , 437).
3 See: https://digitalinspiration.com/product/twitter-archiver
4 Technical issues meant that there was a break of 3 days in data collection, between April 1 and 4.
5 See description on the Know Your Meme website: https://knowyourmeme.com/memes/unfinished-horse-drawing
6 An observation which might in part be due to the methods used and in particular the decision to collect only tweets that had been favourited at least 25 times. More personal complaints may have resonated less widely and therefore achieved a lower level of virality.
Ackers, L. (2008). Internationalisation, Mobility and Metrics: A New Form of Indirect Discrimination?. Minerva 46 (4), 411–435. doi:10.1007/s11024-008-9110-2
CrossRef Full Text | Google Scholar
Amsler, M., and Shore, C. (2017). Responsibilisation and Leadership in the Neoliberal University: A New Zealand Perspective. Discourse: Stud. Cult. Polit. Education 38 (1), 123–137. doi:10.1080/01596306.2015.1104857
Angervall, P., and Beach, D. (2018). The Exploitation of Academic Work: Women in Teaching at Swedish Universities. High Educ. Pol. 31 (1), 1–17. doi:10.1057/s41307-017-0041-0
Balaban, C. (2018). Mobility as Homelessness: The Uprooted Lives of Early Career Researchers. Learn. Teach. 11 (2), 30–50. doi:10.3167/latiss.2018.110203
Ball, S. J. (2015). Living the Neo-Liberal University. Eur. J. Education 50 (3), 258–261. doi:10.1111/ejed.12132
Bataille, P., Le Feuvre, N., and Kradolfer Morales, S. (2017). Should I Stay or Should I Go? The Effects of Precariousness on the Gendered Career Aspirations of Postdocs in Switzerland’. Eur. Educ. Res. J. 16. 313–331. doi:10.1177/1474904116673372
Berthoin Antal, A., and Rogge, J.-C. (2020). Does Academia Still Call? Experiences of Academics in Germany and the United States. Minerva 58 (2), 187–210. doi:10.1007/s11024-019-09391-4
Brantner, C., Lobinger, K., and Stehling, M. (2020). Memes against Sexism? A Multi-Method Analysis of the Feminist Protest Hashtag #distractinglysexy and its Resonance in the Mainstream News Media. Convergence 26 (3), 674–696. doi:10.1177/1354856519827804
Campbell, R. A. (2003). Preparing the Next Generation of Scientists. Soc. Stud. Sci. 33 (6), 897–927. doi:10.1177/0306312703336004
Cannizzo, F. (2018). ‘“You’ve Got to Love What You Do”: Academic Labour in a Culture of Authenticity’. Sociological Rev. 66 (1), 91–106. doi:10.1177/0038026116681439
Cardozo, K. M. (2017). Academic Labor: Who Cares?. Crit. Sociol. 43 (3), 405–428. doi:10.1177/0896920516641733
Courtois, A., and O’Keefe, T. (2015). Precarity in the Ivory Cage: Neoliberalism and Casualisation of Work in the Irish Higher Education Sector. J. Crit. Education Pol. Stud. 13 (1), 43–66.
Google Scholar
Davies, S. R. (2020). Epistemic Living Spaces, International Mobility, and Local Variation in Scientific Practice. Minerva 58, 97–114. doi:10.1007/s11024-019-09387-0
Delfanti, A. (2020). The Financial Market of Ideas: A Theory of Academic Social Media. Soc. Stud. Sci. 51 (2). 259-276. doi:10.1177/0306312720966649
PubMed Abstract | CrossRef Full Text | Google Scholar
Dynel, M. (2021). COVID-19 Memes Going Viral: On the Multiple Multimodal Voices behind Face Masks. Discourse Soc. 32 (2), 175–195. doi:10.1177/0957926520970385
Fahy, D. (2015). The New Celebrity Scientists: Out of the Lab and into the Limelight . London : Rowman & Littlefield.
Felt, U. (2009). Knowing and Living in Academic Research: Convergences and Heterogeneity in Research Cultures in the European Context . (Prague: Institute of Sociology of the Academy of Sciences of the Czech Republic ).
Felt, U., and Fochler, M. (2012). Re-Ordering Epistemic Living Spaces: On the Tacit Governance Effects of the Public Communication of Science. In The Sciences’ Media Connection –Public Communication and its Repercussions , edited by S. Rödder, M. Franzen, and W. Peter, 133–154. (Springer Netherlands): Sociology of the Sciences Yearbook 28 .
Fochler, M. (2016). Variants of Epistemic Capitalism. Sci. Technol. Hum. Values 41 (5), 922–948. doi:10.1177/0162243916652224
Fowler, N., Lindahl, M., and Sköld, D. (2015). The Projectification of University Research. Int. J. Managing Projects Business 8 (1), 9–32. doi:10.1108/ijmpb-10-2013-0059
Graham, R., and Smith, S. (2016). The Content of Our #Characters. Sociol. Race Ethn. 2 (4), 433–449. doi:10.1177/2332649216639067
Gregory, K., and singh, S. S. (2018). Anger in Academic Twitter: Sharing, Caring, and Getting Mad Online. triple C 16 (1), 176–193. doi:10.31269/vol16iss1pp176-193
Hakala, J. (2009). The Future of the Academic Calling? Junior Researchers in the Entrepreneurial University. High Educ. 57 (2), 173–190. doi:10.1007/s10734-008-9140-6
Heijstra, T. M., Einarsdóttir, Þ., Pétursdóttir, G. M., and Steinþórsdóttir, F. S. (2017). Testing the Concept of Academic Housework in a European Setting: Part of Academic Career-Making or Gendered Barrier to the Top?. Eur. Educ. Res. J. 16. 200-214. doi:10.1177/1474904116668884
Hepp, A., Breiter, A., and Hasebrink, U. (2017). Communicative Figurations: Transforming Communications in Times of Deep Mediatization . New York, NY: Palgrave Macmillan.
Hine, C. (2015). Ethnography for the Internet: Embedded, Embodied and Everyday . New York, NY: London Bloomsbury Academic.
Ivancheva, M., Lynch, K., and Keating, K. (2019). Precarity, Gender and Care in the Neoliberal Academy. Gender, Work Organ. 26 (4), 448–462.
Jordan, K. (2020). Imagined Audiences, Acceptable Identity Fragments and Merging the Personal and Professional: How Academic Online Identity Is Expressed through Different Social Media Platforms. Learn. Media Tech. 45 (2), 165–178. doi:10.1080/17439884.2020.1707222
Kimmons, R., and Veletsianos, G. (2016). ‘Education Scholars’ Evolving Uses of Twitter as a Conference Backchannel and Social Commentary Platform: Twitter Backchannel Use’. Br. J. Educ. Technol. 47 (3), 445–464. doi:10.1111/bjet.12428
Leemann, R. J. (2010). Gender Inequalities in Transnational Academic Mobility and the Ideal Type of Academic Entrepreneur. Discourse: Stud. Cult. Polit. Education 31 (5), 605–625. doi:10.1080/01596306.2010.516942
Leigh Star, S., and Ruhleder, K. (1996). Steps toward an Ecology of Infrastructure: Design and Access for Large Information Spaces. Inf. Syst. Res. 7 (1), 25. doi:10.1287/isre.7.1.111
Linkova, M. (2013). Unable to Resist: Researchers’ Responses to Research Assessment in the Czech Republic. Hum. Aff. 24 (1), 78–88.
Lorenz-Meyer, D. (2018). The Academic Productivist Regime: Affective Dynamics in the Moral-Political Economy of Publishing. Sci. as Cult. 27 (2), 151–174. doi:10.1080/09505431.2018.1455821
Loveday, Vik. (2017). ‘“Luck, Chance, and Happenstance? Perceptions of Success and Failure Amongst Fixed-Term Academic Staff in UK Higher Education”: Luck, Chance, and Happenstance?. Br. J. Sociol. 69 (3). 758-775. doi:10.1111/1468-4446.12307
Lund, Rebecca. W. B. (2015). Doing the Ideal Academic - Gender, Excellence and Changing Academia . (Aalto, Finland): Aalto University .
Lupton, D., Mewburn, I., and Thomson, P. (2017). The Digital Academic: Critical Perspectives on Digital Technologies in Higher Education (Abingdon, Oxon ; New York, NY: Routledge ).
Machin, D. (2013). What Is Multimodal Critical Discourse Studies?. Crit. Discourse Stud. 10 (4), 347–355. doi:10.1080/17405904.2013.813770
Markham, Annette. N. (2020). ‘Pattern Recognition: Using Rocks, Wind, Water, Anxiety, and Doom Scrolling in a Slow Apocalypse (To Learn More About Methods for Changing the World)'. Qualitative Inquiry, October, doi:10.1177/1077800420960191
Marwick, A. E., and boyd., d. (2011). I Tweet Honestly, I Tweet Passionately: Twitter Users, Context Collapse, and the Imagined Audience. New Media Soc. 13 (1). 114–133. doi:10.1177/1461444810365313
Marwick, A. (2013). “Ethnographic and Qualitative Research on Twitter,” in Twitter and Society . Editors K Weller, A Bruns, J Burgess, and M Mahrt (New York: Peter Lang ), 109–22.
Milner, R. M. (2018). The World Made Meme: Public Conversations and Participatory Media . (Cambridge, Massachusetts London): The MIT Press
Pariser, E. (2011). The Filter Bubble: What the Internet Is Hiding from You . London: Viking.
Phillips, W., and Milner, R. M. (2017). The Ambivalent Internet: Mischief, Oddity, and Antagonism Online . Cambridge, UK Malden, MA: Polity.
Reitz, T. (2017). Academic Hierarchies in Neo-Feudal Capitalism: How Status Competition Processes Trust and Facilitates the Appropriation of Knowledge. High Educ. 73 (6), 871–886. doi:10.1007/s10734-017-0115-3
Rivas, C. (2018). “Finding Themes in Qualitative Data,” in Researching Society and Culture : 431-453. Editor C. Seale ( SAGE ). doi:10.1332/policypress/9781447337683.003.0001
Roumbanis, L. (2019). Symbolic Violence in Academic Life: A Study on How Junior Scholars Are Educated in the Art of Getting Funded. Minerva 57 (2), 197–218. doi:10.1007/s11024-018-9364-2
Rushforth, A., Franssen, T., and de Rijcke, S. (2018). .Portfolios of Worth: Capitalizing on Basic and Clinical Problems in Biomedical Research Groups. Sci. Technol. Hum. Values 44 (2). 209–236. doi:10.1177/0162243918786431
Schönbauer, S. M. (2020). ‘“From Bench to Stage” How Life Scientists’ Leisure Groups Build Collective Self-Care’. Sci. as Cult. January , 1–22.
Shapin, S. (2009). The Scientific Life: A Moral History of a Late Modern Vocation . London, United Kingdom: University of Chicago Press.
Shifman, L. (2014). Memes in Digital Culture . Cambridge, MA: The MIT Press.
Sigl, L. (2016). On the Tacit Governance of Research by Uncertainty. Sci. Technol. Hum. Values 41 (3), 347–374. doi:10.1177/0162243915599069
Slaughter, S., and Leslie, L. L. (1997). Academic Capitalism: Politics, Policies, and the . (Athens, Georgia): Entrepreneurial UniversityThe Johns Hopkins University Press.
Stewart, B. (2016). Collapsed Publics: Orality, Literacy, and Vulnerability in Academic Twitter. J. Appl. Soc. Theor. 1 (1), 61–86.
Taylor, Y., and Breeze, M. (2020). All Imposters in the University? Striking (Out) Claims on Academic Twitter. Women's Stud. Int. Forum 81 : 102367. doi:10.1016/j.wsif.2020.102367
Veletsianos, G. (2016). Social Media in Academia: Networked Scholars . New York: Routledge . doi:10.4324/9781315742298
CrossRef Full Text
Veletsianos, G., and Kimmons, R. (2012). Networked Participatory Scholarship: Emergent Techno-Cultural Pressures toward Open and Digital Scholarship in Online Networks. Comput. Education 58 (2), 766–774. doi:10.1016/j.compedu.2011.10.001
Veletsianos, G., and Stewart, B. (2016). Discreet Openness: Scholars' Selective and Intentional Self-Disclosures Online. Soc. Media + Soc. 2 (3), 205630511666422. doi:10.1177/2056305116664222
Watermeyer, R., and Olssen, M. (2016). 'Excellence' and Exclusion: The Individual Costs of Institutional Competitiveness. Minerva 54 (2), 201–218. doi:10.1007/s11024-016-9298-5
Williams, M. L., Burnap, P., and Sloan, L. (2017). Towards an Ethical Framework for Publishing Twitter Data in Social Research: Taking into Account Users' Views, Online Context and Algorithmic Estimation. Sociology 51 (6), 1149–1168. doi:10.1177/0038038517708140
Winkler, I. (2013). Moments of Identity Formation and Reformation: A Day in the Working Life of an Academic. J. Org Ethnography 2 (2), 191–209. doi:10.1108/joe-11-2011-0001
Ylijoki, O.-H. (2014). Conquered by Project Time? Conflicting Temporalities in University Research. Universities in the Flux of Time . Abingdon, United Kingdom: Routledge , 108–21.
Zippel, K. S. (2017). Women in Global Science: Advancing Academic Careers through International Collaboration . Stanford, California: Stanford University Press . doi:10.1515/9781503601505
Keywords: social media, Twitter, academia, COVID-19, multimodality
Citation: Davies SR (2021) Chaos, Care, and Critique: Performing the Contemporary Academy During the COVID-19 Pandemic. Front. Commun. 6:657823. doi: 10.3389/fcomm.2021.657823
Received: 24 January 2021; Accepted: 13 April 2021; Published: 30 April 2021.
Reviewed by:
Copyright © 2021 Davies. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Sarah R. Davies, [email protected]
This article is part of the Research Topic
Science in a Time of Crisis: Communication, Engagement and the Lived Experience of the Covid-19 Pandemic
Volume 26, Number 7—July 2020
Another Dimension
A critique of coronavirus.
Cite This Article
Why did the quiet descend?
Does this plague not know
that apocalypses come with fanfare,
wails of lamentation,
howls of wayward dogs,
explosive blasts?
Or, maybe, silence.
Just shop-window glass crunching underfoot
puncturing the eerie nothing.
Never quiet.
Why does the sun still shine?
Can it not see what transpires
from its lofty throne
above the Earth?
Read the room, sun.
Now’s the time for greyscale filter.
Or, maybe, an eclipse.
One last blinding ray of blazing flare
to scorch the land,
to boil the sea,
to serve up des hommes brûlés
to whichever vengeful deity
dines with us tonight .
Not sunshine.
Never sunshine.
Why can I smell the tulips?
I thought the virus
wiped olfaction from our
paltry list of powers?
Or, maybe, smoke.
You know, from voracious flames
feasting on our foliage and flesh,
the smog of industry,
of mushroom clouds.
Why does that not sting my nostrils?
Not flowers.
Never flowers.
Why does life go on inexorably?
Is Ragnarök not supposed to happen
around now?
Where are the horsemen?
Where are the double gates of Paradise?
What a lame apocalypse:
we’ve been sold a lemon.
Or, maybe, pop culture eschatology
isn’t all it is cracked up to be.
I thought the zombies would be roaming
all my haunts
Never life.
Miss Osen is a Specialty Registrar in the ENT Department at St George’s University Hospitals NHS Foundation Trust, London. Her professional interests include ENT and history of medicine; extracurricular interests include composing bleak poetry and flash/sudden fiction.
DOI: 10.3201/eid2607.201426
Original Publication Date: May 26, 2020
Related Links
- More Another Dimension Articles
Table of Contents – Volume 26, Number 7—July 2020
Please use the form below to submit correspondence to the authors or contact them at the following address:
Elana R. Osen, ENT Department, St George’s University Hospitals NHS Foundation Trust, Blackshaw Rd, Tooting, London, SW17 0QT, UK
Comment submitted successfully, thank you for your feedback.
There was an unexpected error. Message not sent.
Exit Notification / Disclaimer Policy
- The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
- Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
- You will be subject to the destination website's privacy policy when you follow the link.
- CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.
CDC.gov Privacy Settings
We take your privacy seriously. You can review and change the way we collect information below.
These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.
Cookies used to make website functionality more relevant to you. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests.
Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data.
Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. These cookies may also be used for advertising purposes by these third parties.
Thank you for taking the time to confirm your preferences. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page.
Article Citations
Highlight and copy the desired format.
Metric Details
Article views: 10824.
Data is collected weekly and does not include downloads and attachments. View data is from .
What is the Altmetric Attention Score?
The Altmetric Attention Score for a research output provides an indicator of the amount of attention that it has received. The score is derived from an automated algorithm, and represents a weighted count of the amount of attention Altmetric picked up for a research output.
An official website of the United States government
The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.
The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
- Publications
- Account settings
- Advanced Search
- Journal List
- Elsevier Public Health Emergency Collection
A critical analysis of the impacts of COVID-19 on the global economy and ecosystems and opportunities for circular economy strategies
T. ibn-mohammed.
a Warwick Manufacturing Group (WMG), The University of Warwick, Coventry CV4 7AL, United Kingdom
K.B. Mustapha
b Faculty of Engineering and Science, University of Nottingham (Malaysia Campus), Semenyih, Selangor43500, Malaysia
c School of The Built Environment and Architecture, London South Bank University, London SE1 0AA, United Kingdom
K.A. Babatunde
d Faculty of Economics and Management, Universiti Kebangsaan Malaysia, Bangi, Selangor43600, Malaysia
e Department of Economics, Faculty of Management Sciences, Al-Hikmah University, Ilorin, Nigeria
D.D. Akintade
f School of Life Sciences, University of Nottingham, Nottingham NG7 2UH United Kingdom
g Kent Business School, University of Kent, Canterbury CT2 7PE, United Kingdom
h Faculty of Economics, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
M.M. Ndiaye
i Department of Industrial Engineering, College of Engineering, American University of Sharjah, Sharjah, UAE
F.A. Yamoah
j Department of Management, Birkbeck University of London, London WC1E 7JL United Kingdom
k Sheffield University Management School (SUMS), The University of Sheffield, Sheffield S10 1FL, United Kingdom
The World Health Organization declared COVID-19 a global pandemic on the 11th of March 2020, but the world is still reeling from its aftermath. Originating from China, cases quickly spread across the globe, prompting the implementation of stringent measures by world governments in efforts to isolate cases and limit the transmission rate of the virus. These measures have however shattered the core sustaining pillars of the modern world economies as global trade and cooperation succumbed to nationalist focus and competition for scarce supplies. Against this backdrop, this paper presents a critical review of the catalogue of negative and positive impacts of the pandemic and proffers perspectives on how it can be leveraged to steer towards a better, more resilient low-carbon economy. The paper diagnosed the danger of relying on pandemic-driven benefits to achieving sustainable development goals and emphasizes a need for a decisive, fundamental structural change to the dynamics of how we live. It argues for a rethink of the present global economic growth model, shaped by a linear economy system and sustained by profiteering and energy-gulping manufacturing processes, in favour of a more sustainable model recalibrated on circular economy (CE) framework. Building on evidence in support of CE as a vehicle for balancing the complex equation of accomplishing profit with minimal environmental harms, the paper outlines concrete sector-specific recommendations on CE-related solutions as a catalyst for the global economic growth and development in a resilient post-COVID-19 world.
1. Introduction
The world woke up to a perilous reality on the 11th of March, 2020 when the World Health Organization (WHO) declared novel coronavirus (COVID-19) a pandemic ( Sohrabi et al., 2020 ; WHO, 2020a ). Originating from Wuhan, China, cases rapidly spread to Japan, South Korea, Europe and the United States as it reached global proportions. Towards the formal pandemic declaration, substantive economic signals from different channels, weeks earlier, indicated the world was leaning towards an unprecedented watershed in our lifetime, if not in human history ( Gopinath, 2020 ). In series of revelatory reports ( Daszak, 2012 ; Ford et al., 2009 ; Webster, 1997 ), experts across professional cadres had long predicted a worldwide pandemic would strain the elements of the global supply chains and demands, thereby igniting a cross-border economic disaster because of the highly interconnected world we now live in. By all accounts, the emerging havoc wrought by the pandemic exceeded the predictions in those commentaries. At the time of writing, the virus has killed over 800,000 people worldwide ( JHU, 2020 ), disrupted means of livelihoods, cost trillions of dollars while global recession looms ( Naidoo and Fisher, 2020 ). In efforts to isolate cases and limit the transmission rate of the virus, while mitigating the pandemic, countries across the globe implemented stringent measures such as mandatory national lockdown and border closures.
These measures have shattered the core sustaining pillars of modern world economies. Currently, the economic shock arising from this pandemic is still being weighed. Data remains in flux, government policies oscillate, and the killer virus seeps through nations, affecting production, disrupting supply chains and unsettling the financial markets ( Bachman, 2020 ; Sarkis et al., 2020 ). Viewed holistically, the emerging pieces of evidence indicate we are at a most consequential moment in history where a rethink of sustainable pathways for the planet has become pertinent. Despite this, the measures imposed by governments have also led to some “accidental” positive effects on the environment and natural ecosystems. As a result, going forward, a fundamental change to human bio-physical activities on earth now appears on the spectrum of possibility ( Anderson et al., 2020 ). However, as highlighted by Naidoo and Fisher (2020) , our reliance on globalization and economic growth as drivers of green investment and sustainable development is no longer realistic. The adoption of circular economy (CE) – an industrial economic model that satisfies the multiple roles of decoupling of economic growth from resource consumption, waste management and wealth creation – has been touted to be a viable solution.
No doubt, addressing the public health consequences of COVID-19 is the top priority, but the nature of the equally crucial economic recovery efforts necessitates some key questions as governments around the world introduce stimulus packages to aid such recovery endeavours: Should these packages focus on avenues to economic recovery and growth by thrusting business as usual into overdrive or could they be targeted towards constructing a more resilient low-carbon CE? To answer this question, this paper builds on the extant literature on public health, socio-economic and environmental dimensions of COVID-19 impacts ( Gates, 2020b ; Guerrieri et al., 2020 ; Piguillem and Shi, 2020 ; Sohrabi et al., 2020 ), and examines its interplay with CE approaches. It argues for the recalibration and a rethink of the present global economic growth model, shaped by a linear economy system and sustained by profit-before-planet and energy-intensive manufacturing processes, in favour of CE. Building on evidence in support of CE as a vehicle for optimizing the complex equation of accomplishing profit while minimizing environmental damage, the paper outlines tangible sector-specific recommendations on CE-related solutions as a catalyst for the global economic boom in a resilient post-COVID-19 world. It is conceived that the “accidental” or the pandemic-induced CE strategies and behavioural changes that ensued during coronavirus crisis can be leveraged or locked in, to provide opportunities for both future resilience and competitiveness.
In light of the above, the paper is structured as follows. In Section 2 , the methodological framework, which informed the critical literature review is presented. A brief overview of the historical context of previous epidemics and pandemics is presented in Section 3 as a requisite background on how pandemics have shaped human history and economies and why COVID-19 is different. In Section 4 , an overview of the impacts (both negative and positive) of COVID-19 in terms of policy frameworks, global economy, ecosystems and sustainability are presented. The role of the CE as a constructive change driver is detailed in Section 5 . In Section 6 , opportunities for CE after COVID-19 as well as sector-based recommendations on strategies and measures for advancing CE are presented, leading to the summary and concluding remarks in Section 7.
A literature review exemplifies a conundrum because an effective one cannot be conducted unless a problem statement is established ( Ibn-Mohammed, 2017 ). Yet, a literature search plays an integral role in establishing many research problems. In this paper, the approach taken to overcome this conundrum involves searching and reviewing the existing literature in the specific area of study (i.e. impacts of COVID-19 on global economy and ecosystems in the context of CE). This was used to develop the theoretical framework from which the current study emerges and adopting this to establish a conceptual framework which then becomes the basis of the current review. The paper adopts the critical literature review (CLR) approach given that it entails the assessment, critique and synthetisation of relevant literature regarding the topic under investigation in a manner that facilitates the emergence of new theoretical frameworks and perspectives from a wide array of different fields ( Snyder, 2019 ). CLR suffers from an inherent weakness in terms of subjectivity towards literature selection ( Snyder, 2019 ), prompting Grant and Booth (2009) to submit that systematic literature review (SLR) could mitigate this bias given its strict criteria in literature selection that facilitates a detailed analysis of a specific line of investigation. However, a number of authors ( Morrison et al., 2012 ; Paez, 2017 ) have reported that SLR does not allow for effective synthesis of academic and grey literature which are not indexed in popular academic search engines like Google Scholar, Web-of-Science and Scopus. The current review explores the impacts of COVID-19 on the global economy and ecosystems and opportunities for circular economy strategies, rather than investigating a specific aspect of the pandemic. As such, adopting a CLR approach is favoured in realising the goal of the paper as it allows for the inclusion of a wide range of perspectives and theoretical underpinnings from different sources ( Greenhalgh et al., 2018 ; Snyder, 2019 ).
Considering the above, this paper employed archival data consisting of journal articles, documented news in the media, expert reports, government and relevant stakeholders’ policy documents, published expert interviews and policy feedback literature that are relevant to COVID-19 and the concept of CE. To identify the relevant archival data, we focused on several practical ways of literature searching using appropriate keywords that are relevant to this work including impact (positive and negative) of COVID-19, circular economy, economic resilience, sustainability, supply chain resilience, climate change, etc. After identifying articles and relevant documents, their contents were examined to determine inclusions and exclusions based on their relevance to the topic under investigation. Ideas generated from reading the resulting papers from the search were then used to develop a theoretical framework and a research problem statement, which forms the basis for the CLR. The impact analysis for the study was informed by the I = P × A × T model whereby the “impact” (I) of any group or country on the environment is a function of the interaction of its population size (P), per capita affluence (A), expressed in terms of real per capita GDP, as a valid approximation of the availability of goods and services and technology (T) involved in supporting each unit of consumption.
As shown in the methodological framework in Fig. 1 , the paper starts with a brief review of the impacts of historical plagues to shed more light on the link between the past and the unprecedented time, which then led to an overview of the positive and negative impacts of COVID-19. The role of CE as a vehicle for constructive change in the light of COVID-19 was then explored followed by the synthesis, analysis and reflections on the information gathered during the review, leading to sector-specific CE strategy recommendations in a post-COVID-19 world.
Methodological framework for the critical literature review.
3. A brief account of the socio-economic impacts of historical outbreaks
At a minimum, pandemics result in the twin crisis of stressing the healthcare infrastructure and straining the economic system. However, beyond pandemics, several prior studies have long noted that depending on latency, transmission rate, and geographic spread, any form of communicable disease outbreak is a potent vector of localized economic hazards ( Bloom and Cadarette, 2019 ; Bloom and Canning, 2004 ; Hotez et al., 2014 ). History is littered with a catalogue of such outbreaks in the form of endemics, epidemics, plagues and pandemics. In many instances, some of these outbreaks have hastened the collapse of empires, overwhelmed the healthcare infrastructure, brought social unrest, triggered economic dislocations and exposed the fragility of the world economy, with a knock-on effect on many sectors. Indeed, in the initial few months of COVID-19 pandemic, it has become more evident that natural, accidental or intentional biological threats or outbreak in any country now poses an unquantifiable risk to global health and the world economy ( Bretscher et al., 2020 ).
Saunders-Hastings and Krewski (2016) reported that there have been several pandemics over the past 100 years. A short but inexhaustible list of outbreaks of communicable diseases include ‘the great plague’ ( Duncan-Jones, 1996 ; Littman and Littman, 1973 ), the Justinian plague ( Wagner et al., 2014 ), the Black Death ( Horrox, 2013 ), the Third Plague pandemic ( Bramanti et al., 2019 ; Tan et al., 2002 ), the Spanish flu ( Gibbs et al., 2001 ; Trilla et al., 2008 ), HIV/AIDS ( De Cock et al., 2012 ), SARS ( Lee and McKibbin, 2004 ), dengue ( Murray et al., 2013 ), and Ebola ( Baseler et al., 2017 ), among others. The potency of each of these outbreaks varies. Consequently, their economic implications differ according to numerous retrospective analyses ( Bloom and Cadarette, 2019 ; Bloom and Canning, 2004 ; Hotez et al., 2014 ). For instance, the Ebola epidemic of 2013-2016 created socio-economic impact to the tune of $53 billion across West Africa, plummeted Sierra Leone's GDP in 2015 by 20% and that of Liberia by 8% between 2013 and 2014, despite the decline in death rates across the same timeframe ( Fernandes, 2020 ).
As the world slipped into the current inflection point, some of the historical lessons from earlier pandemics remain salutary, even if the world we live in now significantly differs from those of earlier period ( McKee and Stuckler, 2020 ). Several factors differentiate the current socio-economic crisis of COVID-19 from the previous ones ( Baker et al., 2020 ), which means direct simple comparisons with past global pandemics are impossible ( Fernandes, 2020 ). Some of the differentiating factors include the fact that COVID-19 is a global pandemic and it is creating knock-on effects across supply chains given that the world has become much more integrated due to globalisation and advancements in technology ( McKenzie, 2020 ). Moreover, the world has witnessed advances in science, medicine and engineering. The modest number of air travellers during past pandemics delayed the global spread of the virus unlike now where global travel has increased tremendously. From an economic impact perspective, interest rates are at record lows and there is a great imbalance between demand and supply of commodities ( Fernandes, 2020 ). More importantly, many of the countries that are hard hit by the current pandemic are not exclusively the usual low-middle income countries, but those at the pinnacle of the pyramid of manufacturing and global supply chains. Against this backdrop, a review of the impact of COVID-19 is presented in the next section.
4. COVID-19: Policy frameworks, global economy, ecosystems and sustainability
4.1. evaluation of policy frameworks to combat covid-19.
The strategies and policies adopted by different countries to cope with COVID-19 have varied over the evolving severity and lifetime of the pandemic during which resources have been limited ( Siow et al., 2020 ). It is instructive that countries accounting for 65% of global manufacturing and exports (i.e. China, USA, Korea, Japan, France, Italy, and UK) were some of the hardest to be hit by COVID-19 ( Baldwin and Evenett, 2020 ). Given the level of unpreparedness and lack of resilience of hospitals, numerous policy emphases have gone into sourcing for healthcare equipment such as personal protective equipment (PPE) and ventilators ( Ranney et al., 2020 ) due to global shortages. For ventilators, in particular, frameworks for rationing them along with bed spaces have had to be developed to optimise their usage ( White and Lo, 2020 ). Other industries have also been affected, with shocks to their existence, productivity and profitability ( Danieli and Olmstead-Rumsey, 2020 ) including the CE-sensitive materials extraction and mining industries that have been hit by disruption to their operations and global prices of commodities ( Laing, 2020 ).
As highlighted in subsequent sub-sections, one of the psychological impacts of COVID-19 is panic buying ( Arafat et al., 2020 ), which happens due to uncertainties at national levels (e.g. for scarce equipment) and at individual levels (e.g. for everyday consumer products). In both instances, the fragility, profiteering and unsustainability of the existing supply chain model have been exposed ( Spash, 2020 ). In fact, Sarkis et al. (2020) questioned whether the global economy could afford to return to the just-in-time (JIT) supply chain framework favoured by the healthcare sector, given its apparent shortcomings in dealing with much needed supplies. The sub-section that follow examines some of the macro and micro economic ramifications of COVID-19.
4.1.1. Macroeconomic impacts: Global productions, exports, and imports
One challenge faced by the healthcare industry is that existing best practices, in countries like the USA (e.g. JIT macroeconomic framework), do not incentivise the stockpiling of essential medical equipment ( Solomon et al., 2020 ). Although vast sums were budgeted, some governments (e.g. UK, India and USA) needed to take extraordinary measures to protect their supply chain to the extent that manufacturers like Ford and Dyson ventured into the ventilator design/production market ( Iyengar et al., 2020 ). The US, in particular activated the Defense Production Act to compel car manufacturers to shift focus on ventilator production ( American Geriatrics Society, 2020 ; Solomon et al., 2020 ) due to the high cost and shortage of this vital equipment. Hospitals and suppliers in the US were also forced to enter the global market due to the chronic shortfall of N95 masks as well as to search for lower priced equipment ( Solomon et al., 2020 ). Interestingly, the global production of these specialist masks is thought to be led by China ( Baldwin and Evenett, 2020 ; Paxton et al., 2020 ) where COVID-19 broke out, with EU's supply primarily from Malaysia and Japan ( Stellinger et al., 2020 ). Such was the level of shortage that the US was accused of ‘pirating’ medical equipment supplies from Asian countries intended for EU countries ( Aubrecht et al., 2020 ).
France and Germany followed suit with similar in-ward looking policy and the EU itself imposed restrictions on the exportation of PPEs, putting many hitherto dependent countries at risk ( Bown, 2020 ). Unsurprisingly, China and the EU saw it fit to reduce or waive import tariffs on raw materials and PPE, respectively ( Stellinger et al., 2020 ). Going forward, the life-threatening consequences of logistics failures and misallocation of vital equipment and products could breathe new life and impetus to technologies like Blockchain, RFID and IoT for increased transparency and traceability ( Sarkis et al., 2020 ). Global cooperation and scenario planning will always be needed to complement these technologies. In this regard, the EU developed a joint procurement framework to reduce competition amongst member states, while in the US, where states had complained that federal might was used to interfere with orders, a ventilator exchange program was developed ( Aubrecht et al., 2020 ). However, even with trade agreements and cooperative frameworks, the global supply chain cannot depend on imports – or donations ( Evenett, 2020 ) for critical healthcare equipment and this realisation opens doors for localisation of production with consequences for improvements in environmental and social sustainability ( Baldwin and Evenett, 2020 ). This can be seen in the case of N95 masks which overnight became in such high demand that airfreights by private and commercial planes were used to deliver them as opposed to traditional container shipping ( Brown, 2020 ).
As detailed in forthcoming sections, a significant reduction in emissions linked to traditional shipping was observed, yet there was an increase in use of airfreighting due to desperation and urgency of demand. Nevertheless, several countries are having to rethink their global value chains ( Fig. 2 ) as a result of realities highlighted by COVID-19 pandemic ( Javorcik, 2020 ). This is primarily because national interests and protectionism have been a by-product of COVID-19 pandemic and also because many eastern European/Mediterranean countries have a relative advantage with respect to Chinese exports. As shown in Fig. 2 , the global export share which each of these countries has, relative to China's share of the same exports (x-axis) is measured against the economies of countries subscribing to the European Bank for Reconstruction and Development (EBRD) (y-axis). For each product, the ideal is to have a large circle towards the top right-hand corner of the chart.
A summary of how some Eastern European / Mediterranean countries have advantages over China on certain exports – based on the Harmonized Commodity Description and Coding System from 2018, where export volume is represented by dot sizes in millions of USD; Source: Javorcik (2020) .
4.1.2. Microeconomic impacts: Consumer behaviour
For long, there has been a mismatch between consumerist tendencies and biophysical realities ( Spash, 2020 ). However, COVID-19 has further exacerbated the need to reflect on the social impacts of individual lifestyles. The behaviour of consumers, in many countries, was at some point alarmist with a lot of panic buying of food and sanitary products ( Sim et al., 2020 ). At private level, consumer sentiment is also changing. Difficult access to goods and services has forced citizens to re-evaluate purchasing patterns and needs, with focus pinned on the most essential items ( Company, 2020 ; Lyche, 2020 ). Spash (2020) argued that technological obsolescence of modern products brought about by rapid innovation and individual consumerism is also likely to affect the linear economy model which sees, for instance, mobile phones having an average life time of four years (two years in the US), assuming their manufacture/repair services are constrained by economic shutdown and lockdowns ( Schluep, 2009 ). On the other hand, a sector like healthcare, which could benefit from mass production and consumerism of vital equipment, is plagued by patenting. Most medical equipment are patented and the issue of a 3D printer's patent infringement in Italy led to calls for ‘Open Source Ventilators’ and ‘Good Samaritan Laws’ to help deal with global health emergencies like COVID-19 ( Pearce, 2020 ). It is plausible that such initiatives/policies could help address the expensive, scarce, high-skill and material-intensive production of critical equipment, via cottage industry production.
For perspective, it should be noted that production capacity of PPE (even for the ubiquitous facemasks) have been shown by COVID-19 to be limited across many countries ( Dargaville et al., 2020 ) with some countries having to ration facemask production and distribution in factories ( San Juan, 2020 ). Unsurprisingly, the homemade facemask industry has not only emerged for the protection of mass populations as reported by Livingston et al. (2020) , it has become critical for addressing shortages ( Rubio-Romero et al., 2020 ) as well as being part of a post-lockdown exit strategy ( Allison et al., 2020 ). A revival of cottage industry production of equipment and basic but essential items like facemasks could change the landscape of global production for decades, probably leading to an attenuation of consumerist tendencies.This pandemic will also impact on R&D going forward, given the high likelihood that recession will cause companies to take short-term views, and cancel long and medium-term R&D in favour of short-term product development and immediate cash flow/profit as was certainly the case for automotive and aerospace sectors in previous recessions.
4.2. Overview of the negative impacts of COVID-19
The negative effects have ranged from a severe contraction of GDP in many countries to multi-dimensional environmental and social issues across the strata of society. In many respects, socio-economic activities came to a halt as: millions were quarantined; borders were shut; schools were closed; car/airline, manufacturing and travel industries crippled; trade fairs/sporting/entertainment events cancelled, and unemployment claims reached millions while the international tourist locations were deserted; and, nationalism and protectionism re-surfaced ( Baker et al., 2020 ; Basilaia and Kvavadze, 2020 ; Devakumar et al., 2020 ; Kraemer et al., 2020 ; Thunstrom et al., 2020 ; Toquero, 2020 ). In the subsections that follow, an overview of some of these negative impacts on the global economy, environment, and society is presented.
4.2.1. Negative macroeconomic impact of COVID-19
Undoubtedly, COVID-19 first and foremost, constitutes a ferocious pandemic and a human tragedy that swept across the globe, resulting in a massive health crisis ( WHO, 2020b ), disproportionate social order ( UN DESA, 2020 ), and colossal economic loss ( IMF, 2020 ). It has created a substantial negative impact on the global economy, for which governments, firms and individuals scramble for adjustments ( Fernandes, 2020 ; Pinner et al., 2020 ; Sarkis et al., 2020 ; Sohrabi et al., 2020 ; Van Bavel et al., 2020 ). Indeed, the COVID-19 pandemic has distorted the world's operating assumptions, revealing the absolute lack of resilience of the dominant economic model to respond to unplanned shocks and crises ( Pinner et al., 2020 ). It has exposed the weakness of over-centralization of the complex global supply and production chains networks and the fragility of global economies, whilst highlighting weak links across industries( Fernandes, 2020 ; Guan et al., 2020 ; Sarkis et al., 2020 ). This has had a direct impact on employment and heightened the risk of food insecurity for millions due to lockdown and border restrictions ( Guerrieri et al., 2020 ). To some extent, some of the interventional measures introduced by governments across the world have resulted in the flattening of the COVID-19 curve (as shown in Fig. 3 ). This has helped in preventing healthcare systems from getting completely overwhelmed ( JHU, 2020 ), although as at the time of writing this paper, new cases are still being reported in different parts of the globe. Fernandes (2020) and McKibbin and Fernando (2020) reported thatthe socio-economic impact of COVID-19 will be felt for many months to come.
Daily confirmed new COVID-19 cases of the current 10 most affected countries based on a 5-day moving average. Valid as of August 31st, 2020 at 11:46 PM EDT ( JHU, 2020 ).
Guan et al. (2020) submitted that how badly and prolonged the recession rattles the world depends on how well and quickly the depth of the socio-economic implications of the pandemic is understood. IMF (2020) reported that in an unprecedented circumstance (except during the Great Depression), all economies including developed, emerging, and even developing will likely experience recession. In its April World Economic Outlook, IMF (2020) reversed its early global economic growth forecast from 3.3% to -3 %, an unusual downgrade of 6.3% within three months. This makes the pandemic a global economic shock like no other since the Great Depression and it has already surpassed the global financial crisis of 2009 as depicted in Fig. 4 . Economies in the advanced countries are expected to contract by -6.1% while recession in emerging and developing economies is projected (with caution) to be less adverse compared to the developed nations with China and India expected to record positive growth by the end of 2020. The cumulative GDP loss over the next year from COVID-19 could be around $9 trillion ( IMF, 2020 ).
Socioeconomic impact of COVID-19 lockdown: (a) Comparison of global economic recession due to COVID-19 and the 2009 global financial crisis; (b) Advanced economies, emerging and developing economies in recession; (c) the major economies in recession; (d) the cumulative economic output loss over 2020 and 2021. Note: Real GDP growth is used for economic growth, as year-on-year for per cent change ( IMF, 2020 ).
With massive job loss and excessive income inequality, global poverty is likely to increase for the first time since 1998 ( Mahler et al., 2020 ). It is estimated that around 49 million people could be pushed into extreme poverty due to COVID-19 with Sub-Sahara Africa projected to be hit hardest. The United Nations’ Department of Economic and Social Affairs concluded that COVID-19 pandemic may also increase exclusion, inequality, discrimination and global unemployment in the medium and long term, if not properly addressed using the most effective policy instruments ( UN DESA, 2020 ). The adoption of detailed universal social protection systems as a form of automatic stabilizers, can play a long-lasting role in mitigating the prevalence of poverty and protecting workers ( UN DESA, 2020 ).
4.2.2. Impact of COVID-19 on global supply chain and international trade
COVID-19 negatively affects the global economy by reshaping supply chains and sectoral activities. Supply chains naturally suffer from fragmentation and geographical dispersion. However, globalisation has rendered them more complex and interdependent, making them vulnerable to disruptions. Based on an analysis by the U.S. Institute for Supply Management, 75% of companies have reported disruptions in their supply chain ( Fernandes, 2020 ), unleashing crisis that emanated from lack of understanding and flexibility of the several layers of their global supply chains and lack of diversification in their sourcing strategies ( McKenzie, 2020 ). These disruptions will impact both exporting countries (i.e. lack of output for their local firms) and importing countries (i.e. unavailability of raw materials) ( Fernandes, 2020 ). Consequently, this will lead to the creation of momentary “manufacturing deserts” in which the output of a country, region or city drops significantly, turning into a restricted zone to source anything other than essentials like food items and drugs ( McKenzie, 2020 ). This is due to the knock-on effect of China's rising dominance and importance in the global supply chain and economy ( McKenzie, 2020 ). As a consequence of COVID-19, the World Trade Organization (WTO) projected a 32% decline in global trade ( Fernandes, 2020 ). For instance, global trade has witnessed a huge downturn due to reduced Chinese imports and the subsequent fall in global economic activities. This is evident because as of 25 th March 2020, global trade fell to over 4% contracting for only the second time since the mid-1980s ( McKenzie, 2020 ). Fig. 5 shows a pictorial representation of impact of pandemics on global supply chains based on different waves and threat levels.
Impact of pandemics on global supply chains. Adapted from Eaton and Connor (2020) .
4.2.3. Impact of COVID-19 on the aviation sector
The transportation sector is the hardest hit sector by COVID-19 due to the large-scale restrictions in mobility and aviation activities ( IEA, 2020 ; Le Quéré et al., 2020 ; Muhammad et al., 2020 ). In the aviation sector, for example, where revenue generation is a function of traffic levels, the sector has experienced flight cancellations and bans, leading to fewer flights and a corresponding immense loss in aeronautical revenues. This is even compounded by the fact that in comparison to other stakeholders in the aviation industry, when traffic demand declines, airports have limited avenues to reducing costs because the cost of maintaining and operating an airport remains the same and airports cannot relocate terminals and runaways or shutdown ( Hockley, 2020 ). Specifically, in terms of passenger footfalls in airports and planes, the Air Transport Bureau (2020) modelled the impact of COVID-19 on scheduled international passenger traffic for the full year 2020 under two scenarios namely Scenario 1 (the first sign of recovery in late May) and Scenario 2 (restart in the third quarter or later). Under Scenario 1, it estimated an overall reduction of: between 39%-56% of airplane seats; 872-1,303 million passengers, corresponding to a loss of gross operating revenues between ~$153 - $ 231 billion. Under Scenario 2, it predicted an overall drop of: between 49%-72% of airplane seats; 1,124 to 1,540 million passengers, with an equivalent loss of gross operating revenues between ~$198 - $ 273 billion. They concluded that the predicted impacts are a function of the duration and size of the pandemic and containment measures, the confidence level of customers for air travel, economic situations, and the pace of economic recovery ( Air Transport Bureau, 2020 ).
The losses incurred by the aviation industry require context and several other comparison-based predictions within the airline industry have also been reported. For instance, the International Civil Aviation Organization ICAO (2020) predicted an overall decline ininternational passengers ranging from 44% to 80% in 2020 compared to 2019. Airports Council International, ACI (2020) also forecasted a loss of two-fifths of passenger traffic and >$76 billion in airport revenues in 2020 in comparison to business as usual. Similarly, the International Air Transport Association IATA (2020) forecasted $113 billion in lost revenue and 48% drop in revenue passenger kilometres (RPKs) for both domestic and international routes ( Hockley, 2020 ). For pandemic scenario comparisons, Fig. 6 shows the impact of past disease outbreaks on aviation. As shown, the impact of COVID‐19 has already outstripped the 2003 SARS outbreak which had resulted in the reduction of annual RPKs by 8% and $6 billion revenues for Asia/Pacific airlines, for example. The 6‐month recovery path of SARS is, therefore, unlikely to be sufficient for the ongoing COVID-19 crisis ( Air Transport Bureau, 2020 ) but gives a backdrop and context for how airlines and their domestic/international markets may be impacted.
Impact of past disease outbreaks on aviation ( Air Transport Bureau, 2020 ).
Notably, these predictions are bad news for the commercial aspects of air travel (and jobs) but from the carbon/greenhouse gas emission and CE perspective, these reductions are enlightening and should force the airline industry to reflect on more environmentally sustainable models. However, the onus is also on the aviation industry to emphasise R&D on solutions that are CE-friendly (e.g. fuel efficiency; better use of catering wastes; end of service recycling of aircraft in sectors such as mass housing, or re-integrating airplane parts into new supply chains) and not merely investigating ways to recoup lost revenue due to COVID-19.
4.2.4. Impact of COVID-19 on the tourism industry
Expectedly, the impact of COVID-19 on aviation has led to a knock-on effect on the tourismindustry, which is nowadays hugely dependent on air travel. For instance, the United Nation World Tourism Organization UNWTO (2020) reported a 22% fall in international tourism receipts of $80 billion in 2020, corresponding to a loss of 67 million international arrivals. Depending on how long the travel restictions and border closures last, current scenario modelling indicated falls between 58% to 78% in the arrival of international tourists, but the outlook remains hugely uncertain. The continuous existence of the travel restrictions could put between 100 to 120 million direct tourism-related jobs at risk. At the moment, COVID-19 has rendered the sector worst in the historical patterns of international tourism since 1950 with a tendency to halt a 10-year period of sustained growth since the last global economic recession ( UNWTO, 2020 ). It has also been projected that a drop of ~60% in international tourists will be experienced this year, reducing tourism's contribution to global GDP, while affecting countries whose economy relies on this sector ( Naidoo and Fisher, 2020 ). Fig. 7 depicts the impact of COVID-19 on tourism in Q1 of 2020 based on % change in international tourists’ arrivals between January and March.
The impact of COVID-19 on tourism in quarter 1of 2020. Provisional data but current as of 31st August 2020 ( UNWTO, 2020 ).
4.2.5. Impact of COVID-19 on sustainable development goals
In 2015, the United Nations adopted 17 Sustainable Development Goals (SDGs) with the view to improve livelihood and the natural world by 2030, making all countries of the world to sign up to it. To succeed, the foundations of the SDGs were premised on two massive assumptions namely globalisation and sustained economic growth. However, COVID-19 has significantly hampered this assumption due to several factors already discussed. Indeed, COVID-19 has brought to the fore the fact that the SDGs as currently designed are not resilient to shocks imposed by pandemics. Prior to COVID-19, progress across the SDGs was slow. Naidoo and Fisher (2020) reported that two-thirds of the 169 targets will not be accomplished by 2030 and some may become counterproductive because they are either under threat due to this pandemic or not in a position to mitigate associated impacts.
4.3. Positive impact of COVID-19
In this section, we discussed some of the positive ramifications of COVID-19. Despite the many detrimental effects, COVID-19 has provoked some natural changes in behaviour and attitudes with positive influences on the planet. Nonetheless, to the extent that the trends discussed below were imposed by the pandemic, they also underscore a growing momentum for transforming business operations and production towards the ideal of the CE.
4.3.1. Improvements in air quality
Due to the COVID-19-induced lockdown, industrial activities have dropped, causing significant reductions in air pollution from exhaust fumes from cars, power plants and other sources of fuel combustion emissions in most cities across the globe, allowing for improved air quality ( Le Quéré et al., 2020 ; Muhammad et al., 2020 ). This is evident from the National Aeronautics and Space Administration ( NASA, 2020a ) and European Space Agency ( ESA, 2020 ) Earth Observatory pollution satellites showing huge reductions in air pollution over China and key cities in Europe as depicted in Fig. 8 . In China, for example, air pollution reduction of between 20-30% was achieved and a 20-year low concentration of airborne particles in India is observed; Rome, Milan, and Madrid experienced a fall of ~45%, with Paris recording a massive reduction of 54% ( NASA, 2020b ). In the same vein, the National Centre for Atmospheric Science, York University, reported that air pollutants induced by NO 2 fell significantly across large cities in the UK. Although Wang et al. (2020) reported that in certain parts of China, severe air pollution events are not avoided through the reduction in anthropogenic activities partially due to the unfavourable meteorological conditions. Nevertheless, these data are consistent with established accounts linking industrialization and urbanization with the negative alteration of the environment ( Rees, 2002 ).
The upper part shows the average nitrogen dioxide (NO 2 ) concentrations from January 1-20, 2020 to February 10-25, 2020, in China. While the lower half shows NO 2 concentrations over Europe from March 13 to April 13, 2020, compared to the March-April averaged concentrations from 2019 ( ESA, 2020 ; NASA, 2020a ).
The scenarios highlighted above reiterates the fact that our current lifestyles and heavy reliance on fossil fuel-based transportation systems have significant consequences on the environment and by extension our wellbeing. It is this pollution that was, over time, responsible for a scourge of respiratory diseases, coronary heart diseases, lung cancer, asthma etc.( Mabahwi et al., 2014 ), rendering plenty people to be more susceptible to the devastating effects of the coronavirus ( Auffhammer et al., 2020 ). Air pollution constitutes a huge environmental threat to health and wellbeing. In the UK for example, between ~28,000 to ~36,000 deaths/year was linked to long-term exposure to air pollutants ( PHE, 2020 ). However, the reduction in air pollution with the corresponding improvements in air quality over the lockdown period has been reported to have saved more lives than already caused by COVID-19 in China ( Auffhammer et al., 2020 ).
4.3.2. Reduction in environmental noise
Alongside this reduction in air pollutants is a massive reduction in environmental noise. Environmental noise, and in particular road traffic noise, has been identified by the European Environment Agency, EEA (2020) to constitute a huge environmental problem affecting the health and well-being of several millions of people across Europe including distortion in sleep pattern, annoyance, and negative impacts on the metabolic and cardiovascular system as well as cognitive impairment in children. About 20% of Europe's population experiences exposure to long-term noise levels that are detrimental to their health. The EEA (2020) submitted that 48000new cases of ischaemic heart disease/year and ~12000 premature deaths are attributed to environmental noise pollution. Additionally, they reported that ~22 million people suffer chronic high annoyance alongside ~6.5 million people who experienceextreme high sleep disturbance. In terms of noise from aircraft, ~12500 schoolchildren were estimated to suffer from reading impairment in school. The impact of noise has long been underestimated, and although more premature deaths are associated with air pollution in comparison to noise, however noise constitutes a bigger impact on indicators of the quality of life and mental health ( EEA, 2020 ).
A recent study on the aftereffect of COVID-19 pandemic on exercise rates across the globe concluded that reduced traffic congestions and by extension reduced noise and pollution has increased the rate at which people exercise as they leveraged the ensued pleasant atmosphere. Average, moderate, and passive (i.e. people who exercised once a week before COVID-19) athletes have seen the frequency of their exercise regime increased by 88%, 38%, and 156% respectively ( Snider-Mcgrath, 2020 ).
4.3.3. Increased cleanliness of beaches
Beaches constitute the interface between land and ocean, offering coastal protection from marine storms and cyclones ( Temmerman et al., 2013 ), and are an integral part of natural capital assets found in coastal areas ( Zambrano-Monserrate et al., 2018 ). They provide services (e.g. tourism, recreation) that are crucial for the survival of coastal communities and possess essential values that must be prevented against overexploitation ( Lucrezi et al., 2016 ; Vousdoukas et al., 2020 ). Questionable use to which most beaches have been subjected have rendered them pollution ridden ( Partelow et al., 2015 ). However, due to COVID-19-induced measures, notable changes in terms of the physical appearance of numerous beaches across the globe have been observed ( Zambrano-Monserrate et al., 2020 ).
4.3.4. Decline in primary energy use
Global energy demand during the first quarter of 2020 fell by ~3.8% compared to the first quarter of 2019, with a significant effect noticeable in March as control efforts heightened in North America and Europe ( IEA, 2020 ). The International Energy Agency (IEA) submitted that if curtailment measures in the form of restricted movement continue for long and economic recoveries are slow across different parts of the globe, as is progressively likely, annual energy demand will plummet by up to 6%, erasing the last five years energy demand growth. As illustrated in Fig. 9 , if IEA's projections become the reality, the world could experience a plunge in global energy use to a level not recorded in the last 70 years. The impact will surpass the effect of the 2008 financial crisis by a factor of more than seven times. On the other hand, if COVID-19 is contained earlier than anticipated and there is an early re-start of the economy at a successful rate, the fall in energy could be constrained to <4% ( IEA, 2020 ). However, a rough re-start of the economy characterised by supply chain disruptions and a second wave of infections in the second half of the year could further impede growth ( IEA, 2020 ).
Annual rate of change in primary energy demand, since 1900, with key events impacting energy demand highlighted ( IEA, 2020 ).
Coal was reported to have been hit the hardest by ~8% in comparison to the first quarter of 2019 due to the impact of COVID-19 in China whose economy is driven by coal, reduced gas costs, continued growth in renewables, and mild weather conditions. Oil demand was also strongly affected, plummeting by ~5% in the first quarter driven mainly by restrictions in mobility and aviation activities which constitute ~60% of global oil demand ( IEA, 2020 ). For instance, global road transport and aviation activities were respectively ~50% and 60% below the 2019 average. Global electricity demand declined by >20% during full lockdown restrictions, with a corresponding spill over effect on the energy mix. Accordingly, the share of renewable energy sources across the energy supply increased due to priority dispatch boosted by larger installed capacity and the fact that their outputs are largely unconstrained by demand ( IEA, 2020 ). However, there was a decline for all other sources of electricity including gas, coal and nuclear power ( IEA, 2020 ).
4.3.5. Record low CO 2 emissions
Unprecedented reduction in global CO 2 emissions is another positive effect that can be attributed to the COVID-19 pandemic.The massive fall in energy demand induced by COVID-19 accounted for the dramatic decline in global GHG emissions. The annual CO 2 emissions have not only been projected to fall at a rate never seen before, but the fall is also envisioned to be the biggest in a single year outstripping the fall experienced from the largest recessions of the past five decades combined ( IEA, 2020 ).The global CO 2 emissions are projected to decline by ~8% (2.6 GCO 2 ) to the levels of the last decade. If achieved, this 8% emissions reduction will result in the most substantial reduction ever recorded as it is expected to be six times larger than the milestone recorded during the 2009 financial crisis, ( Fig. 10 ). Characteristically, after an economic meltdown, the surge in emissions may eclipse the decline, unless intervention options to set the economy into recovery mode is based on cleaner and more resilient energy infrastructure ( IEA, 2020 ).
Global energy-related emissions (top) and annual change (bottom) in GtCO 2 , with projected 2020 levels highlighted in red. Other major events are indicated to provide a sense of scale ( IEA, 2020 ).
4.3.6. Boost in digitalisation
The COVID-19 pandemic has been described as an opportunity to further entrench digital transformation without the ‘digitalism’ which is an extreme and adverse form of connectedness ( Bayram et al., 2020 ). Protecting patients from unnecessary exposure was a driver for telemedicine ( Moazzami et al., 2020 ) and virtual care would become the new reality ( Wosik et al., 2020 ). The necessity for social distancing under lockdown circumstances has also highlighted the importance (and need) for remote working ( Dingel and Neiman, 2020 ; Omary et al., 2020 ), which has had implications for broadband connectivity ( Allan et al., 2020 ) as well as reductions in transportation-related pollution levels ( Spash, 2020 ). The impact of COVID-19 on remote working and digitalisation of work is expected to constitute long-term implications for reduced fossil fuel consumption due to mobility and commuting ( Kanda and Kivimaa, 2020 ). Besides, the survival and thriving of many small business restaurants during the lockdown period depended on whether they had a digital resilience, via online platforms, through which they could exploit the home delivery market via Uber Eats ( Raj et al., 2020 ). For consumers, the pandemic has seen a noticeable increase in online orders for food in many countries such as: Taiwan ( Chang and Meyerhoefer, 2020 ); Malaysia ( Hasanat et al., 2020 ); Germany ( Dannenberg et al., 2020 ) as well as Canada ( Hobbs, 2020 ).
4.4. Unsustainability of current economic and business models amidst COVID-19
It is interesting to observe that while COVID-19 has led to a very steep reduction in air pollution in advanced economies due to reduced economic activity imposed by the lockdown, this pandemic-driven positive impact is only temporary as they do not reflect changes in economic structures of the global economy ( Le Quéré et al., 2020 ). The changes are not due to the right decisions from governments in terms of climate breakdown policies and therefore should not be misconstrued as a climate triumph. More importantly, life in lockdown will not linger on forever as economies will need to rebuild and we can expect a surge in emissions again. To drive home the point, we conducted a decomposition analysis of key drivers (accelerators or retardants) of four global air pollutants using Logarithmic Mean Divisia Index (LMDI) framework ( Ang, 2005 ; Fujii et al., 2013 ), with the results shown in Fig. 11 . The drivers of the pollutants considered based on the production side of an economy include: (i) economic activity effect, given thatemissions can increase or decrease as a result of changes in the activity level of the entire economy; (ii) industrialeconomy structure effect, based on the fact thatthe growth in emissions is a function of the changes in the industrial activity composition; (iii) emissions intensity effect, which can be improvements or deteriorations at the sectoral level, depending on theenergy efficiency (e.g. cleaner production processes) of the sector; (iv) fuel mix or fuel dependency effect, given that its composition influences the amount of emissions; and (v) emission factors effect, because these factors, for different fuel types, changes over time due toswitching from fossil fuels to renewables, for example.
Drivers of representative four (4) global pollutants: a) CO 2 emissions; b) NO x emissions; c) SO x emissions; d) CO emissions. All data for the decomposition analysis of the four pollutants were obtained from the WIOD database ( Timmer et al., 2012 ).
As shown in Fig. 11 a, for example, between 1995 and 2009, global change in CO 2 emission was 32%, where economic activity (+48%) and emission factor (+2%) acted as accelerators, while economic structure (-8%), emission intensity (-9%) and fuel mix (-1%) acted as retardants, of the global CO 2 emission dynamics and trajectory.This implies that although economic activities, as expected, alongside emission factor drove up emissions, however, the upward effect of both drivers was offset by the combined improvements of other driving factors namely economic structure, emission intensity, and fuel mix. Indeed, cutting back on flying or driving less as we have experienced due to COVID-19 contributed to ~8% in emission reduction, however, zero-emissions cannot be attained based on these acts alone. Simply put, emissions reduction cannot be sustained until an optimal balance across the aforementioned drivers informed by structural changes in the economy is attained. As Gates (2020a) rightly stated – the world should be using more energy, not less, provided it is clean.
Characteristically, after an economic meltdown, like the global recession in 2008, there is a surge in emissions ( Feng et al., 2015 ; Koh et al., 2016 ). The current social trauma of lockdown and associated behavioural changes tends to modify the future trajectory unpredictably. However, social responses would not drive the profound and sustained reduction required to attain a low-carbon economy ( Le Quéré et al., 2020 ). This is evident given that we live on a planet interlinked by networked product supply chains, multidimensional production technologies, and non-linear consumption patterns ( Acquaye et al., 2017 ; Ibn-Mohammed et al., 2018 ; Koh et al., 2016 ). Additionally, post COVID-19, the society may suffer from green bounce back– there appears to be an increasing awareness of climate change and air pollution because of this pandemic (though the linkages are non-causal). On the one hand this might promote greener choices on behalf of consumers, but on the other it may result in increased car ownership (at the expense of mass transit), driving up emissions. As such, establishing approaches that ensure an optimal balance between quality of life and the environmental burden the planet can bear is pertinent, if the boundaries of environmental sustainability informed by the principles of low-carbon CE are to be extended. In the next section, the role of the CE as a potential strategy for combating pandemics such as COVID-19 is discussed.
5. The role of circular economy
For long, the central idea of the industrial economy rests on the traditional linear economic system of taking resources, making products from them, and disposing of the product at the end of life. Experts referred to this as “extract-produce-use-dump”, “take-make-waste”, or “take-make-dispose” energy flow model of industrial practice ( Geissdoerfer et al., 2017 ; Kirchherr et al., 2017 ; MacArthur, 2013 ). However, the unlimited use of natural resources with no concern for sustainability jeopardizes the elastic limit of the planet's resource supply. For instance, Girling (2011) submitted that ~90% of the raw materials used in manufacturing become waste before the final product leaves the production plant while ~80% of products manufactured are disposed of within the first 6 months of their life. Similarly, Hoornweg and Bhada-Tata (2012) reported that ~1.3 billion tonnes of solid waste with a corresponding cost implication of $205.4 billion/year is generated by cities across the globe and that such waste might grow to ~2.2 billion tonnes by 2025, with a corresponding rate of $375.5 billion. This is further compounded by the fact that at the global level, the demand for resources is forecasted to double by 2050 ( Ekins et al., 2016 ).
Against this backdrop, the search for an industrial economic model that satisfies the multiple roles of decoupling of economic growth from resource consumption, waste management and wealth creation, has heightened interests in concepts about circular economy ( Ekins et al., 2016 ; MacArthur, 2013 ).In theory, CE framework hinges on three principles: designing out waste, keeping products and materials in use and regenerating the natural systems ( MacArthur, 2013 ). Practically, CE is aimed at: (i) emphasizing environmentally-conscious manufacturing and product recovery ( Gungor and Gupta, 1999 ); (ii) promoting the avoidance of unintended ecological degradation in symbiotic cooperation between corporations, consumers and government ( Bauwens et al., 2020 ); and (iii) shifting the focus to a holistic product value chain and cradle-to-cradle life cycle via promotion of product repair/re-use and waste management ( Duflou et al., 2012 ; Lieder and Rashid, 2016 ; Rashid et al., 2013 ).
Given the current COVID-19 pandemic, there has never been a more adequate time to consider how the principles of CE could be translated into reality when the global economy begins to recover. This is pertinent because the pandemic has further exposed the limitations of the current dominant linear economy regarding how it is failing the planet and its inhabitants, and has revealed the global ecosystem's exposure to many risks including climate breakdown, supply chain vulnerabilities and fragility, social inequality and inherent brittleness ( Bachman, 2020 ; Sarkis et al., 2020 ). The pandemic continues to amplify the global interlinkages of humankind and the interdependencies that link our natural environment, economic, and social systems ( Haigh and Bäunker, 2020 ). In the subsections that follow, the potentials of CE as a tool for: (i) climate change mitigation; (ii) crafting a more resilient economy, and ; (iii) facilitating a socially just and inclusive society, is briefly discussed.
5.1. Circular economy as a tool for climate breakdown mitigation
As highlighted in Section 4.3.5 , a CO 2 emission reduction of 8%, which in real terms implies an equivalent of ~172 billion tCO 2 will be released instead of ~187 billion tCO 2 , is indeed unprecedented. Nevertheless, the peculiar conclusion from the lockdown is that it still entails emissions of 92% of the initial value while there was restrictions to mobility and other related leisure activities. Measures for mitigating climate change have often been presented dramatically as a "prohibition of the nice things of life", but as shown, a cut-off of such an amount of nice things only delivers an 8% reduction. More importantly, it comes at a heavy cost of between $3,200/tCO 2 and $5,400/tCO 2 in the US, for example, based on data from the Rhodium Group ( Gates, 2020a ). In other words, the shutdown is reducing emissions at a cost between 32 and 54 times the $100/tCO 2 deemed a reasonable carbon price by economists ( Gates, 2020a ). This suggests that a completely different approach to tackling climate issue is required.
Accordingly, there is the need for a system that calls for greater adoption of a more resilient low-carbon CE model, given the predictions by experts that climate breakdown and not COVID-19 will constitute the biggest threat to global health ( Hussey and Arku, 2020 ; Watts et al., 2018a ; Watts et al., 2018b ). International bodies and country-level environmental policies have highlighted the fact that a significant reduction in GHG emissions cannot be achieved by transitioning to renewables alone but with augmentation with CE strategies. The demands side CE strategies such as (i)material recirculation (more high-value recycling, less primary material production, lower emissions per tonne of material); (ii)product material efficiency (improved production process, reuse of components and designing products with fewer materials); (iii)circular business models (higher utilisation and longer lifetime of products through design for durability and disassembly, utilisation of long-lasting materials, improved maintenance and remanufacturing), could reduce emissions whilst contributing to climate change mitigation ( Enkvist et al., 2018 ). CE principles, when adopted in a holistic manner provide credible solutions to the majority of the structural weaknesses exposed by COVID-19, offering considerable opportunities in competitiveness and long-term reduced GHG emissions across value chains. Investments in climate-resilient infrastructure and the move towards circular and low-carbon economy future can play the dual role of job creation while enhancing environmental and economic benefits.
5.2. Circular economy as a vehicle for crafting more resilient economies
Haigh and Bäunker (2020) reported that if we muddle through every new crisis based on the current economic model, using short-term solutions to mitigate the impact, future shocks will continue to surpass capacities. It is, therefore, necessary to devise long-term risk-mitigation and sustainable fiscal thinking with the view to shift away from the current focus on profits and disproportionate economic growth. Resilience in the context of the CE largely pertains to having optimized cycles (i.e. products are designed for longevity and optimized for a cycle of disassembly and reuse that renders them easier to handle and transform). Some cycles can be better by being closed locally (e.g. many food items), and for other cycles, a global value chain could be a better option (e.g. rare earth elements). Due to globalization, all cycles have become organized at the global level, diminishing resilience. COVID-19 has further shown how some particular cycles had the wrong scale level, as such, the adoption of CE can be seen as an invitation to reconsider the optimal capacity of cycles.
Sustainability through resilience thinking would have a positive and lasting impact as reported by the Stockholm Resilience Centre (2016) , which concluded that prosperity and sustainability cannot be accomplished without building “ resilient systems that promote radical innovation in economic policy, corporate strategy, and in social systems and public governance”. It calls for sustainability through resilience thinking to become an overarching policy driver and encourages the application of the principles of such thinking to enhance social innovation. Haigh and Bäunker (2020) concluded that when resilience thinking is employed as a guide, all innovations emanating from circular thinking would extend beyond focusing mainly on boosting the market and competitiveness and recognise the general well-being of the populace as an equal goal. As the global economy recovers from COVID-19, it has become more apparent that there is a strong sense of interconnectedness between environmental, economic and social sustainability ( Bauwens et al., 2020 ).
5.3. Circular economy as a facilitator of a socially just and inclusive society
Advanced economies have mainly focused on maintaining the purchasing power of households through the establishment of the furlough scheme (in the UK, for example). Most developing countries have also adopted a similar approach through the integration of containment measures with a huge increase in social protection spending. However, these intervention strategies in response to the pandemic have further revealed the social injustice and inequality between countries and communities given that the deployment of such strategy in advanced economies could devastate developing countries and communities ( Ahmed et al., 2020 ; Haigh and Bäunker, 2020 ). Guan and Hallegatte (2020) revealed that developing and underdeveloped economies face tougher and more challenging situation in comparison to their developed counterparts, because even under the assumption that social protection systems could fully replace income and shield businesses from bankruptcy, maintaining access to essential commodities is impossible if the country is lacking in production capabilities in the first place. Furthermore, in the underdeveloped world, the idea of working from home is very difficult due to the lack of infrastructure and access to health facilities is severely cumbersome. As such, short-term fixes adopted by governments cannot adequately address deep-rooted inequality and social injustice.
Accordingly, Preston et al. (2019) submitted that CE has the potential to minimise prevailing pressures and struggles regarding conflicts due to imbalanced distribution of resources, through participatory forms of governance that entails the inclusion of local stakeholders in resource management initiatives. This can be achieved through the adoption of CE strategy such as closed-loop value chains, where wastes are transformed into resources with the view to not only reduce pollution but to simultaneously aid the pursuance of social inclusion objectives. A number of companies are already embracing this idea. For instance, under the Food Forward SA initiative, “ the world of excess is connected with the world of need ” through the recovery of edible surplus food from the consumer goods supply chain and gets redistributed to the local community. This ensures loops are closed and the needy receive nourishment ( Haigh and Bäunker, 2020 ). With sufficient investment in the CE, developing countries can leapfrog their developed counterparts in digital and materials innovation to integrate sustainable production and consumption and low-carbon developments at the core of their economies. Additionally, Stahel (2016) reported that another benefit of the CE as a facilitator of a socially just and inclusive society is that it is likely to be more labour-intensive due to the variety of end-of-life products and the high cost of automating their processing compared to manual work. As such, CE can enable the creation of local jobs and “reindustrialisation of regions” ( Stahel, 2019 ) through the substitution of: manpower for energy, materials for (local) labour, and local workshops for centralised factories ( Stahel, 2019 ), while boosting the repair economy and local micro industries. Of course, not everybody will see this as a benefit, and many would like to see more automation, not less. However, this is a political/economic argument, not an engineering or scientific one. In the next section, barriers to CE in general and in the context of COVID-19 is discussed.
5.4. Barriers to CE in the context of COVID-19
On the surface, the benefits of CE should be obvious as it strives for three wins in the three dimensions of social, economic and environment impacts through a symbiotic vision of reduced material usage, reduced waste generation, extending value retention in products and designing products for durability. However, limiting barriers obviating the success of CE have existed around technical implementation, behavioural change, financial and intellectual investments, policy and regulations, market dynamics, socio-cultural considerations as well as operational cost of transforming from the linear economy to one based on circularity ( Friant et al., 2020 ). In more concrete terms, the barriers dwell within the ecosystem of actors (and the interactions within the actors) involved in the move towards CE ( Lieder and Rashid, 2016 ).
Pre-COVID-19, Korhonen et al. (2018) enumerated six fundamental factors hindering the promise of CE: (i) thermodynamic factors (i.e. limit imposed by material and energy combustion in recycling/re-manufacturing); (ii) complexity of spatial and temporal boundaries (i.e. material and energy footprints for a product cannot be easily reduced to a point in space and time for an in-depth analysis of environmental impacts); (iii) interlink of governance and nation's economy; (iv) consumer and organizational inertia (i.e. reluctance to embrace new way of doing things due to uncertainty about the success of business models as well as fuzziness around organizational culture and management models that rely on CE); (v) fragile industrial ecosystems (featuring the difficulty of establishing and managing intra-/inter-organizational collaboration along with local/regional authorities); and (vi) lack of consensus on what the many Rs (re-use, recycle, recover, repurpose, repair, refurbish, remanufacture) embedded in CE framework really means ( Kirchherr et al., 2017 ). Challenges in data sharing between product end points and stakeholders, complexity in the supply chain with unclear details of product biography over time, and prohibitive start-up investment costs have also been identified as CE barrier in other climes ( Jaeger and Upadhyay, 2020 ; Manninen et al., 2018 ). Other issues along similar lines were captured in the work by several other authors including Galvão et al. (2020) , Kirchherr et al. (2018) , Govindan and Hasanagic (2018) , De Jesus and Mendonça (2018) and many more.
The paradox of COVID-19 is grounded on creating a once in a lifetime opportunity to re-examine the difficulty of some of these barriers, but it also unveiled a new set of challenges. For instance, the sharing economy models that have been hitherto hailed as exemplars of CE strategy is now perceived differently by many urban dwellers because of the behavioural change embedded in “social distancing”, which is necessary to limit the spread of the virus. Although if concepts such as “access over ownership” or “pay for performance” service have become fully operational, they could have constituted a significant solution to offer flexibility. Additionally, it has been argued that COVID-19 will ‘disrupt some disruptors’ peer-to-peer (P2P) providers such as Airbnb, which has reported a 4.16% drop in local bookings for every doubling new COVID-19 cases ( Hu and Lee, 2020 ). In transportation, demand from ride-sharing modes could increase due to commuters wanting to minimise exposure to COVID-19 in mass transport systems like buses and trains ( Chandra, 2020 ). However, the risks of human-to-human transmission of COVID-19 for passengers not wearing facemask have been noted ( Liu and Zhang, 2020 ), including when either passengers or drivers in ride-hailing and car-sharing disruptors like Uber do not wear facemasks ( Wong et al., 2020 ).
Reducing emissions, in the long run, requires large investments, from both the public and private sectors, in low-carbon technologies and infrastructure in terms of both innovation and diffusion ( OECD, 2018 ). Given the downturn of the global economy due to COVID-19, the prospects of significant low-carbon investments from the private sector have significantly reduced compared to pre-COVID-19. This view is not just limited to the private sector, but also to the public sector, as echoed by Naidoo and Fisher (2020) . Hence, post COVID-19, accelerating progress towards CE still requires: (i) a decisive legal and financial championships from local, regional and national authorities; (ii) innovation across multiple domains (product design, production technologies, business models, financing and consumer behaviours); (iii) governments to promote green logistics and waste management regulations with reasonable incentives to aid producers and manufacturers in minimizing loss while maximizing value. It is therefore recommended that governments provide the much-needed policy framework that will eliminate some of aforementioned barriers to facilitate the urgent transition to CE. Doing this will build resilience for community response to future pandemic and it also aligns with some of the existing roadmaps for resource efficiency ( European Commission, 2011 ).
6. Opportunities for circular economy post COVID-19
COVID-19 has instigated a focus on vibrant local manufacturing as an enabler of resilient economy and job creation; fostered behavioural change in consumers; triggered the need for diversification and circularity of supply chains, and evinced the power of public policy for tackling urgent socio-economic crises. As we rise to the challenges imposed by COVID-19, the question is no longer should we build back better, but how. Consequently, going forward, crafting a roadmap for a sustainable future is as much about the governmental will to forge a new path to socio-economic growth as it is about local businesses joining forces with the consumers to enable the transition to CE. As already documented in the earlier sections of this paper, governments around the world have deployed many financial policy instruments to combat the short-term consequences of COVID-19 pandemic. Still, in the long-term, the adoption of circular economy principles across various technological frontiers holds the promise to bring about a desired technical and behavioural change that will benefit many nations around the world.
Specifically, adopting the CE principle will alleviate some of the detrimental effects of COVID-19 pandemic in the future. To mention just a few: (i) a national level adoption of CE will reduce the over-reliance on one country as the manufacturing hub of the world; (ii) a systematic shift away from the traditional polluting, energy-intensive, manufacturing-driven economy to a CE, based on renewable energy, smart materials, smart re-manufacturing, and digital technology will strengthen the fight against pollution; and (iii) the transition to CE will also spur local job creation along several of the axes of societal needs (e.g. built environment, mobility, health, consumables, etc.). Accordingly, in the subsections that follow, an overview of recommendations as well as policy measures, incentives, and regulatory support for advancing sector-specific CE strategies in a post-COVID-19 world is presented.
6.1. Local manufacturing and re-manufacturing of essential medical accessories
Disruptions due to COVID-19 has been attributed to unprecedented demand, panic buying, and intentional hoarding of essential medical goods for profit ( Bradsher and Alderman, 2020 ; Fischer et al., 2020 ). The shortage of many items was so dire in many countries that the principle of CE, such as re-use, is already been unwittingly recommended ( Gondi et al., 2020 ), by respectable bodies such as the US Centres for Disease Control and Prevention (CDC) ( Ranney et al., 2020 ). However, designed and produced from non-CE compliant processes, medical accessories such as PPE cannot be easily refurbished for re-use without leading to severe degradation in their efficiencies, as noticed for example, in the case of particulate respirators ( Liao et al., 2020 ). Accordingly, it is recommended that companies strive to establish competencies in eco-design and environmentally beneficial innovation to facilitate product re-use in the long run. Some of the desired competencies centre on design strategies for closing resource loops (e.g. designing for technological and biological cycles) as pioneered by McDonough and Braungart (2010) .
A detailed discussion of these competencies is also enunciated by Braungart et al. (2007) , where the authors differentiated between eco-efficiency (less desirable) and eco-effectiveness (the desired dream of CE), for companies to be compliant with the CE framework. Meanwhile, a starting point for companies to shift to eco-effectiveness at the product design level, which will facilitate product re-use, is to follow the five-step framework enumerated by Braungart et al. (2007) or to adopt the analytical framework to explore some of the key dimensions in eco-design innovations developed by Carrillo-Hermosilla et al. (2010) . During implementation, the preceding steps comport with the idea of eco-factories that take pride in design for effortless end-of-life product re-use and design for “upcycling” and remanufacturing ( Bocken et al., 2016 ; Herrmann et al., 2014 ; Ijomah, 2010 ), all of which falls under the umbrella of CE.
Another emerging evidence in favour of CE, also adopted inadvertently during this pandemic, is the ease with which several manufacturers have pivoted their factory floors to make different products in response to the shortage of medical accessories. Few examples of these companies in the UK include, but not limited to: AE Aerospace, which retooled its factory floor to produce milled parts for ventilators; Alloy Wire International re-purposed its machinery to make springs for ventilators; AMTICO (flooring manufacture) re-configured its production lines to make visors for front line workers; BAE Systems deployed its factory resources to produce and distribute over 40000 face shields; and BARBOUR (a clothing company) re-purposed to produce PPE for nurses ( Williamson, 2020 ).
6.2. CE strategies for managing hospital medical and general waste
Wastes generated by the healthcare industry (HCI) normally arouse concerns about operational, public, and environmental safety as a result of the awareness of the corrosive, hazardous, infectious, reactive, possibly radioactive, and toxic nature of the wastes’ composition ( Lee et al., 1991 ; Prüss-Üstün et al., 1999 ). Consequently, the management of the different categories of healthcare waste far removed from the traditional municipal wastes, falls under stringent national or local regulatory frameworks. Pre-COVID-19, the staggering scale of HCI waste is reported to reach into millions of tonnes per year and there have been many studies of national-level attempts at managing these wastes ( Da Silva et al., 2005 ; Insa et al., 2010 ; Lee et al., 1991 ; Oweis et al., 2005 ; Tudor et al., 2005 ). However, this problem is expected to worsen with the tremendous surge, in the last few months, in the volume of disposable medical hardware (PPE, masks, gloves, disposable gears worn by healthcare workers and sanitation workers as well as those contaminated by contacts with COVID-19 patients). Another allied problem is the troubling shift among consumers who now prioritize concerns for hygiene by leaning towards plastic packaging (e.g. in food delivery and grocery shopping) during this pandemic at the expense of environmental impacts ( Prata et al., 2020 ). Most of these products are derived from non-biodegradable plastics, and their disposal has not been given much thought. As a result, the management of these wastes has raised understandable angst in several quarters ( Klemeš et al., 2020 ; Xiao and Torok, 2020 ). Frustratingly, there is much less that can be done at the moment apart from devising judicious waste management policy for these potentially hazardous wastes.
The traditional steps concerning the treatment of HCI wastes (such as collection and separation, storage, transportation to landfill, and decontamination/disposal) suffer from many complications that make the management a challenging undertaking ( Windfeld and Brooks, 2015 ). To alleviate the complexity, the characterization of the physicochemical composition of HCI waste has become an important tool in devising crucial steps for setting up waste minimization and recycling programs ( Kaiser et al., 2001 ). This aligns with the objective of circular economy (CE), which prioritizes the prevention of waste, failing which it proposes the re-use/recyclability of materials from waste to close the loop.
Wong et al. (1994) reported that hospital wastes involve different types of materials: plastics (tubes, gloves, syringes, blood bags), metals (basins, aluminium cans), papers (towel papers, toilet papers, newspapers), cotton/textiles (drapes, table covers, diapers, pads, bandages), glass (bottles) etc. With this categorization in mind, a CE product design consideration that looks promising in the near future, as a way to avert some of the dangers that can be triggered by events such as COVID-19, is to increase the volume of recyclable materials and biodegradable bioplastics in the production of medical accessories. However, the reality is that not all medical gears and products can be derived from bio-plastics or recyclable materials, and some will inevitably continue to be fabricated with materials that need further downstream processing. Yet, the application of CE to the healthcare industry (HCI) remains a touchy subject. Understandably, health and safety concerns, as well as requirements to meet stringent regulations, tend to override the environmental gain from the 4R practice promoted by CE ( Kane et al., 2018 ). Nonetheless, the benefits of CE are starting to catch on in the HCI as a means of optimizing hospital supply chains and reduce overhead cost, all the while creating environmental benefits in the course of saving human lives.
Principally, the applications of CE in HCI, like in other fields, are tied to materials flow and an examination of the nature of wastes. Pioneering studies on hospital wastes characterizations ( Diaz et al., 2008 ; Eleyan et al., 2013 ; Özkan, 2013 ; Wong et al., 1994 ), revealed that close to 80% of the wastes can be classified as general wastes, while the remaining 20% falls under the infectious waste category ( WHO, 1998 ). A prevalent method of dealing with the two HCI waste categories has been incineration ( Wong et al., 1994 ). Although suitable for large volumes, incineration produces toxic pollutants such as heavy metals, dioxins, acid gases, and hydrogen chloride ( Yang et al., 2009 ). Consequently, pre-COVID-19, besides incineration, reducing or preventing the volume of wastes in both categories is also shaped by the adoption of green purchasing practices ( Wormer et al., 2013 ). While this may help in the short term, a holistic approach to confronting this problem is the adoption of CE, which can facilitate the shift towards eco-efficient HCI, starting with lifecycle evaluations of medical products to the proposal for re-usable medical instruments ( Cimprich et al., 2019 ; De Soete et al., 2017 ; Penn et al., 2012 ). Numerous CE strategies for healthcare waste management are detailed by Kane et al. (2018) and Voudrias (2018) . Undoubtedly, with COVID-19, there is an uptick in the percentage of waste under the infectious category due to hospitals taking various precautions to facilitate control of the pandemic ( Peng et al., 2020 ). Nevertheless, by subjecting the general waste category to proper sterilization procedure via any of thermal, microwave, bio-chemical sterilization, the huge potential from upcycling of the retrieved materials will edge towards fulfilling the promise of CE within the sector ( Yang et al., 2009 ).
6.3. Embracing resource efficiency in the construction and built environment
As with other economic sectors, COVID-19 has exposed the shortcomings of the built and natural environment's business-as-usual practices, highlighting the prevalence of poor-quality buildings, issues regarding affordability of decent housing and rigidity of the current building stocks ( EMF, 2020b ). Living in poor-quality houses and in small constricted energy inefficient homes, led to the in-house transmission of the virus in some cases ( Clair, 2020 ). This is particularly the case in poorer countries where inadequate access to sanitation amenities has prevented people from adopting best practices necessary for halting the transmission ( Andrew et al., 2020 ). These issues alongside the growing concern and awareness regarding the resource-wasting nature of the sector, present a strong case for rethinking it. The CE is well positioned to offer potential solutions to these problems.
CE can help balance behavioural challenges and opportunities from occupancy requirements. Humans spend up to 90% of their time indoors ( Marques et al., 2018 ; Pitarma et al., 2017 ). The pandemic has led to people spending more time at ‘home’ than at work, leading to massively underutilised office and business spaces, which is likely to increase due to on-going social distancing constraints ( Feber et al., 2020 ) or perhaps due to more organisation discovering the cost benefits of remote working. It is also plausible that upgrading of existing (or design of new) office and commercial spaces would require making them flexible and adaptable to cope with changing needs (e.g. occupant density, social distancing, ventilation, etc.) by using movable walls ( Carra and Magdani, 2017 ). Insufficient ventilation can increase the risk of infection to healthcare workers and susceptible patients in healthcare buildings, especially makeshift hospitals ( Chen and Zhao, 2020 ). The impact of these engineering measures on energy consumption of typical buildings and healthcare facilities needs to be considered because of social distancing measures, which may require a decrease in occupant density but an increase in ventilation rates. So, although energy recovery is high on the agenda for CE in the built environment ( Eberhardt et al., 2019 ), the additional requirement of more mechanical ventilation for less people will stretch the energy consumed by buildings. Some researchers have argued for buildings to avoid recirculation (essential for energy savings) and use 100% fresh outdoor air for mechanical ventilation systems ( Pinheiro and Luís, 2020 ). Such scenarios are likely to increase the adoption of renewable energy sources to support acceptable indoor air quality (IAQ).
The adoption of CE strategies such as material reuse and development of recycling infrastructure can facilitate value circulation and efficient use of resources within the built and natural environment, ensuring a more competitive and cost-effective post-COVID-19 recovery, while contributing to GHG emissions reduction and creating job opportunities ( EMF, 2020b ). For instance, a study by ARUP estimated that designing for steel reuse has the potential of generating savings of 6-27% and 9-43% for a warehouse and an office respectively, whilst constituting up to 25% savings on material costs ( SYSTEMIQ, 2017 ). The EU is leading in policy direction that would make it a legal requirement to introduce recycled content (i.e. material looping) in specific construction products, after the functionality and safety have been vetted ( European Commission, 2020 ). Such initiatives will encourage designers and researchers to incorporate material looping into their overall design strategy across the value chain to ensure they are fit for circulation ( Deloitte, 2020 ). This material looping has been shown to reduce disposal fees and generate new income streams from the secondary materials market ( Rios et al., 2015 ). It is an approach that would help reduce construction waste, which accounts for a third of all solid wastes in countries like India ( EMF, 2016 ). The adoption of digital material passports that supports end-to-end tracking of building materials has been reported by SYSTEMIQ (2017) to aid the identification of materials for reuse as they approach their end of first life, thereby allowing the longevity and encouraging tighter material looping.
COVID-19 in the context of CE will encourage prefabrication, design thinking and renovation. As the building industry moves towards the industrialisation of construction via prefabrication/offsite production, seven strategies have been suggested by Minunno et al. (2018) out of which the principle of designing for eventual disassembly and reuse is critical. With a combined smart and industrialised prefabrication (SAIP) process ( Abbas Elmualim et al., 2018 ), the intelligent performance and circularity of buildings can be boosted by advanced smart technologies ( Windapo and Moghayedi, 2020 ). The building of 1,000 bed Huoshenshan Hospital in Wuhan covering 34,000m 2 in ten days using modular pre-fabricated components, which can be disassembled and reused ( Zhou et al., 2020 ) has demonstrated the capability of the construction industry to deliver adaptable buildings in record time. But it is perhaps in the sphere of refurbishment and renovation that CE in the built environment would mostly be felt. A CE strategy that promotes repair and refurbishment is preferable to one which encourages recycling, since the economic and environmental value of a product is retained better by the former ( Sauerwein et al., 2019 ).
Renovation helps achieve carbon reduction targets while contributing to economic stimulation ( Ibn-Mohammed et al., 2013 ) . Retrofitting, refurbishing or repairing existing buildings leads to lower emission facilities, is less resource-intensive and more cost-effective than demolition or new construction ( Ardente et al., 2011 ; Ibn-Mohammed et al., 2014 ). Nevertheless, circular renovation of buildings must align with circular design thinking – as alluded to above, in terms of re-integrating materials back into the value chain – as well as the need to enhance material/product durability and energy efficiency ( Pomponi and Moncaster, 2017 ). In Europe, renovation of buildings decreases the residential sector's GHG emissions by 63%, with a reduction of up to 73% in the non-residential sector ( Artola et al., 2016 ). In meeting the emerging needs of the renovation sub-sector, digital infrastructure technologies (such as thermographic and infrared surveys, photogrammetry and 3D laser scanning, as well as BIM and Digital Twinning) will play a crucial role in ensuring the low carbon and energy-efficient future of the built environment ( ARUP, 2020 ).
6.4. Bio-cycle economy and the food sector
COVID-19 or not, the food sector is generally wasteful ( Dilkes-Hoffman et al., 2018 ), contributes to environmental degradation ( Beretta and Hellweg, 2019 ), disrupts nutrient flows due to the current linear nature of its value chain, thereby diminishing the nutritional quality of food ( Castañé and Antón, 2017 ). To address these issues, as part of a future resilience in the food sector, a number of CE levers applicable to the sector is highlighted: (i) closing nutrient loops through the adoption of regenerative agriculture ( Rhodes, 2017 ). The organic content of soil reflects its healthiness and propensity to produce nutritious crops. The adoption of regenerative agriculture can facilitate the preservation of soil health through returning organic matter to the soil in the form of food waste or composted by-products or digestates from treatment plants ( Sherwood and Uphoff, 2000 ); (ii) value recovery from organic nutrients through the adoption of anaerobic digestion facilities ( De Gioannis et al., 2017 ; Huang et al., 2017 ), which is related to controlled biogas production for onward injection into natural gas network or conversion to electrical energy ( Atelge et al., 2020 ; Monlau et al., 2015 ). This has the potential to transform ensuing methane from food waste into carbon-neutral energy; and (iii) the embrace of urban and peri-urban agriculture ( Ayambire et al., 2019 ; Lwasa et al., 2014 ; Opitz et al., 2016 ; Thebo et al., 2014 ), which entails the “ cultivation of crops and rearing of animals for food and other uses within and surrounding the boundaries of cities, including fisheries and forestry ”( EPRS, 2014 ). Indeed, by cultivating food in proximity to where it will be consumed, carbon footprint can be mitigated in numerous ways. For instance, through the adoption of urban agriculture, Lee et al. (2015) demonstrated GHG reduction of 11,668 t yr −1 in the transportation sector. The popularity of local farms has severely increased as a direct consequence of COVID-19, whereby people could experience the power of local food cycles and avoid perceived contamination risks in supermarkets. This will further bolster urban and peri-urban agriculture.
All the above-mentioned CE strategies will contribute towards the establishment of a better and more resilient future food system. However, in the context of COVID-19, transitioning to regenerative agricultural production processes and expanding food collection, redistribution and volarisation facilities constitute an integral part of a more resilient and healthy food system that allows greater food security and less wastage, post COVID-19 ( EMF, 2020a ). Investments towards accelerating regenerative agriculture offer economic benefits facilitated by reforms in food, land, and ocean use ( World Economic Forum, 2020 ). It also offer environmental benefits by supporting biologically active ecosystems ( EMF, 2020a ) and through numerous farming mechanisms including no-till farming, adoption of cover crops, crop rotations and diversification ( Ranganatha et al., 2020 ) as well as managed grazing for regenerative livestock rearing ( Fast Company, 2019 ). Similarly, expanding food collection, redistribution and volarisation facilities offers both economic and environmental benefits for the food system ( EMF, 2020a ). However, realising these benefits will require investment in: (i) physical infrastructure like cold chains that support the storage, processing, and supply of edible food, especially in low-income countries, and (ii) processing infrastructure for the collection and volarisation of waste food ( EMF, 2020a ). This will facilitate door-to-door waste food collection, offering avenues for municipal organic waste volarisation.
6.5. Opportunities for CE in the transport and mobility sector
Facilitating the movement of people, products and materials, transportation infrastructures are imperative to the success of circularity in the shift towards sustainable cities given its impact on the quality of life, the local environment and resource consumption ( Van Buren et al., 2016 ). As noted in an earlier section, the transport sector was one of the sectors most heavily impacted by COVID-19. Going forward, many CE strategies could be adopted as part of building a resilient transport sector. Development of compact city for effective mobility given their attributes in terms of being dense with mixed-use neighbourhoods and transit-oriented ( EMF, 2019 ), can create an enabling environment for both shared mobility options (e.g. trams, buses, ride-shares) and active mobility options (e.g. bicycling, walking) ( Chi et al., 2020 ; Shaheen and Cohen, 2020 ). This will help to re-organize urban fabric and promote intelligent use of transportation infrastructures ( Marcucci et al., 2017 ). However, the behavioural change embedded in “social distancing”, which is necessary to limit the contagion, may affect the perception of many urban dwellers about this. On the other hand, less compact cities require increased mobility infrastructure with a corresponding increase in operational vehicle use, leading to more traffic congestion, energy and resource depletion as well as pollution ( UN Habitat, 2013 ).
The use of urban freight strategies for effective reverse logistics and resource flows is also a viable CE strategy for the transport sector ( EMF, 2019 ) as it enables the provision of services in a manner that also supports similar priorities for economic growth, air quality, environmental noise and waste management ( Akgün et al., 2019 ; Kiba-Janiak, 2019 ). Beyond vehicles and infrastructure, the adoption of these strategies can enable the development of new technologies and practices such as virtualisation of products, digital manufacturing, waste collection, and sorting systems. Interestingly, innovative environmentally-friendly logistics solutions resting on the backbone of the CE framework are already materializing and being trialled in various capacities, including: urban consolidation centre (UCC) ( Johansson and Björklund, 2017 ), crowshipping ( Buldeo Rai et al., 2017a ; Rai et al., 2018 ) and off-hour delivery ( Gatta et al., 2019 ). UCC stresses the use of logistics facilities in city suburbs to ease good deliveries to customers ( Browne et al., 2005 ), while crowshipping is a collaborative measure that employs the use of free mobility resources to perform deliveries ( Buldeo Rai et al., 2017b ).
The availability of rich transport data (e.g. impacts of events on transport, commuter habits) and AI-enabled complex data processing technologies can be leveraged to inform the planning, management, and operations of transport networks over time. Real-time data can also be adopted for monitoring and for instant regulations of traffic flow based on route planning, dynamic pricing and parking space allocation. Noticeably, many of these innovative CE-related initiatives still need an efficient governance mechanism ( Janné and Fredriksson, 2019 ). However, coupling them with the deployment of environmentally efficient vehicles and superior technical solutions hinging on the internet-of-things will bring many nations closer to reaping the benefits of CE. Given that urban planning is most often within the remit of governmental agencies, they must therefore develop integrated pathways and strategies for urban mobility to ensure effective logistics and resource flows. Stakeholder engagements within the transport sector can also facilitate innovative solutions that enable better use of assets and big data solutions.
6.6. Sustaining improvements in air quality
Improvements in air quality is one of the positives recorded due to the COVID-19-imposed lockdown as transportation and industrial activities halted. To sustain such improvements, there is the need to facilitate a step change by ramping up the uptake of low emission vehicles through setting more ambitious targets for the embrace of electric vehicles, constructing more electric car charging points as well as encouraging low emissions fuels. This entails heightening investments in cleaner means of public transportation as well as foot and cycle paths for health improvements; redesigning of cities to ensure no proximity to highly polluting roads and the populace as well as preventing highly polluting vehicles from accessing populated areas using classifications such as clear air or low emission zones ( PHE, 2020 ).
Batteries constitute an integral part towards the decarbonisation of road transportation and support the move to a renewable energy system ( World Economic Forum, 2019 ). As such, it is important to establish a battery value chain that is circular, responsible and just, to realise the aforementioned transitions. This entails the identification of the ( World Economic Forum, 2019 ): (i) challenges inhibiting the scaling up of the battery value chain (e.g. battery production processes, risks of raw materials supplies); (ii) levers to mitigate the challenges such as a circular value chain (e.g. design for life extension, implementation of V1G and V2G and scaling up of electric shared and pooled mobility, coupling the transport and power sectors); sustainable business and technology (e.g. increasing the share of renewables and energy efficiency measures across the value chain, effective regulations and financial incentives to support value creation); and a responsible and just value chain based on a balanced view and interplay between environmental, social and economic factors. Indeed, cost-effective and sustainable batteries, as well as an enabling ecosystem for the deployment of battery-enabled renewable energy technologies backed with a dense infrastructure network for charging, will facilitate the transition towards broader acceptance of electric vehicles and by extension guarantees a sustained improvement in air quality ( Masiero et al., 2017 ; PHE, 2020 ; World Economic Forum, 2019 ).We recognize that if all cars are simply replaced by electricones, there will still be the same volume of traffic and an increased need for raw materials, posing significant social, environmental and integrity risks across its value chain. However, CE through the aforementioned levers can address these challenges and support the achievement of a sustainable battery value chain. This will entail lowering emission during manufacturing, eradicating human rights violations, ensuring safe working conditions across the value chain and improving reuse, recycling and remanufacturing ( World Economic Forum, 2019 ).
6.7. Digitalisation for supply chain resilience post COVID-19
Digitalisation of supply chains through leveraging disruptive digital technologies (DDTs) - technologies or tools underpinning smart manufacturing such as the Internet of Things (IoT), artificial intelligence, big data analytics, cloud computing and 3D printing - constitute an important step for companies to prepare for and mitigate against the disruptions and attain business resilience amidst global pandemics such as COVID-19. Circular supply chain value drivers’ entails elongation of useful lifespan and maximisation of asset utilisation. Intelligent assets value drivers entail gathering knowledge regarding the location, condition and availability of assets ( Morlet et al., 2016 ). Paring these drivers could provide a broad range of opportunities, which could change the nature of both products and business models, enabling innovation and value creation ( Antikainen et al., 2018 ; Morlet et al., 2016 ). For instance, big data analytics, when adopted properly can aid companies in streamlining their supplier selection processes; cloud-computing is currently being used to facilitate and manage supplier relationships; through automation and the IoT, logistics and shipping processes can be greatly enhanced ( McKenzie, 2020 ). Digitalisation enables predictive maintenance, preventing failures while extending the lifespan of a product across the supply chains. It therefore, constitutes an ideal vehicle for circular supply chains transitioning, providing opportunities to close material loops and improve processes ( Morlet et al., 2016 ; Pagoropoulos et al., 2017 ).
Indeed, COVID-19 has prompted renewed urgency in the adoption of automation and robotics towards mitigating against the disruptive impact on supply chains through restrictions imposed on people's movement. Numerous companies are taking advantage of this to automate their production lines. Prior to COVID-19, momentum towards adopting 5G mobile technology was mounting but delays caused by factors including anticipated use evaluations, security, competition and radio communications regulatory issues limited progress ( McKenzie, 2020 ). It is likely that the experience of COVID-19 may accelerate the provision of regulatory certainty for 5G, which will in turn fast-track the deployment of IoT-enabled devices for remote monitoring, to support supply chain resilience post COVID-19.
Despite the benefits of DDTs, tension exists between their potential benefits (i.e. ability to deliver measurable environmental benefits at an affordable cost), and the problems (i.e. heavy burden imposed during manufacturing and disposal phases of their lifecycle) they constitute, creating rebound effects. As such, the tension between the push for increasing digitalisation and the associated energy costs and environmental impacts should be investigated such that they do not exacerbate the existing problems of resource use and pollution caused by rapid obsolescence and disposal of products containing such technologies. This entails identifying, mapping and mitigating unintended consequences across their supply chains, whilst taking into account technological design embedded within green ethical design processes, to identify environmental sustainability hotspots, both in conception, application and end of life phases.
6.8. Policy measures, incentives and regulatory support for CE transitioning
Becque et al. (2016) in their analysis of the political economy of the CE identified six main types of policy intervention to facilitate, advance and guide the move to a CE by addressing either barriers that aim to fix the market and regulatory failures or encourage market activity. Some of the policy intervention options identified include: (i) education, information and awareness that entails the integration of CE and lifecycle systems thinking into educational curricula supported by public communication and information campaigns; (ii) setting up platforms for collaboration including public-private partnerships with ventures at the local, regional and national levels, encouraging information sharing as well as value chain and inter-sectoral initiatives, establishing research and development to facilitate breakthroughs in materials science and engineering, biomaterials systems etc.; (iii) introduction of sustainability initiatives in public procurement and infrastructure ; (iv) provision of business/financial/technical support schemes such as initial capital outlay, incentive programs, direct subsidies and financial guarantees as well as technical support, training, advice and demonstration of best practices; (v) regulatory frameworks such as regulation of products (including design), extension of warranties and product passports; strategies for waste management including standards and targets for collection and treatments, take-back systems and extended producer responsibility; strategies at the sectoral levels and associated targets for resource productivity and CE; consumer, competition, industry and trade regulations; introduction of standard carbon accounting standards and methodologies; and (vi) fiscal frameworks such as reductions of VAT or excise tax for products and services designed with CE principles.
7. Conclusion
COVID-19 has highlighted the environmental folly of ‘extract-produce-use-dump’ economic model of material and energy flows. Short-term policies to cope with the urgency of the pandemic are unlikely to be sustainable models in the long run. Nonetheless, they shed light on critical issues that deserve emphases, such as the clear link between environmental pollution and transportation/industrialization. The role of unrestricted air travel in spreading pandemics particularly the viral influenza types (of which COVID-19 is one) is not in doubt, with sectors like tourism and aviation being walloped (some airlines may never recover or return to profitability in a long time) due to reduced passenger volumes. The fallout will re-shape the aviation sector, which like tourism has been among the hardest to be hit economically, albeit with desirable outcomes for the reduction in adverse environmental impacts. Peer-to-peer (P2P) or sharing economy models (e.g. Uber, Airbnb) which have birthed a new generation of service providers and employees are found to be non-resilient to global systemic shocks.
The urgency of supply and demand led to a reduction in cargo shipping in favour of airfreights whose transatlantic cost/kg tripled overnight. This is matched by job losses, income inequalities, mass increase in global poverty levels and economic shocks across industries and supply chains. The practicability of remote working (once the domain of technology/service industries) has been tried and tested for specific industries/professions with its associated impacts on reduced commuting for workers. Remote healthcare/telemedicine/ and remote working, in general, is no longer viewed as unfeasible because it has been practiced with success over the best part of a four-month global lockdown period. There was a corresponding reduction in primary energy consumption due to the slowing and shutting down of production and economic activities, and the delivery of education remotely is also no longer questioned. The potential of automation, IoT, and robotics in improving manufacturing processes, as well as the use of cloud computing and big data analytics in streamlining supplier selection processes and management of supplier relationships and logistics are now better appreciated.
The inadequacies of modern healthcare delivery systems to cope with mass casualties and emergencies are universally acknowledged, primarily due to the incapacity of hospital JIT procurement process to provide essential medical and emergency supplies in vast quantities at short notice. This had deadly consequences with thousands of patients and healthcare workers paying the ultimate price for lack of planning and shortfalls in PPE inventory and critical care equipment. Protectionism and in-ward looking policies on exports and tariff reductions/waivers on the importation of raw materials and critical PPE have emphasized the importance of cooperation to cope with shortages, which evolved in tandem with profiteering, thereby emphasizing the role/need for cottage industries to help meet global production of essentials (facemasks, 3D printed parts/equipment, etc.). The increase in infectious hospital wastes due to the pandemic was necessitated by precautionary measures to control the transmission, but proper/advanced sterilization procedures via thermal, microwave, biochemical processes can help in upcycling discarded or retrieved materials and PPE.
Changes in consumer behaviour with social distancing have necessitated a huge increase in online purchasing, which has benefitted the big players but seriously harmed SMEs, who were not exploiting web-based product and service delivery. A CE-based resilience of the consumer food sector was found to require: (i) closing nutrient loops with the use of regenerative agriculture; (ii) value recovery from organic nutrients via anaerobic digestion facilities; (iii) adoption of urban and peri-urban agriculture; and (iv) expanding food collection, redistribution and volarisation facilities. It is believed that CE will facilitate a socially just and inclusive society,driven by the need for resilience and sustainability goals, which could see a rise in bio-economy and sharing economy (SE). The consequences of these would be felt in terms of global cooperation and mutual interests; long-term planning as well as the need to strike an optimum balance between dependence on outsourcing/importation and local manufacturing/productivity. A realignment of value chains is likely to occur because of countries with raw materials exploiting this pandemic for their sustainable growth, and a new world order not shaped by the technological superiority of super-powers is likely to emerge.
During the lockdown, offices and commercial spaces were massively underutilized and the need to increase ventilation rates, e.g. in hospitals is leading to more energy consumption. However, there are opportunities to (re)design buildings to have movable walls for adaptable use. The use of modular techniques for fast construction of buildings that can be disassembled and re-configured for new needs, as demonstrated in China, is likely to increase. Renovation and refurbishment will witness a renewed vigour as existing buildings get a new lease of life with reduced carbon emissions and new jobs being created. Nonetheless, integrating circularity (product durability, energy efficiency, recyclability, etc.) via design thinking is essential from the onset if all these potential benefits are to be achieved. Digital technologies will play a crucial role in ensuring the low carbon and energy-efficient future of the built environment.
Governments are recognizing the need for national-level CE policies in many aspects, such as: (a) reducing over-reliance on other manufacturing countries for essential goods as massive shortages forced the unwitting adoption of CE principles such as re-use; (b) intensive research into bio-based materials for the development of biodegradable products and the promotion of bio-economy; (c) legal framework for local, regional and national authorities to promote green logistics and waste management regulations which incentivize local production and manufacturing; and (d) development of compact smart cities for effective mobility (with social distancing considerations) as well as enabling environment for shared mobility options (e.g. ride-shares) and active mobility options (e.g. bicycling, walking).
Going forward, resilience thinking should guide lessons learnt and innovations emanating from circular thinking should target the general well-being of the populace and not merely focus on boosting the competitiveness, profitability or growth of businesses and national economies. The post-COVID-19 investments needed to accelerate towards more resilient, low carbon and circular economies should also be integrated into the stimulus packages for economic recovery being promised by governments, since the shortcomings in the dominant linear economic model are now recognized and the gaps to be closed are known.
Credit author statement
IMT, MKB and GJ conceived the idea. IMT developed the methodological notes. IMT, MKB, AZ & FH conducted the analysis. IMT, MKB, AZ, BKA, ADD, AA and FH designed the structure and outline of the paper. All authors contributed to the writing the paper, with comments and feedback from GJ and KSCL.
Declaration of Competing Interest
- Abbas Elmualim S.M., Chileshe N., Rameezdeen R. Construction and the circular economy: smart and industrialised prefabrication. Unmak. Waste Product. Consump. 2018:323. [ Google Scholar ]
- ACI Policy Brief – COVID-19: Relief measures to ensure the survival of the airport industry. Airport Council Int. 2020 [ Google Scholar ]
- Acquaye A., Feng K., Oppon E., Salhi S., Ibn-Mohammed T., Genovese A., Hubacek K. Measuring the environmental sustainability performance of global supply chains: A multi-regional input-output analysis for carbon, sulphur oxide and water footprints. J. Environ. Manag.187. 2017:571–585. [ PubMed ] [ Google Scholar ]
- Ahmed F., Ahmed N.e., Pissarides C., Stiglitz J. Why inequality could spread COVID-19. The Lancet Public Health. 2020; 5 :e240. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Air Transport Bureau . International Civil Aviation Organization (ICAO); Montréal, Canada: 2020. Effects of Novel Coronavirus (COVID‐19) on Civil Aviation: Economic Impact Analysis. [ Google Scholar ]
- Akgün E.Z., Monios J., Rye T., Fonzone A. Influences on urban freight transport policy choice by local authorities. Transport Policy. 2019; 75 :88–98. [ Google Scholar ]
- Allan J., Donovan C., Ekins P., Gambhir A., Hepburn C., Robins N., Reay D., Shuckburgh E., Zenghelis D. A net-zero emissions economic recovery from COVID-19. COP26 Univ. Netw. Brief. 2020 April. [ Google Scholar ]
- Allison A.L., Ambrose-Dempster E., Domenech Aparsi T., Bawn M., Casas Arredondo M., Chau C., Chandler K., Dobrijevic D., Hailes H.C., Lettieri P. The environmental dangers of employing single-use face masks as part of a COVID-19 exit strategy. UCL Open. 2020 Preprint. [ Google Scholar ]
- American Geriatrics Society American Geriatrics Society (AGS) policy brief: COVID‐19 and nursing homes. J. American Geriatrics Society. 2020 [ Google Scholar ]
- Anderson R.M., Heesterbeek H., Klinkenberg D., Hollingsworth T.D. How will country-based mitigation measures influence the course of the COVID-19 epidemic? The Lancet. 2020; 395 :931–934. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Andrew A., Armand A., Augsburg B., Taveras I.K. Challenges of adopting coronavirus precautions in low-income countries. The IFS, Inst. Fiscal Stud. 2020 [ Google Scholar ]
- Ang B.W. The LMDI approach to decomposition analysis: a practical guide. Energy Policy33. 2005:867–871. [ Google Scholar ]
- Antikainen M., Uusitalo T., Kivikytö-Reponen P. Digitalisation as an enabler of circular economy. Procedia CIRP. 2018; 73 :45–49. [ Google Scholar ]
- Arafat S.Y., Kar S.K., Marthoenis M., Sharma P., Apu E.H., Kabir R. Psychological underpinning of panic buying during pandemic (COVID-19) Psychiatry Res. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Ardente F., Beccali M., Cellura M., Mistretta M. Energy and environmental benefits in public buildings as a result of retrofit actions. Renew. Sustain. Energy Rev.15. 2011:460–470. [ Google Scholar ]
- Artola I., Rademaekers K., Williams R., Yearwood J. Study for the iTRE Committee, Commissioned by DG for Internal Policies Policy Department A. Vol. 72. 2016. Boosting building renovation: What potential and value for Europe. [ Google Scholar ]
- ARUP . ARUP; 2020. Transform and Reuse:Low-Carbon Futures for Existing Buildings. [ Google Scholar ]
- Atelge M., Atabani A., Banu J.R., Krisa D., Kaya M., Eskicioglu C., Kumar G., Lee C., Yildiz Y., Unalan S. A critical review of pretreatment technologies to enhance anaerobic digestion and energy recovery. Fuel. 2020; 270 [ Google Scholar ]
- Aubrecht, P., Essink, J., Kovac, M., Vandenberghe, A.-S., 2020. Centralized and decentralized responses to COVID-19 in federal systems: US and EU comparisons. Available at SSRN 3584182.
- Auffhammer M., Burke M., Burney J., Hsiang S., Lobell D., Roberts M., Schlenker W. COVID-19 reduces economic activity, which reduces pollution, which saves lives. Global Food, Environment and Economic Dynamics (G-FEED), United States. 2020 [ Google Scholar ]
- Ayambire R.A., Amponsah O., Peprah C., Takyi S.A. A review of practices for sustaining urban and peri-urban agriculture: Implications for land use planning in rapidly urbanising Ghanaian cities. Land Use Policy. 2019; 84 :260–277. [ Google Scholar ]
- Bachman D. COVID-19 could affect the global economy in three main ways. Deloitte. 2020 [ Google Scholar ]
- Baker S.R., Bloom N., Davis S.J., Terry S.J. National Bureau of Economic Research; 2020. Covid-induced economic uncertainty. [ Google Scholar ]
- Baldwin R., Evenett S. CEPR Press; London: 2020. Covid-19 and Trade Policy: Why turning inward won't work. [ Google Scholar ]
- Baseler L., Chertow D.S., Johnson K.M., Feldmann H., Morens D.M. The pathogenesis of ebola virus disease. Annu. Rev. Pathol. 2017; 12 :387–418. [ PubMed ] [ Google Scholar ]
- Basilaia G., Kvavadze D. Transition to Online Education in Schools during a SARS-CoV-2 Coronavirus (COVID-19) Pandemic in Georgia. Pedag. Res.5. 2020 [ Google Scholar ]
- Bauwens T., Hekkert M., Kirchherr J. Circular futures: what will they look like? Ecol. Econ.175. 2020 [ Google Scholar ]
- Bayram M., Springer S., Garvey C.K., Özdemir V. COVID-19 digital health innovation policy: A portal to alternative futures in the making. OMICS J. Integrat. Biol. 2020 [ PubMed ] [ Google Scholar ]
- Becque, R., Roy, N., Hamza-Goodacre, D., 2016. The Political Economy of the Circular Economy-lessons to date and questions for research. San Francisco, pp. 1-16.
- Beretta C., Hellweg S. Potential environmental benefits from food waste prevention in the food service sector. Resour. Conserv. Recycl.147. 2019:169–178. [ Google Scholar ]
- Bloom D.E., Cadarette D. Infectious disease threats in the 21st century: strengthening the global response. Front. Immunol.10. 2019:549. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Bloom D.E., Canning D. Epidemics and economics. Interact. Glob. Chang. Hum. Health Scripta Varia. 2004; 106 :304–331. [ Google Scholar ]
- Bocken N.M., De Pauw I., Bakker C., van der Grinten B. Product design and business model strategies for a circular economy. J. Indust. Prod. Eng.33. 2016:308–320. [ Google Scholar ]
- Bown C.P. A CEPR Press; 2020. COVID-19: Demand spikes, export restrictions, and quality concerns imperil poor country access to medical supplies. VoxEU.org eBook, 31. [ Google Scholar ]
- Bradsher K., Alderman L. New York Times; 2020. The world needs masks. China makes them, but has been hoarding them. [ Google Scholar ]
- Bramanti B., Dean K.R., Walloe L., Chr Stenseth N. The third plague pandemic in Europe. Proc. Biol. Sci. 2019; 286 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Braungart M., McDonough W., Bollinger A. Cradle-to-cradle design: creating healthy emissions – a strategy for eco-effective product and system design. J. Clean. Prod.15. 2007:1337–1348. [ Google Scholar ]
- Bretscher, L., Hsu, A., Tamoni, A., 2020. The supply channel of uncertainty shocks and the cross-section of returns: evidence from the COVID-19 crisis. Available at SSRN 3588418.
- Browne M., Sweet M., Woodburn A., Allen J. Vol. 10. Transport Studies Group, University of Westminster; 2005. (Urban freight consolidation centres final report). [ Google Scholar ]
- Buldeo Rai H., Verlinde S., Merck J., Macharis C. Crowd logistics: an opportunity for more sustainable urban freight transport? Eur. Transp. Res. Rev. 2017; 9 (39) [ Google Scholar ]
- Buldeo Rai H., Verlinde S., Merckx J., Macharis C. Crowd logistics: an opportunity for more sustainable urban freight transport? Eur. Transp. Res. Rev.9. 2017:39. [ Google Scholar ]
- Carra G., Magdani N. Circular business models for the built environment. Arup BAM. 2017:1–44. [ Google Scholar ]
- Carrillo-Hermosilla J., Del Río P., Könnölä T. Diversity of eco-innovations: Reflections from selected case studies. J. Clean. Prod.18. 2010:1073–1083. [ Google Scholar ]
- Castañé S., Antón A. Assessment of the nutritional quality and environmental impact of two food diets: A Mediterranean and a vegan diet. J. Clean. Prod.167. 2017:929–937. [ Google Scholar ]
- Chandra, S., 2020. Speed, space and sustainability (3S) in transportation amid COVID-19 crisis. SSRN 3598501.
- Chang H.-H., Meyerhoefer C. National Bureau of Economic Research; 2020. COVID-19 and the Demand for Online Food Shopping Services: Empirical Evidence from Taiwan. [ Google Scholar ]
- Chen C., Zhao B. Makeshift hospitals for COVID-19 patients: where health-care workers and patients need sufficient ventilation for more protection. J. Hosp. Infect.105. 2020:98–99. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Chi M., George J.F., Huang R., Wang P. Unraveling sustainable behaviors in the sharing economy: An empirical study of bicycle-sharing in China. J. Clean. Prod. 2020 [ Google Scholar ]
- Cimprich A., Santillán‐Saldivar J., Thiel C.L., Sonnemann G., Young S.B. Potential for industrial ecology to support healthcare sustainability: Scoping review of a fragmented literature and conceptual framework for future research. J. Indust. Ecol.23. 2019:1344–1352. [ Google Scholar ]
- Clair A. Social Market Foundation (SMF); 2020. Homes, health, and COVID-19: how poor housing adds to the hardship of the coronavirus crisis. Online. [ Google Scholar ]
- Company M. A global view of how consumer behavior is changing amid COVID-19. McKinsey. 2020 [ Google Scholar ]
- Da Silva C., Hoppe A., Ravanello M., Mello N. Medical wastes management in the south of Brazil. Waste Manag.25. 2005:600–605. [ PubMed ] [ Google Scholar ]
- Danieli, A., Olmstead-Rumsey, J., 2020. Sector-specific shocks and the expenditure elasticity channel during the covid-19 crisis. Available at SSRN 3593514.
- Dannenberg, P., Fuchs, M., Riedler, T., Wiedemann, C., 2020. Digital transition by COVID‐19 pandemic? The German food online retail. Tijdschrift voor economische en sociale geografie. [ PMC free article ] [ PubMed ]
- Dargaville T., Spann K., Celina M. Opinion to address a potential personal protective equipment shortage in the global community during the COVID-19 outbreak. Polym. Degrad. Stab. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Daszak P. Anatomy of a pandemic. The Lancet. 2012; 380 :1883–1884. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- De Cock K.M., Jaffe H.W., Curran J.W. The evolving epidemiology of HIV/AIDS. Aids. 2012; 26 :1205–1213. [ PubMed ] [ Google Scholar ]
- De Gioannis G., Muntoni A., Polettini A., Pomi R., Spiga D. Energy recovery from one-and two-stage anaerobic digestion of food waste. Waste Manag.68. 2017:595–602. [ PubMed ] [ Google Scholar ]
- De Jesus A., Mendonça S. Lost in transition? Drivers and barriers in the eco-innovation road to the circular economy. Ecol. Econ.145. 2018:75–89. [ Google Scholar ]
- De Soete W., Jiménez-González C., Dahlin P., Dewulf J. Challenges and recommendations for environmental sustainability assessments of pharmaceutical products in the healthcare sector. Green Chem.19. 2017:3493–3509. [ Google Scholar ]
- Deloitte . Deloitte; 2020. Understanding the sector impact of COVID-19: Engineering and Construction sector; p. 2. [ Google Scholar ]
- Devakumar D., Shannon G., Bhopal S.S., Abubakar I. Racism and discrimination in COVID-19 responses. The Lancet. 2020; 395 :1194. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Diaz L.F., Eggerth L., Enkhtsetseg S., Savage G. Characteristics of healthcare wastes. Waste Manag.28. 2008:1219–1226. [ PubMed ] [ Google Scholar ]
- Dilkes-Hoffman L.S., Lane J.L., Grant T., Pratt S., Lant P.A., Laycock B. Environmental impact of biodegradable food packaging when considering food waste. J. Clean. Prod.180. 2018:325–334. [ Google Scholar ]
- Dingel J.I., Neiman B. National Bureau of Economic Research; 2020. How many jobs can be done at home? [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Duflou J.R., Sutherland J.W., Dornfeld D., Herrmann C., Jeswiet J., Kara S., Hauschild M., Kellens K. Towards energy and resource efficient manufacturing: A processes and systems approach. CIRP Anna.61. 2012:587–609. [ Google Scholar ]
- Duncan-Jones R.P. The impact of the Antonine plague. J. Roman Arch.9. 1996:108–136. [ Google Scholar ]
- Eaton J., Connor Y. How to strengthen your supply chain in the face of COVID-19 disruption: 8 Lessons for strengthening your supply chain today. Grant Thornton. 2020 Online. [ Google Scholar ]
- Eberhardt L.C.M., Birgisdottir H., Birkved M. IOP Conference Series: Materials Science and Engineering. IOP Publishing; 2019. Potential of circular economy in sustainable buildings. [ Google Scholar ]
- EEA . Vol. 2020. Publications Office of the European Union; Luxembourg: 2020. pp. 1–104. (Environmental noise in Europe — 2020. European Environment Agency (EEA)). [ Google Scholar ]
- Ekins, P., Hughes, N., Brigenzu, S., Arden Clark, C., Fischer-Kowalski, M., Graedel, T., Hajer, M., Hashimoto, S., Hatfield-Dodds, S., Havlik, P., 2016. Resource efficiency: Potential and economic implications.
- Eleyan D., Al-Khatib I.A., Garfield J. System dynamics model for hospital waste characterization and generation in developing countries. Waste Manag. Res.31. 2013:986–995. [ PubMed ] [ Google Scholar ]
- EMF . Ellen MacArthur Foundation; London: 2016. Circular economy in India: Rethinking growth for long-term prosperity; p. 86. [ Google Scholar ]
- EMF . Ellen MacArthur Foundation; 2019. Planning effective transport of people, products and materials; p. 6. [ Google Scholar ]
- EMF . Ellen MacArthur Foundation; 2020. 10 circular investment opportunities to build back better: food sector; p. 13. [ Google Scholar ]
- EMF . Ellen MacArthur Foundation; London: 2020. 10 circular investment opportunities to build back better: The built environment; p. 10. [ Google Scholar ]
- Enkvist P., Klevnäs P., Teiwik A., Jönsson C., Klingvall S., Hellberg U. Material Economics Sverige AB; Stockholm, Sweden: 2018. The circular economy–a powerful force for climate mitigation: transformative innovation for prosperous and low-carbon industry. [ Google Scholar ]
- EPRS . European Parliamentary Research Service (EPRS); 2014. Urban And Peri-Urban Agriculture. [ Google Scholar ]
- ESA . European Space Agency (ESA); 2020. Air pollution remains low as Europeans stay at home. Online. [ Google Scholar ]
- European Commission . European Commission; 2011. The Roadmap to a Resource Efficient Europe; p. 26. [ Google Scholar ]
- European Commission . European Commission; 2020. EU Circular Economy Action Plan: A new Circular Economy Action Plan for a Cleaner and More Competitive Europe. [ Google Scholar ]
- Evenett S.J. Flawed prescription: Export curbs on medical goods won't tackle shortages. COVID-19 and Trade Policy: Why Turning Inward Won't Work. 2020; 49 [ Google Scholar ]
- Fast Company . Fast Company; 2019. Is it possible to raise a carbon-neutral cow? [ Google Scholar ]
- Feber D., Lingqvist O., Nordigården D. McKinsey & Company McKinsey & Company; 2020. Shaping the next normal of packaging beyond COVID-19; p. 6. [ Google Scholar ]
- Feng K., Davis S.J., Sun L., Hubacek K. Drivers of the US CO2 emissions 1997-2013. Nat. Commun.6. 2015 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Fernandes, N., 2020. Economic effects of coronavirus outbreak (COVID-19) on the world economy. Available at SSRN 3557504.
- Fischer R., Morris D.H., van Doremalen N., Sarchette S., Matson J., Bushmaker T., Yinda C.K., Seifert S., Gamble A., Williamson B. Assessment of N95 respirator decontamination and re-use for SARS-CoV-2. medRxiv. 2020 [ Google Scholar ]
- Ford T.E., Colwell R.R., Rose J.B., Morse S.S., Rogers D.J., Yates T.L. Using satellite images of environmental changes to predict infectious disease outbreaks. Emerg. Infect. Dis.15. 2009:1341. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Friant M.C., Vermeulen W.J., Salomone R. A typology of circular economy discourses: Navigating the diverse visions of a contested paradigm. Resour. Conserv. Recycl.161. 2020 [ Google Scholar ]
- Fujii H., Managi S., Kaneko S. Decomposition analysis of air pollution abatement in China: empirical study for ten industrial sectors from 1998 to 2009. J. Clean. Prod.59. 2013:22–31. [ Google Scholar ]
- Galvão G.D.A., Homrich A.S., Geissdoerfer M., Evans S., Ferrer P.S.s., Carvalho M.M. Towards a value stream perspective of circular business models. Resour. Conserv. Recycl.162. 2020 [ Google Scholar ]
- Gates B. COVID-19 is awful. Climate change could be worse. Clim. Coronavirus. 2020 GatesNotes. [ Google Scholar ]
- Gates B. Responding to Covid-19—a once-in-a-century pandemic? N. Engl. J. Med.382. 2020:1677–1679. [ PubMed ] [ Google Scholar ]
- Gatta V., Marcucci E., Delle Site P., Le Pira M., Carrocci C.S. Planning with stakeholders: Analysing alternative off-hour delivery solutions via an interactive multi-criteria approach. Res. Transp. Econ.73. 2019:53–62. [ Google Scholar ]
- Geissdoerfer M., Savaget P., Bocken N.M., Hultink E.J. The Circular Economy–A new sustainability paradigm? J. Clean. Prod.143. 2017:757–768. [ Google Scholar ]
- Gibbs M.J., Armstrong J.S., Gibbs A.J. Recombination in the hemagglutinin gene of the 1918" Spanish flu". Science. 2001; 293 :1842–1845. [ PubMed ] [ Google Scholar ]
- Girling R. Random House; 2011. Rubbish!: Dirt on Our Hands and Crisis Ahead. [ Google Scholar ]
- Gondi S., Beckman A.L., Deveau N., Raja A.S., Ranney M.L., Popkin R., He S. Personal protective equipment needs in the USA during the COVID-19 pandemic. The Lancet. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Gopinath G. Limiting the economic fallout of the coronavirus with large targeted policies. IMF. 2020 [ Google Scholar ]
- Govindan K., Hasanagic M. A systematic review on drivers, barriers, and practices towards circular economy: a supply chain perspective. Int. J. Prod. Res.56. 2018:278–311. [ Google Scholar ]
- Grant M.J., Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Inform. Libr. J.26. 2009:91–108. [ PubMed ] [ Google Scholar ]
- Greenhalgh T., Thorne S., Malterud K. Time to challenge the spurious hierarchy of systematic over narrative reviews? Eur. J. Clin. Invest. 2018; 48 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Guan, D., Hallegatte, S., 2020. The containment divide: COVID-19 lockdowns and basic needs in developing countries.
- Guan, D., Wang, D., Hallegatte, S., Huo, J., Li, S., Bai, Y., Lei, T., Xue, Q., Davis, S.J., Coffman, D.M., 2020. Global economic footprint of the COVID-19 pandemic.
- Guerrieri V., Lorenzoni G., Straub L., Werning I. National Bureau of Economic Research; 2020. Macroeconomic Implications of COVID-19: Can Negative Supply Shocks Cause Demand Shortages? [ Google Scholar ]
- Gungor A., Gupta S.M. Issues in environmentally conscious manufacturing and product recovery: a survey. Comp. Indust. Eng.36. 1999:811–853. [ Google Scholar ]
- Haigh, L., Bäunker, L., 2020. Covid-19 and the circular economy: opportunities and reflections.
- Hasanat M.W., Hoque A., Shikha F.A., Anwar M., Hamid A.B.A., Tat H.H. The impact of coronavirus (Covid-19) on e-business in Malaysia. Asian J. Multidiscipl. Stud.3. 2020:85–90. [ Google Scholar ]
- Herrmann C., Schmidt C., Kurle D., Blume S., Thiede S. Sustainability in manufacturing and factories of the future. Int. J. Precis. Eng. Manuf.-Green Tech.1. 2014:283–292. [ Google Scholar ]
- Hobbs J.E. Food supply chains during the COVID‐19 pandemic. Can. J. Agricult. Econ./Revue canadienne d’agroeconomie. 2020 [ Google Scholar ]
- Hockley L. Coronavirus roundtable: How is the aviation industry responding to the COVID-19 pandemic? Int. Airport Rev. 2020 Online. [ Google Scholar ]
- Hoornweg, D., Bhada-Tata, P., 2012. What a waste: a global review of solid waste management.
- Horrox R. Manchester University Press; 2013. The Black Death. [ Google Scholar ]
- Hotez P.J., Alvarado M., Basáñez M.-G., Bolliger I., Bourne R., Boussinesq M., Brooker S.J., Brown A.S., Buckle G., Budke C.M. The global burden of disease study 2010: interpretation and implications for the neglected tropical diseases. PLoS Neglect. Tropic. Dis.8. 2014 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Hu M.R., Lee A.D. Airbnb, COVID-19 risk and lockdowns: global evidence. COVID-19 Risk Lockdowns Glob. Evid. 2020 (April 30, 2020) [ Google Scholar ]
- Huang W., Zhao Z., Yuan T., Huang W., Lei Z., Zhang Z. Low-temperature hydrothermal pretreatment followed by dry anaerobic digestion: A sustainable strategy for manure waste management regarding energy recovery and nutrients availability. Waste Manag.70. 2017:255–262. [ PubMed ] [ Google Scholar ]
- Hussey L.K., Arku G. Are we ready for it? Health systems preparedness and capacity towards climate change-induced health risks: perspectives of health professionals in Ghana. Clim. Dev.12. 2020:170–182. [ Google Scholar ]
- IATA Air transport & COVID-19 coronavirus. Int. Air Transp. Assoc. 2020 www.airlines.iata.org [ Google Scholar ]
- Ibn-Mohammed T. Application of mixed-mode research paradigms to the building sector: a review and case study towards decarbonising the built and natural environment. Sustain. Cities Soc.35. 2017:692–714. [ Google Scholar ]
- Ibn-Mohammed T., Greenough R., Taylor S., Ozawa-Meida L., Acquaye A. Operational vs. embodied emissions in buildings—A review of current trends. Energy Build.66. 2013:232–245. [ Google Scholar ]
- Ibn-Mohammed T., Greenough R., Taylor S., Ozawa-Meida L., Acquaye A. Integrating economic considerations with operational and embodied emissions into a decision support system for the optimal ranking of building retrofit options. Build. Environ.72. 2014:82–101. [ Google Scholar ]
- Ibn-Mohammed T., Reaney I., Koh S., Acquaye A., Sinclair D., Randall C., Abubakar F., Smith L., Schileo G., Ozawa-Meida L. Life cycle assessment and environmental profile evaluation of lead-free piezoelectrics in comparison with lead zirconate titanate. J. Eur. Cer. Soc. 2018 [ Google Scholar ]
- ICAO Effects of novel coronavirus (COVID-19) on civil aviation: economic impact analysis. Unit. Aviat. 2020 [ Google Scholar ]
- IEA . International Energy Agency, IEA Publications; 2020. Global Energy Review 2020:The impacts of the COVID-19 crisis on global energy demand and CO2 emissions; pp. 1–56. [ Google Scholar ]
- Ijomah W.L. Proceedings of the Institution of Civil Engineers-Waste and Resource Management. Thomas Telford Ltd; 2010. The application of remanufacturing in sustainable manufacture; pp. 157–163. [ Google Scholar ]
- IMF . The International Monetary Fund (IMF); Washington, DC: 2020. World Economic Outlook: The Great Lockdown; p. 37. -37. [ Google Scholar ]
- Insa E., Zamorano M., López R. Critical review of medical waste legislation in Spain. Resour. Conserv. Recycl.54. 2010:1048–1059. [ Google Scholar ]
- Iyengar K., Bahl S., Vaishya R., Vaish A. Challenges and solutions in meeting up the urgent requirement of ventilators for COVID-19 patients. Diab. Metabol. Syndr. Clin. Res. Rev. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Jaeger B., Upadhyay A. Understanding barriers to circular economy: cases from the manufacturing industry. J. Enterp. Inform. Manag. 2020 [ Google Scholar ]
- Janné M., Fredriksson A. Construction logistics governing guidelines in urban development projects. Constr. Innov. 2019 [ Google Scholar ]
- Javorcik B. Global supply chains will not be the same in the post-COVID-19 world. COVID-19 and Trade Policy: Why Turning Inward Won't Work. 2020; 111 [ Google Scholar ]
- JHU . Coronavirus Resource Center, Johns Hopkins University (JHU); 2020. MAPS & TRENDS: New Cases of COVID-19 In World Countries. [ Google Scholar ]
- Johansson H., Björklund M. Urban consolidation centres: retail stores’ demands for UCC services. Int. J. Phys. Distrib. Logist. Manag. 2017 [ Google Scholar ]
- Kaiser B., Eagan P.D., Shaner H. Solutions to health care waste: life-cycle thinking and“ green” purchasing. Environ. Health Perspect.109. 2001:205–207. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Kanda W., Kivimaa P. What opportunities could the COVID-19 outbreak offer for sustainability transitions research on electricity and mobility? Energy Res. Soc. Sci.68. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Kane G.M., Bakker C.A., Balkenende A.R. Towards design strategies for circular medical products. Resour. Conserv. Recycl.135. 2018:38–47. [ Google Scholar ]
- Kiba-Janiak M. EU cities’ potentials for formulation and implementation of sustainable urban freight transport strategic plans. Transp. Res. Procedia. 2019; 39 :150–159. [ Google Scholar ]
- Kirchherr J., Piscicelli L., Bour R., Kostense-Smit E., Muller J., Huibrechtse-Truijens A., Hekkert M. Barriers to the circular economy: evidence from the European Union (EU) Ecol. Econ.150. 2018:264–272. [ Google Scholar ]
- Kirchherr J., Reike D., Hekkert M. Conceptualizing the circular economy: An analysis of 114 definitions. Resour. Conserv. Recycl.127. 2017:221–232. [ Google Scholar ]
- Klemeš J.J., Fan Y.V., Tan R.R., Jiang P. Minimising the present and future plastic waste, energy and environmental footprints related to COVID-19. Renew. Sustain. Energy Rev.127. 2020 -109883. [ Google Scholar ]
- Koh S., Ibn-Mohammed T., Acquaye A., Feng K., Reaney I., Hubacek K., Fujii H., Khatab K. Drivers of US toxicological footprints trajectory 1998–2013. Sci. Rep.6. 2016:39514. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Korhonen J., Honkasalo A., Seppälä J. Circular economy: the concept and its limitations. Ecol. Econ.143. 2018:37–46. [ Google Scholar ]
- Kraemer M.U., Yang C.-H., Gutierrez B., Wu C.-H., Klein B., Pigott D.M., du Plessis L., Faria N.R., Li R., Hanage W.P. The effect of human mobility and control measures on the COVID-19 epidemic in China. Science. 2020; 368 :493–497. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Laing T. The economic impact of the Coronavirus 2019 (Covid-2019): Implications for the mining industry. Extract. Indust. Soc. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Le Quéré C., Jackson R.B., Jones M.W., Smith A.J., Abernethy S., Andrew R.M., De-Gol A.J., Willis D.R., Shan Y., Canadell J.G. Temporary reduction in daily global CO 2 emissions during the COVID-19 forced confinement. Nat. Clim. Chang. 2020:1–7. [ Google Scholar ]
- Lee C., Huffman G., Nalesnik R. Medical waste management. Environ. Sci. Tech.25. 1991:360–363. [ Google Scholar ]
- Lee G.-G., Lee H.-W., Lee J.-H. Greenhouse gas emission reduction effect in the transportation sector by urban agriculture in Seoul, Korea. Landscape and Urban Plan.140. 2015:1–7. [ Google Scholar ]
- Lee J.-W., McKibbin W.J. National Academies Press; Washington, DC: 2004. Estimating the global economic costs of SARS, Learning from SARS: preparing for the next disease outbreak: workshop summary; p. 92. [ Google Scholar ]
- Liao L., Xiao W., Zhao M., Yu X., Wang H., Wang Q., Chu S., Cui Y. Can N95 respirators be reused after disinfection? How many times? ACS Nano. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Lieder M., Rashid A. Towards circular economy implementation: a comprehensive review in context of manufacturing industry. J. Clean. Prod.115. 2016:36–51. [ Google Scholar ]
- Littman R.J., Littman M.L. Galen and the Antonine plague. Am. J. Philol.94. 1973:243–255. [ PubMed ] [ Google Scholar ]
- Liu X., Zhang S. COVID‐19: Face masks and human‐to‐human transmission. Influen. Other Respir. Virus. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Livingston E., Desai A., Berkwits M. Sourcing personal protective equipment during the COVID-19 pandemic. JAMA. 2020 [ PubMed ] [ Google Scholar ]
- Lucrezi S., Saayman M., Van der Merwe P. An assessment tool for sandy beaches: A case study for integrating beach description, human dimension, and economic factors to identify priority management issues. Ocean Coast. Manag. 2016; 121 :1–22. [ Google Scholar ]
- Lwasa S., Mugagga F., Wahab B., Simon D., Connors J., Griffith C. Urban and peri-urban agriculture and forestry: Transcending poverty alleviation to climate change mitigation and adaptation. Urban Climate. 2014; 7 :92–106. [ Google Scholar ]
- Lyche, H., 2020. Might a disaster trigger a new circular-economy?
- Mabahwi N.A.B., Leh O.L.H., Omar D. Human health and wellbeing: Human health effect of air pollution. Procedia-Soc. Behav. Sci.153. 2014:221–229. [ Google Scholar ]
- MacArthur E. Ellen MacArthur Foundation; Cowes, UK: 2013. Towards the circular economy, economic and business rationale for an accelerated transition. [ Google Scholar ]
- Mahler D.G., Lakner C., Aguilar R.A.C., Wu H. World Bank; Washington, D.C., United States: 2020. The impact of COVID-19 (Coronavirus) on global poverty: Why Sub-Saharan Africa might be the region hardest hit. [ Google Scholar ]
- Manninen K., Koskela S., Antikainen R., Bocken N., Dahlbo H., Aminoff A. Do circular economy business models capture intended environmental value propositions? J. Clean. Prod.171. 2018:413–422. [ Google Scholar ]
- Marcucci E., Le Pira M., Carrocci C.S., Gatta V., Pieralice E. 2017 5th IEEE International Conference on Models and Technologies for Intelligent Transportation Systems (MT-ITS) IEEE; 2017. Connected shared mobility for passengers and freight: Investigating the potential of crowdshipping in urban areas; pp. 839–843. [ Google Scholar ]
- Marques G., Roque Ferreira C., Pitarma R. A system based on the internet of things for real-time particle monitoring in buildings. Int. J. Environ. Res. Public Health15. 2018 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Masiero G., Ogasavara M.H., Jussani A.C., Risso M.L. The global value chain of electric vehicles: A review of the Japanese, South Korean and Brazilian cases. Renew. Sustain. Energy Rev.80. 2017:290–296. [ Google Scholar ]
- McDonough W., Braungart M. North point press; 2010. Cradle to cradle: Remaking the way we make things. [ Google Scholar ]
- McKee M., Stuckler D. If the world fails to protect the economy, COVID-19 will damage health not just now but also in the future. Nat. Med.26. 2020:640–642. [ PubMed ] [ Google Scholar ]
- McKenzie B. Beyond COVID-19: supply chain resilience holds key to recovery. Oxford Econ.24. 2020:20. [ Google Scholar ]
- McKibbin, W.J., Fernando, R., 2020. The global macroeconomic impacts of COVID-19: Seven scenarios.
- Minunno R., O'Grady T., Morrison G.M., Gruner R.L., Colling M. Strategies for applying the circular economy to prefabricated buildings. Buildings. 2018; 8 :125. [ Google Scholar ]
- Moazzami B., Razavi-Khorasani N., Moghadam A.D., Farokhi E., Rezaei N. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J. Clin. Virol. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Monlau F., Sambusiti C., Antoniou N., Barakat A., Zabaniotou A. A new concept for enhancing energy recovery from agricultural residues by coupling anaerobic digestion and pyrolysis process. Appl. Energy. 2015; 148 :32–38. [ Google Scholar ]
- Morlet A., Blériot J., Opsomer R., Linder M., Henggeler A., Bluhm A., Carrera A. Ellen MacArthur Foundation; 2016. Intelligent assets: Unlocking the circular economy potential; pp. 1–25. [ Google Scholar ]
- Morrison A., Polisena J., Husereau D., Moulton K., Clark M., Fiander M., Mierzwinski-Urban M., Clifford T., Hutton B., Rabb D. The effect of English-language restriction on systematic review-based meta-analyses: a systematic review of empirical studies. Int. J. Tech. Assess. Health Care28. 2012:138. [ PubMed ] [ Google Scholar ]
- Muhammad S., Long X., Salman M. COVID-19 pandemic and environmental pollution: A blessing in disguise? Sci. Total Environ. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Murray N.E.A., Quam M.B., Wilder-Smith A. Epidemiology of dengue: past, present and future prospects. Clin. Epidemiol.5. 2013:299. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Naidoo R., Fisher B. Nature Publishing Group; 2020. Reset Sustainable Development Goals for a pandemic world. [ PubMed ] [ Google Scholar ]
- NASA . National Aeronautics and Space Administration (NASA); 2020. Airborne Nitrogen Dioxide Plummets Over China. Online. [ Google Scholar ]
- NASA . NASA; 2020. Airborne Particle Levels Plummet in Northern India. [ Google Scholar ]
- OECD . OECD; Paris: 2018. Financing Climate Futures - Rethinking Infrastructure. [ Google Scholar ]
- Omary M.B., Eswaraka J., Kimball S.D., Moghe P.V., Panettieri R.A., Scotto K.W. The COVID-19 pandemic and research shutdown: staying safe and productive. J. Clin. Invest.130. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Opitz I., Berges R., Piorr A., Krikser T. Contributing to food security in urban areas: differences between urban agriculture and peri-urban agriculture in the Global North. Agricult. Hum. Val.33. 2016:341–358. [ Google Scholar ]
- Oweis R., Al-Widyan M., Al-Limoon O. Medical waste management in Jordan: A study at the King Hussein Medical Center. Waste Manag.25. 2005:622–625. [ PubMed ] [ Google Scholar ]
- Özkan A. Evaluation of healthcare waste treatment/disposal alternatives by using multi-criteria decision-making techniques. Waste Manag. Res.31. 2013:141–149. [ PubMed ] [ Google Scholar ]
- Paez A. Gray literature: An important resource in systematic reviews. J. Evid.‐Based Med.10. 2017:233–240. [ PubMed ] [ Google Scholar ]
- Pagoropoulos A., Pigosso D.C., McAloone T.C. The emergent role of digital technologies in the Circular Economy: A review. Procedia CIRP. 2017; 64 :19–24. [ Google Scholar ]
- Partelow S., von Wehrden H., Horn O. Pollution exposure on marine protected areas: a global assessment. Mar. Pollut. Bull.100. 2015:352–358. [ PubMed ] [ Google Scholar ]
- Paxton, N.C., Forrestal, D.P., Desselle, M., Kirrane, M., Sullivan, C., Powell, S.K., Woodruff, M.A., 2020. N95 respiratory masks for COVID-19: a review of the literature to inform local responses to global shortages.
- Pearce J.M. A review of open source ventilators for COVID-19 and future pandemics. F1000Research. 2020; 9 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Peng J., Wu X., Wang R., Li C., Zhang Q., Wei D. Medical waste management practice during the 2019-2020 novel coronavirus pandemic: Experience in a general hospital. Am. J. Infect. Control. 2020 S0196-6553(0120)30351-30355. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Penn E., Yasso S.F., Wei J.L. Reducing disposable equipment waste for tonsillectomy and adenotonsillectomy cases. Otolaryngol.–Head and Neck Surg.147. 2012:615–618. [ PubMed ] [ Google Scholar ]
- PHE . Public Health England (PHE); London: 2020. Review of interventions to improve outdoor air quality and public health; pp. 1–262. [ Google Scholar ]
- Piguillem F., Shi L. Einaudi Institute for Economics and Finance (EIEF); 2020. The optimal COVID-19 quarantine and testing policies, EIEF Working Papers Series 2004; p. 40. [ Google Scholar ]
- Pinheiro M.D., Luís N.C. COVID-19 Could Leverage a Sustainable Built Environment. Sustainability. 2020; 12 [ Google Scholar ]
- Pinner D., Rogers M., Samandari H. McKinsey & Company; 2020. McKinsey Quarterly: Addressing climate change in a post-pandemic world; pp. 1–6. [ Google Scholar ]
- Pitarma R., Marques G., Ferreira B.R. Monitoring indoor air quality for enhanced occupational health. J. Med. Syst.41. 2017 [ PubMed ] [ Google Scholar ]
- Pomponi F., Moncaster A. Circular economy for the built environment: A research framework. J. Clean. Prod.143. 2017:710–718. [ Google Scholar ]
- Prata J.C., Silva A.L.P., Walker T.R., Duarte A.C., Rocha-Santos T. COVID-19 pandemic repercussions on the use and management of plastics. Environ. Sci. Tech.54. 2020:7760–7765. [ PubMed ] [ Google Scholar ]
- Preston F., Lehne J., Wellesley L. CHATAM HOUSE, The Royal Institute of International Affairs; London: 2019. An Inclusive Circular Economy; Priorities for Developing Countries, Priorities for Developing Countries; pp. 1–82. [ Google Scholar ]
- Prüss-Üstün A., Prüss A., Giroult E., Townend W.K., Rushbrook P., Organization W.H. World Health Organization; 1999. Safe Management of Wastes from Health-care Activities. [ Google Scholar ]
- Rai H.B., Verlinde S., Macharis C. Shipping outside the box. Environmental impact and stakeholder analysis of a crowd logistics platform in Belgium. J. Clean. Prod.202. 2018:806–816. [ Google Scholar ]
- Raj, M., Sundararajan, A., You, C., 2020. COVID-19 and Digital Resilience: Evidence from Uber Eats. arXiv preprint arXiv:2006.07204.
- Ranganatha J., Waite R., Searchinger T., Zionts J. World Resources Institute; 2020. Regenerative Agriculture: Good for Soil Health, but Limited Potential to Mitigate Climate Change. [ Google Scholar ]
- Ranney M.L., Griffeth V., Jha A.K. Critical supply shortages—the need for ventilators and personal protective equipment during the Covid-19 pandemic. N. Engl. J. Med. 2020 [ PubMed ] [ Google Scholar ]
- Rashid A., Asif F.M., Krajnik P., Nicolescu C.M. Resource conservative manufacturing: an essential change in business and technology paradigm for sustainable manufacturing. J. Clean. Prod.57. 2013:166–177. [ Google Scholar ]
- Rees W.E. Footprint: our impact on Earth is getting heavier. Nature. 2002; 420 :267–268. [ PubMed ] [ Google Scholar ]
- Rhodes C.J. The imperative for regenerative agriculture. Sci. Progr.100. 2017:80–129. [ PubMed ] [ Google Scholar ]
- Rios F.C., Chong W.K., Grau D. Design for disassembly and deconstruction-challenges and opportunities. Procedia Eng.118. 2015:1296–1304. [ Google Scholar ]
- Rubio-Romero J.C., del Carmen Pardo-Ferreira M., García J.A.T., Calero-Castro S. Disposable masks: Disinfection and sterilization for reuse, and non-certified manufacturing, in the face of shortages during the COVID-19 pandemic. Safe. Sci. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- San Juan, D.M., 2020. Responding to COVID-19 through socialist (ic) measures: a preliminary review. Available at SSRN 3559398.
- Sarkis J., Cohen M.J., Dewick P., Schröder P. A brave new world: lessons from the COVID-19 pandemic for transitioning to sustainable supply and production. Resour. Conserv. Recycl. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Sauerwein M., Doubrovski E., Balkenende R., Bakker C. Exploring the potential of additive manufacturing for product design in a circular economy. J. Clean. Prod.226. 2019:1138–1149. [ Google Scholar ]
- Saunders-Hastings P.R., Krewski D. Reviewing the history of pandemic influenza: understanding patterns of emergence and transmission. Pathogens. 2016; 5 :66. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Schluep M. UNEP; 2009. Recycling-from e-waste to resources: Sustainable innovation technology transfer industrial sector studies. [ Google Scholar ]
- Shaheen S., Cohen A. Elsevier; 2020. Mobility on demand (MOD) and mobility as a service (MaaS): early understanding of shared mobility impacts and public transit partnerships, Demand for Emerging Transportation Systems; pp. 37–59. [ Google Scholar ]
- Sherwood S., Uphoff N. Soil health: research, practice and policy for a more regenerative agriculture. Appl. Soil Ecol.15. 2000:85–97. [ Google Scholar ]
- Sim K., Chua H.C., Vieta E., Fernandez G. The anatomy of panic buying related to the current COVID-19 pandemic. Psychiatry Res. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Siow W.T., Liew M.F., Shrestha B.R., Muchtar F., See K.C. Springer; 2020. Managing COVID-19 in resource-limited settings: critical care considerations. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Snider-Mcgrath B. 2020. Exercise rates on the rise during COVID-19. [ Google Scholar ]
- Snyder H. Literature review as a research methodology: An overview and guidelines. J. Busi. Res.104. 2019:333–339. [ Google Scholar ]
- Sohrabi C., Alsafi Z., O’Neill N., Khan M., Kerwan A., Al-Jabir A., Iosifidis C., Agha R. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19) Int. J. Surg. 2020 [ Google Scholar ]
- Solomon M.Z., Wynia M., Gostin L.O. Scarcity in the Covid‐19 pandemic. Hast. Cent. Rep.50. 2020:3. -3. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Spash C.L. ‘The economy'as if people mattered: revisiting critiques of economic growth in a time of crisis. Globalizations. 2020:1–18. [ Google Scholar ]
- Stahel W.R. The circular economy. Nature. 2016; 531 :435–438. [ PubMed ] [ Google Scholar ]
- Stahel W.R. Routledge; 2019. The circular economy: A user's guide. [ Google Scholar ]
- Stellinger A., Berglund I., Isakson H. How trade can fight the pandemic and contribute to global health. COVID-19 and Trade Policy: Why Turning Inward Won't Work. 2020; 21 [ Google Scholar ]
- Stockholm Resilience Centre . Stockholm Resilience Centre, Stockholm University; Stockholm: 2016. Through resilience thinking towards sustainability and innovation: recommendations for policy makers in the EU; pp. 1–20. [ Google Scholar ]
- SYSTEMIQ . SUN Institute Environment & Sustainability in collaboration with The Ellen MacArthur Foundation; 2017. ACHIEVING ‘GROWTH WITHIN’: A €320-billion circular economy investment opportunity available to Europe up to 2025; p. 149. [ Google Scholar ]
- Tan J., Liu Y., Shen E., Zhu W., Wang W., Li R., Yang L. Towards<< the atlas of plague and its environment in the People's Republic of China>>: idea, principle and methodology of design and research results. Huan jing ke xue= Huanjing kexue. 2002; 23 :1–8. [ PubMed ] [ Google Scholar ]
- Temmerman S., Meire P., Bouma T.J., Herman P.M., Ysebaert T., De Vriend H.J. Ecosystem-based coastal defence in the face of global change. Nature. 2013; 504 :79–83. [ PubMed ] [ Google Scholar ]
- Thebo A., Drechsel P., Lambin E. Global assessment of urban and peri-urban agriculture: irrigated and rainfed croplands. Environ. Res. Lett.9. 2014 [ Google Scholar ]
- Thunstrom, L., Newbold, S., Finnoff, D., Ashworth, M., Shogren, J.F., 2020. The benefits and costs of flattening the curve for COVID-19. Available at SSRN 3561934.
- Timmer M., Erumban A., Gouma R., Los B., Temurshoev U., de Vries G., Arto I. The world input-output database (WIOD): contents, sources and methods. WIOD Background. 2012 document available at www. wiod. org 40. [ Google Scholar ]
- Toquero C. Challenges and opportunities for higher education amid the COVID-19 pandemic: The Philippine Context. Pedag. Res.5. 2020 [ Google Scholar ]
- Trilla A., Trilla G., Daer C. The 1918 “Spanish Flu” in Spain. Clin. Infect. Dis.47. 2008:668–673. [ PubMed ] [ Google Scholar ]
- Tudor T., Noonan C., Jenkin L. Healthcare waste management: a case study from the National Health Service in Cornwall, United Kingdom. Waste Manag.25. 2005:606–615. [ PubMed ] [ Google Scholar ]
- UN DESA Everyone included: social impact of COVID-19. UN Depart. Econ. Soc. Aff. (UN DESA) 2020 [ Google Scholar ]
- UN Habitat . Taylor & Francis; 2013. Planning and design for sustainable urban mobility: Global report on human settlements 2013. [ Google Scholar ]
- UNWTO . World Tourism Organization; 2020. Impact assessment of the covid-19 outbreak on international tourism United Nation. [ Google Scholar ]
- Van Bavel J.J., Baicker K., Boggio P.S., Capraro V., Cichocka A., Cikara M., Crockett M.J., Crum A.J., Douglas K.M., Druckman J.N. Using social and behavioural science to support COVID-19 pandemic response. Nat. Hum. Behav. 2020:1–12. [ Google Scholar ]
- Van Buren N., Demmers M., Van der Heijden R., Witlox F. Towards a circular economy: The role of Dutch logistics industries and governments. Sustainability. 2016; 8 :647. [ Google Scholar ]
- Voudrias, E.A., 2018. Healthcare waste management from the point of view of circular economy. [ PubMed ]
- Vousdoukas M.I., Ranasinghe R., Mentaschi L., Plomaritis T.A., Athanasiou P., Luijendijk A., Feyen L. Sandy coastlines under threat of erosion. Nat. Clim. Chang.10. 2020:260–263. [ Google Scholar ]
- Wagner D.M., Klunk J., Harbeck M., Devault A., Waglechner N., Sahl J.W., Enk J., Birdsell D.N., Kuch M., Lumibao C. Yersinia pestis and the Plague of Justinian 541–543 AD: a genomic analysis. Lancet Infect. Dis.14. 2014:319–326. [ PubMed ] [ Google Scholar ]
- Wang P., Chen K., Zhu S., Wang P., Zhang H. Severe air pollution events not avoided by reduced anthropogenic activities during COVID-19 outbreak. Resour. Conserv. Recycl.158. 2020 [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Watts N., Amann M., Arnell N., Ayeb-Karlsson S., Belesova K., Berry H., Bouley T., Boykoff M., Byass P., Cai W. The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. The Lancet. 2018; 392 :2479–2514. [ PubMed ] [ Google Scholar ]
- Watts N., Amann M., Ayeb-Karlsson S., Belesova K., Bouley T., Boykoff M., Byass P., Cai W., Campbell-Lendrum D., Chambers J. The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. The Lancet. 2018; 391 :581–630. [ PubMed ] [ Google Scholar ]
- Webster R.G. Predictions for future human influenza pandemics. J. Infect. Dis.176. 1997:S14–S19. [ PubMed ] [ Google Scholar ]
- White D.B., Lo B. A framework for rationing ventilators and critical care beds during the COVID-19 pandemic. JAMA. 2020 [ PubMed ] [ Google Scholar ]
- WHO . 1998. Safe Management of Wastes from Health-Care Activities. 2014. [ Google Scholar ]
- WHO . World Health Organization; 2020. Coronavirus Disease (COVID-19) Pandemic. [ Google Scholar ]
- WHO, 2020b. Coronavirus disease (COVID-19): Situation Report – 107, pp. 1-17.
- Williamson J. Every UK manufacturer helping to produce PPE and equipment for NHS workers. The Manufacturer. 2020 [ Google Scholar ]
- Windapo A.O., Moghayedi A. Adoption of smart technologies and circular economy performance of buildings. Built Environ. Project Asset Manag. 2020 [ Google Scholar ]
- Windfeld E.S., Brooks M.S.-L. Medical waste management – A review. J. Environ. Manag.163. 2015:98–108. [ PubMed ] [ Google Scholar ]
- Wong H.J.Y., Deng Z., Yu H., Huang J., Leung C., Miao C. Proceedings of the Twenty-Ninth International Joint Conference on Artificial Intelligence (IJCAI-20)Demonstrations Track. 2020. A testbed for studying COVID-19 spreading in ride-sharing systems; pp. 5294–5296. [ Google Scholar ]
- Wong K.-F.V., Narasimhan R., Kashyap R., Fu J. Medical waste characterization. J. Environ. Health. 1994:19–25. [ Google Scholar ]
- World Economic Forum . World Economic Forum; Geneva: 2019. A Vision for a Sustainable Battery Value Chain in 2030: Unlocking the Full Potential to Power Sustainable Development and Climate Change Mitigation; pp. 1–52. [ Google Scholar ]
- World Economic Forum . World Economic Forum; 2020. New Nature Economy Report II: The Future of Nature and Business. [ Google Scholar ]
- Wormer B.A., Augenstein V.A., Carpenter C.L., Burton P.V., Yokeley W.T., Prabhu A.S., Harris B., Norton S., Klima D.A., Lincourt A.E. The green operating room: simple changes to reduce cost and our carbon footprint. Am. Surg.79. 2013:666–671. [ PubMed ] [ Google Scholar ]
- Wosik J., Fudim M., Cameron B., Gellad Z.F., Cho A., Phinney D., Curtis S., Roman M., Poon E.G., Ferranti J. Telehealth transformation: COVID-19 and the rise of virtual care. J. Am. Med. Inform. Assoc.27. 2020:957–962. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Xiao Y., Torok M.E. Taking the right measures to control COVID-19. The Lancet Infect. Dis.20. 2020:523–524. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Yang C., Peijun L., Lupi C., Yangzhao S., Diandou X., Qian F., Shasha F. Sustainable management measures for healthcare waste in China. Waste Manag. 2009; 29 :1996–2004. [ PMC free article ] [ PubMed ] [ Google Scholar ]
- Zambrano-Monserrate M.A., Ruano M.A., Sanchez-Alcalde L. Indirect effects of COVID-19 on the environment. Sci. Total Environ. 2020 [ Google Scholar ]
- Zambrano-Monserrate M.A., Silva-Zambrano C.A., Ruano M.A. The economic value of natural protected areas in Ecuador: A case of Villamil Beach National Recreation Area. Ocean Coast. Manag.157. 2018:193–202. [ Google Scholar ]
- Zhou M., Chen Y., Su X., An L. Proceedings of the Institution of Civil Engineers-Civil Engineering. Thomas Telford Ltd; 2020. Rapid construction and advanced technology for a Covid-19 field hospital in Wuhan, China; pp. 1–29. [ Google Scholar ]
Critique Paper About The Covid-19 in the Philippines
Partial preview of the text, related documents, get ready for your exams with the best study resources, description:.
Recently viewed documents
Follow us on :
Take a look at the Recent articles
A short review on covid-19: a great concern to public health, ashok chakraborty.
Allexcel, Inc. CT, USA
E-mail : [email protected]
Nanoviricides, CT, USA
Vijetha Chinige
Preetam Holkar
Vinod Arora
DOI: 10.15761/TR.1000167
Objectives: Very recently a novel coronavirus, SARS-CoV-2, was identified as the causative agent of an outbreak of viral pneumonia centered around Wuhan, Hubei, China in Dec 2019, now called as COVID-19. In this article, the current knowledge of deadly, pandemic human coronavirus SARS-Cov2 (COVID-19), with special reference to its zoonosis, susceptibility, and different strategies to develop its therapeutics, will be discussed.
Study design: Sources of Corona Virus and Zoonosis, Diagnosis of Corona Virus in Human; Approach for Finding Therapeutics, were highlighted.
Methods: All the information were taken from the several Review and guidelines published by CDC, WHO, NIH, etc.
Results: The zoonosis was shown in Table 1 . Preventive measures, so long any definite cures are available, should be followed as displayed in the Table 2.
Conclusions: In this review, we summarize the current knowledge on human coronavirus causing COVID-19 infection emphasizing on its impact in human life.
SARS, MERS, COVID-19, therapeutics
- Abbreviations
CoV: Coronavirus; DMV: Double membrane vesicles; FDA: Food and drug administration; hAPN: Human aminopeptidase N; ORF: Open reading frame; SARS: Severe acute respiratory syndrome; IFN: Interferon; MERS: Middle east respiratory syndrome; NHP: Non-human primate; TMPRSSII: Transmembrane protease; HCoV: Human coronavirus; PEDV: Porcine epidemic diarrhea virus; RBD: Receptor binding domain; hACE2: Human angiotensin converting enzyme 2
- Introduction
The first severe acute respiratory syndrome coronavirus (SARS-CoV) outbreak in China (in 2003), which spreads out in 29 countries so far and infected about 9000 people with more than 10% mortality [1]. Soon after five more human coronaviruses (HCoV-229E, HCoV-HKU1, HCoV-NL63, and HCoV-OC43) are found also to be associated with a range of respiratory symptoms, including high-morbidity outcomes such as pneumonia and bronchiolitis [2]. In 2012, another virus MERS–CoV (Middle East Respiratory Syndrome coronavirus), was isolated from a patient with pneumonia in Saudi-Arabia [3]. However, a very recent outbreak of a more severe acute respiratory syndrome (SARS)-associated coronavirus (SARS-CoV-2) which one causes COVID-19 disease, a most concerned factor, now-a-days, to human health. Not only the health but it caused a disaster in human social, economic and many other aspects of life, being the disease is highly infectious and fatal too. (Several Review by CDC, WHO, NIH, etc).
In fact, Sars-CoV-2 is originated on 26 th December 2019 at Wuhan city of China, and causes a life-threatening pneumonia, and is the most pathogenic human coronavirus identified so far [4]. No statistical data at this point would be perfect since the disease progression as well as mortality rate is increasing at an exponential rate. As of April 4 th , 2020, according to CNN reports, the worldwide infected cases are about 1,192,028; Deaths 64,316. In USA, infected cases are 308,533 and death 8,376.
In this review, we summarize the current knowledge on human coronavirus COVID-19 (since now will be mentioned as such) infection emphasizing on its impact in human life.
- Sources of corona virus and zoonosis
Sars-CoV-2 like other human corona virus, MERS-CoV, SARS-CoV, has is originated from Bats [5]. The zoonosis has shown in Table 1.
Like Flu virus, SARS-CoV-2 are capable to infect the respiratory system, and facilitating the spread through coughing and sneezing, especially to the immune-compromised and the elderly people [6], However, unlike to other common cold or allergy issues, SARS-CoV-2 attack mainly lower respiratory tract, and results deadly Pneumonia [7]. No medicine is there yet, either control and/or cure, but only several efforts for prevention.
- Diagnosis of corona virus in human
Chest radiography can reveal a typical feature of bronchiolitis. Identification of unknown pathogens using molecular biology tools is difficult, but genome-specific PCR primers can be designed for RT-PCR analysis. The presence of restriction enzyme fragment length polymorphism (RFLP) can also be done.
The Centers for Disease Control and Prevention (CDC) and NIAID has developed a test to diagnose COVID-19 in respiratory and serum samples from clinical specimens [5,8].
Figure 1. Corona virus – basics
Figure 2. Covid-19: Protection and prevention (Sources: CDC, WHO, NIH, YNHHS)
- COVID-19 (SARS-Cov-2) may be seasonal endemic pathogen
New Coronavirus COVID-19 that's marked by fevers, coughing, and occasionally severe lung infections, eventually may become a part of the human respiratory-virus repertoire and may not go away without a proper vaccine.
- Approach for finding therapeutics
Coronaviruses are classified into four distinct phylogenetic groups, a-coronaviruses, b-coronaviruses and g-acoronaviruses which infect mammals, and d-coronaviruses infect avian species [9]. Among all known human coronaviruses (HCoV), SARS-CoV-2, like SARS-CoV and MERS-CoV belongs to a β-corona virus family cause Lower track respiratory problems, whereas others belong to α-type cause only mild upper track infection.
No specific treatment is currently available for human coronaviruses to date, but using the genome knowledge from six previously discovered human coronaviruses, the investigators are examining the progress of the use and development of therapeutic drugs, focusing on the potential roles of virus inhibitors [10].
The innate immune system has a major protective role as the first line of defense against respiratory pathogens. The Receptor determinant identified as N-acetyl-9-O-acetylneuraminic acid or O-Acetylated Sialic acid interferon (IFN) system orchestrates hundreds of different cellular effector proteins that protect the epithelial barrier by altering the physiological and cellular environment, and also impair virus propagation, spread and transmission.
In general, HCoVs do not elicit a strong innate immune response in primary target cells of the human airway early during infection. Despite the presence of all major pathogen recognition receptors, no elevated expression of IFN beta, pro-inflammatory cytokines or interferon stimulated genes can be observed up to 12 h post-infection in HAEs infected with HCoV-229E, MERS- or SARS-CoVs [11]. This is most likely due to the intrinsic CoV properties harbored in the replicative non-structural proteins that actively aid in avoiding recognition by the host innate immune system. For example, the 5′ termini of the viral mRNA are capped making them indistinguishable from the host cellular mRNAs and no longer detectable by cellular sensors.
Vaccines using the spike proteins of both SARS- and MERS-CoVs have proven protective in animal models [12], suggesting that a vaccine against HCoVs for human use might be achievable. Until any specific remedies against COVID-19 becomes available, we must rely on preventive measure that we have displayed in the Table 2.
- Conclusions
Studies with many HCoVs indicate that HCoVs including COVID-19 may be more clinically important in the immune-compromised and/or elderly people than previously thought. Since vaccines are not currently available for any of these respiratory viruses, it is necessary to monitor epidemic patterns and investigate the spread of respiratory infections to efficiently identify, control and prevent epidemics.
A detailed study of COVID-19, both genomics and proteomics is needed to know the infection mechanism as well as to drug design. This, however, may be hampered by the lack of an appropriate in vitro as well as in vivo model. Further, future experiments with more sensitive diagnostic tools should yield a more accurate picture of the prevalence of this virus (COVID-19) and its association with respiratory diseases.
- Declarations
Conflict of interests: All the authors declare no competing interests.
Authors’ contribution: All the authors contributed equally to prepare this article, read, and approved the final manuscript.
Acknowledgement: We acknowledge all our colleagues for their help during the preparation of the manuscript by providing all the relevant information. Funding from Nanoviricide is highly appreciated.
- WHO: Cumulative number of reported probable cases of SARS. https://www.who.int/csr/sars/country/2003_07_11/en/ .
- Woo PC, Lau SK, Tsoi HW, Huang Y, Poon RW, et. al. (2005) Clinical and molecular epidemiological features of coronavirus HKU1-associated community-acquired pneumonia. J Infect Dis 192: 1898-1907.
- De Wit E, van Doremalen N, Falzarano D, Munster VJ (2016) SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol 214: 523-534.
- Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R (2020) Features, evaluation and treatment coronavirus (COVID-19) [Updated 2020 Mar 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. https://www.ncbi.nlm.nih.gov/books/NBK554776/
- NIAID: https://www.niaid.nih.gov/diseases-conditions/covid-19 .
- Pyrc K, Sims AC, Dijkman R, Jebbink M, Long C, et al. (2010) Culturing the unculturable: human coronavirus HKU1 infects, replicates, and produces progeny virions in human ciliated airway epithelial cell cultures. J Virol 84: 11255-11263.
- Razuri H, Malecki M, Tinoco Y, Ortiz E, Guezala MC et al. (2015) Human coronavirus-associated influenza-like illness in the community setting in Peru. Am J Trop Med Hyg 93: 1038-1040.
- CDC: https://www.cdc.gov/coronavirus/2019-ncov/testing-in-us.html .
- Lefkowitz EJ, Dempsey DM, Hendrickson RC, Orton RJ, Siddell SG, et al. (2018) Virus taxonomy: the database of the International Committee on Taxonomy of Viruses (ICTV). Nucleic Acids Res 46: D708–D717.
- Pillaiyar T, Meenakshisundaram S, Manickam M (2020) Recent discovery and development of inhibitors targeting coronaviruses. Drug Discov Today .
- Kindler E, Jonsdottir HR, Muth D, Hamming OJ, Hartmann R, et al. (2013) Efficient replication of the novel human betacoronavirus EMC on primary human epithelium highlights its zoonotic potential. MBio 4: e00611–e00612.
- Volz A, Kupke A, Song F, Jany S, Fux R, et al. (2015) Protective efficacy of recombinant modified vaccinia virus Ankara delivering Middle East respiratory syndrome coronavirus spike glycoprotein. J Virol 89: 8651-8656.
- WHO: COVID-19, March 11, 2020? https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 .
Editorial Information
Editor-in-chief.
Hiroyuki Aizawa Aizawa Science Museum
Article Type
Research Article
Publication history
Received date: June 07, 2020 Accepted date: June 22, 2020 Published date: June 25, 2020
©2020 Chakraborty A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Chakraborty A, Diwan A, Chinige V, Holkar P, Arora V (2020) A short review on COVID-19: A great concern to public health. Trends in Res 3: DOI: 10.15761/TR.1000167
Corresponding author
Ph.D., Allexcel, Inc. CT, USA
Journal Home
- Article Info
- Author Info
- Figures & Data
- Privacy Policy
- Terms & conditions
© 2022 Copyright OAT. All rights reserved.
- Open Access
- Published: 04 February 2022
Analysis of the COVID-19 pandemic: lessons towards a more effective response to public health emergencies
- Yibeltal Assefa ORCID: orcid.org/0000-0003-2393-1492 1 ,
- Charles F. Gilks 1 ,
- Simon Reid 1 ,
- Remco van de Pas 2 ,
- Dereje Gedle Gete 1 &
- Wim Van Damme 2
Globalization and Health volume 18 , Article number: 10 ( 2022 ) Cite this article
23k Accesses
6 Citations
10 Altmetric
Metrics details
The pandemic of Coronavirus Disease 2019 (COVID-19) is a timely reminder of the nature and impact of Public Health Emergencies of International Concern. As of 12 January 2022, there were over 314 million cases and over 5.5 million deaths notified since the start of the pandemic. The COVID-19 pandemic takes variable shapes and forms, in terms of cases and deaths, in different regions and countries of the world. The objective of this study is to analyse the variable expression of COVID-19 pandemic so that lessons can be learned towards an effective public health emergency response.
We conducted a mixed-methods study to understand the heterogeneity of cases and deaths due to the COVID-19 pandemic. Correlation analysis and scatter plot were employed for the quantitative data. We used Spearman’s correlation analysis to determine relationship strength between cases and deaths and socio-economic and health systems. We organized qualitative information from the literature and conducted a thematic analysis to recognize patterns of cases and deaths and explain the findings from the quantitative data.
We have found that regions and countries with high human development index have higher cases and deaths per million population due to COVID-19. This is due to international connectedness and mobility of their population related to trade and tourism, and their vulnerability related to older populations and higher rates of non-communicable diseases. We have also identified that the burden of the pandemic is also variable among high- and middle-income countries due to differences in the governance of the pandemic, fragmentation of health systems, and socio-economic inequities.
The COVID-19 pandemic demonstrates that every country remains vulnerable to public health emergencies. The aspiration towards a healthier and safer society requires that countries develop and implement a coherent and context-specific national strategy, improve governance of public health emergencies, build the capacity of their (public) health systems, minimize fragmentation, and tackle upstream structural issues, including socio-economic inequities. This is possible through a primary health care approach, which ensures provision of universal and equitable promotive, preventive and curative services, through whole-of-government and whole-of-society approaches.
The pandemic of Coronavirus Disease 2019 (COVID-19) is a timely reminder of the nature and impact of emerging infectious diseases that become Public Health Emergency of International Concern (PHEIC) [ 1 ]. The COVID-19 pandemic takes variable shapes and forms in how it affects communities in different regions and countries [ 2 , 3 ]. As of 12 January, 2022, there were over 314 million cases and over 5.5 million deaths notified around the globe since the start of the pandemic. The number of cases per million population ranged from 7410 in Africa to 131,730 in Europe while the number of deaths per million population ranged from 110 in Oceania to 2740 in South America. Case-fatality rates (CFRs) ranged from 0.3% in Oceania to 2.9% in South America [ 4 , 5 ]. Regions and countries with high human development index (HDI), which is a composite index of life expectancy, education, and per capita income indicators [ 6 ], are affected by COVID-19 more than regions with low HDI. North America and Europe together account for 55 and 51% of cases and deaths, respectively. Regions with high HDI are affected by COVID-19 despite their high universal health coverage index (UHCI) and Global Health Security index (GHSI) [ 7 ].
This seems to be a paradox (against the established knowledge that countries with weak (public) health systems capacity will have worse health outcomes) in that the countries with higher UHCI and GHSI have experienced higher burdens of COVID-19 [ 7 ]. The paradox can partially be explained by variations in testing algorithms, capacity for testing, and reporting across different countries. Countries with high HDI have health systems with a high testing capacity; the average testing rate per million population is less than 32, 000 in Africa and 160,000 in Asia while it is more than 800, 000 in HICs (Europe and North America). This enables HICs to identify more confirmed cases that will ostensibly increase the number of reported cases [ 3 ]. Nevertheless, these are insufficient to explain the stark differences between countries with high HDI and those with low HDI. Many countries with high HDI have a high testing rate and a higher proportion of symptomatic and severe cases, which are also associated with higher deaths and CFRs [ 7 ]. On the other hand, there are countries with high HDI that sustain a lower level of the epidemic than others with a similar high HDI. It is, therefore, vital to analyse the heterogeneity of the COVID-19 pandemic and explain why some countries with high HDI, UHCI and GHSI have the highest burden of COVID-19 while others are able to suppress their epidemics and mitigate its impacts.
The objective of this study was to analyse the COVID-19 pandemic and understand its variable expression with the intention to learn lessons for an effective and sustainable response to public health emergencies. We hypothesised that high levels of HDI, UHCI and GHSI are essential but not sufficient to prevent and control COVID-19.
We conducted an explanatory mixed-methods study to understand and explain the heterogeneity of the pandemic around the world. The study integrated quantitative and qualitative secondary data. The following steps were included in the research process: (i) collecting and analysing quantitative epidemiological data, (ii) conducting literature review of qualitative secondary data and (iii) evaluating countries’ pandemic responses to explain the variability in the COVID-19 epidemiological outcomes. The study then illuminated specific factors that were vital towards an effective and sustainable epidemic response.
We used the publicly available secondary data sources from Johns Hopkins University ( https://coronavirus.jhu.edu/data/new-cases ) for COVID-19 and UNDP 2020 HDI report ( http://hdr.undp.org/en/2019-report ) for HDI, demographic and epidemiologic variables. These are open data sources which are regularly updated and utilized by researchers, policy makers and funders. We performed a correlation analysis of the COVID-19 pandemic. We determined the association between COVID-19 cases, severity, deaths and CFRs at the 0.01 and 0.05 levels (2-tailed). We used Spearman’s correlation analysis, as there is no normal distribution of the variables [ 8 ].
The UHCI is calculated as the geometric mean of the coverage of essential services based on 17 tracer indicators from: (1) reproductive, maternal, newborn and child health; (2) infectious diseases; (3) non-communicable diseases; and, (4) service capacity and access and health security [ 9 ]. The GHSI is a composite measure to assess a country’s capability to prevent, detect, and respond to epidemics and pandemics [ 10 ].
We then conducted a document review to explain the epidemic patterns in different countries. Secondary data was obtained from peer-reviewed journals, reputable online news outlets, government reports and publications by public health-related associations, such as the WHO. To explain the variability of COVID-19 across countries, a list of 14 indicators was established to systematically assess country’s preparedness, actual pandemic response, and overall socioeconomic and demographic profile in the context of COVID-19. The indicators used in this study include: 1) Universal Health Coverage Index, 2) public health capacity, 3) Global Health Security Index, 4) International Health Regulation, 5) leadership, governance and coordination of response, 6) community mobilization and engagement, 7) communication, 8) testing, quarantines and social distancing, 9) medical services at primary health care facilities and hospitals, 10) multisectoral actions, 11) social protection services, 12) absolute and relative poverty status, 13) demography, and 14) burden of communicable and non-communicable diseases. These indicators are based on our previous studies and recommendation from the World Health Organization [ 3 , 4 ]. We conducted thematic analysis and synthesis to identify the factors that may explain the heterogeneity of the pandemic.
Heterogeneity of COVID-19 cases and deaths around the world: what can explain it?
Table 1 indicates that the pandemic of COVID-19 is heterogeneous around regions of the world. Figure 1 also shows that there is a strong and significant correlation between HDI and globalisation (with an increase in trade and tourism as proxy indicators) and a corresponding strong and significant correlation with COVID-19 burden.
Human development index and its correlates associated with COVID-19 in 189 countries*
Globalisation and pandemics interact in various ways, including through international trade and mobility, which can lead to multiple waves of infections [ 11 ]. In at least the first waves of the pandemic, countries with high import and export of consumer goods, food products and tourism have high number of cases, severe cases, deaths and CFRs. Countries with high HDI are at a higher risk of importing (and exporting) COVID-19 due to high mobility linked to trade and tourism, which are drivers of the economy. These may have led to multiple introductions of COVID-19 into these countries before border closures.
The COVID-19 pandemic was first identified in China, which is central to the global network of trade, from where it spread to all parts of the world, especially those countries with strong links with China [ 12 ]. The epidemic then spread to Europe. There is very strong regional dimension to manufacturing and trading, which could be facilitate the spread of the virus. China is the heart of ‘Factory Asia’; Italy is in the heart of ‘Factory Europe’; the United States is the heart of ‘Factory North America’; and Brazil is the heart of ‘Factory Latin America’ [ 13 ]. These are the countries most affected by COVID-19 during the first wave of the pandemic [ 2 , 3 , 14 ].
It is also important to note that two-third of the countries currently reporting more than a million cases are middle-income countries (MICs), which are not only major emerging market economies but also regional political powers, including the BRICS countries (Brazil, Russia, India and South Africa) [ 3 , 15 ]. These countries participate in the global economy, with business travellers and tourists. They also have good domestic transportation networks that facilitate the internal spread of the virus. The strategies that helped these countries to become emerging markets also put them at greater risk for importing and spreading COVID-19 due to their connectivity to the rest of the world.
In addition, countries with high HDI may be more significantly impacted by COVID-19 due to the higher proportion of the elderly and higher rates of non-communicable diseases. Figure 1 shows that there is a strong and significant correlation between HDI and demographic transition (high proportion of old-age population) and epidemiologic transition (high proportion of the population with non-communicable diseases). Countries with a higher proportion of people older than 65 years and NCDs (compared to communicable diseases) have higher burden of COVID-19 [ 16 , 17 , 18 , 19 , 20 ]. Evidence has consistently shown a higher risk of severe COVID-19 in older individuals and those with underlying health conditions [ 21 , 22 , 23 , 24 , 25 ]. CFR is age-dependent; it is highest in persons aged ≥85 years (10 to 27%), followed by those among persons aged 65–84 years (3 to 11%), and those among persons aged 55-64 years (1 to 3%) [ 26 ].
On the other hand, regions and countries with low HDI have, to date, experienced less severe epidemics. For instance, as of January 12, 2022, the African region has recorded about 10.3 million cases and 233,000 deaths– far lower than other regions of the world (Table 1 ) [ 27 ]. These might be due to lower testing rates in Africa, where only 6.5% of the population has been tested for the virus [ 14 , 28 ], and a greater proportion of infections may remain asymptomatic [ 29 ]. Indeed, the results from sero-surveys in Africa show that more than 80% of people infected with the virus were asymptomatic compared to an estimated 40-50% asymptomatic infections in HICs [ 30 , 31 ]. Moreover, there is a weak vital registration system in the region indicating that reports might be underestimating and underreporting the disease burden [ 32 ]. However, does this fully explain the differences observed between Africa and Europe or the Americas?
Other possible factors that may explain the lower rates of cases and deaths in Africa include: (1) Africa is less internationally connected than other regions; (2) the imposition of early strict lockdowns in many African countries, at a time when case numbers were relatively small, limited the number of imported cases further [ 2 , 33 , 34 ]; (3) relatively poor road network has also limited the transmission of the virus to and in rural areas [ 35 ]; (4) a significant proportion of the population resides in rural areas while those in urban areas spend a lot of their time mostly outdoors; (5) only about 3% of Africans are over the age of 65 (so only a small proportion are at risk of severe COVID-19) [ 36 ]; (6) lower prevalence of NCDs, as disease burden in Africa comes from infectious causes, including coronaviruses, which may also have cross-immunity that may reduce the risk of developing symptomatic cases [ 37 ]; and (7) relative high temperature (a major source of vitamin D which influences COVID-19 infection and mortality) in the region may limit the spread of the virus [ 38 , 39 ]. We argue that a combination of all these factors might explain the lower COVID-19 burden in Africa.
The early and timely efforts by African leaders should not be underestimated. The African Union, African CDC, and WHO convened an emergency meeting of all African ministers of health to establish an African taskforce to develop and implement a coordinated continent-wide strategy focusing on: laboratory; surveillance; infection prevention and control; clinical treatment of people with severe COVID-19; risk communication; and supply chain management [ 40 ]. In April 2021, African Union and Africa CDC launched the Partnerships for African Vaccine Manufacturing (PAVM), framework to expanding Africa’s vaccine manufacturing capacity for health security [ 41 ].
Heterogeneity of the pandemic among countries with high HDI: what can explain it?
Figures 2 and 3 illustrate the variability of cases and deaths due to the COVID-19 pandemic across high-income countries (HICs). Contrary to the overall positive correlation between high HDI and cases, deaths and fatality rates due to COVID-19, there are outlier HICs, which have been able to control the epidemic. Several HICs, such as New Zealand, Australia, South Korea, Japan, Denmark, Iceland, and Norway, managed to contain their epidemics (Figs. 2 and 3 ) [ 15 , 42 , 43 ]. It is important to note that most of these countries (especially the island states) have far less cross-border mobility than other HICs.
Scatter plot of COVID-19 cases per million population in countries with high human development index (> 0.70)
Scatter plot of COVID-19 deaths per million population in countries with high human development index (> 0.70)
HICs that have been successful at controlling their epidemics have similar characteristics, which are related to governance of the response [ 44 ], synergy between UHC and GHS, and existing relative socio-economic equity in the country. Governance and leadership is a crucial factor to explain the heterogeneity of the epidemic among countries with high HDI [ 45 ]. There has been substantial variation in the nature and timing of the public health responses implemented [ 46 ]. Adaptable and agile governments seem better able to respond to their epidemics [ 47 , 48 ]. Countries that have fared the best are the ones with good governance and public support [ 49 ]. Countries with an absence of coherent leadership and social trust have worse outcomes than countries with collective action, whether in a democracy or autocracy, and rapid mobilisation of resources [ 50 ]. The erosion of trust in the United States government has hurt the country’s ability to respond to the COVID-19 crisis [ 51 , 52 ]. The editors of the New England Journal of Medicine argued that the COVID-19 crisis has produced a test of leadership; but, the leaders in the United States had failed that test [ 47 ].
COVID-19 has exposed the fragility of health systems, not only in the public health and primary care, but also in acute and long-term care systems [ 49 ]. Fragmentation of health systems, defined here to mean inadequate synergy and/ or integration between GHS and UHC, is typical of countries most affected by the COVID-19 pandemic. Even though GHS and UHC agendas are convergent and interdependent, they tend to have different policies and practices [ 53 ]. The United States has the highest index for GHS preparedness; however, it has reported the world’s highest number of COVID-19 cases and deaths due to its greatly fragmented health system [ 54 , 55 ]. Countries with health systems and policies that are able to integrate International Health Regulations (IHR) core capacities with primary health care (PHC) services have been effective at mitigating the effects of COVID-19 [ 50 , 53 ]. Australia has been able to control its COVID-19 epidemic through a comprehensive primary care response, including protection of vulnerable people, provision of treatment and support services to affected people, continuity of regular healthcare services, protection and support of PHC workers and primary care services, and provision of mental health services to the community and the primary healthcare workforce [ 56 ]. Strict implementation of public health and social intervention together with UHC systems have ensured swift control of the epidemics in Singapore, South Korea, and Thailand [ 57 ].
The heterogeneity of cases and deaths, due to COVID-19, is also explained by differences in levels of socio-economic inequalities, which increase susceptibility to acquiring the infection and disease progression as well as worsening of health outcomes [ 58 ]. COVID-19 has been a stress test for public services and social protection systems. There is a higher burden of COVID-19 in Black, Asian and Minority Ethnic individuals due to socio-economic inequities in HICs [ 59 , 60 ]. Poor people are more likely to live in overcrowded accommodation, are more likely to have unstable work conditions and incomes, have comorbidities associated with poverty and precarious living conditions, and reduced access to health care [ 59 ].
The epidemiology of COVID-19 is also variable across MICs, with HDI between 0.70 and 0.85, around the world. Overall, the epidemic in MICs is exacerbated by the rapid demographic and epidemiologic transitions as well as high prevalence of obesity. While India and Brazil witnessed rapidly increasing rates of cases and deaths, China, Thailand, Vietnam have experienced a relatively lower disease burden [ 15 ]. This heterogeneity may be attributed to a number of factors, including governance, communication and service delivery. Thailand, China and Vietnam have implemented a national harmonized strategic response with decentralized implementation through provincial and district authorities [ 61 ]. Thailand increased its testing capacity from two to over 200 certified facilities that could process between 10,000 to 100,000 tests per day; moreover, over a million village health volunteers in Thailand supported primary health services [ 62 , 63 ]. China’s swift and decisive actions enabled the country to contain its epidemic though there was an initial delay in detecting the disease. China has been able to contain its epidemic through community-based measures, very high public cooperation and social mobilization, strategic lockdown and isolation, multi-sector action [ 64 ]. Overall, multi-level governance (effective and decisive leadership and accountability) of the response, together with coordination of public health and socio-economic services, and high levels of citizen adherence to personal protection, have enabled these countries to successfully contain their epidemics [ 61 , 65 , 66 ].
On the other hand, the Brazilian leadership was denounced for its failure to establish a national surveillance network early in the pandemic. In March 2020, the health minister was reported to have stated that mass testing was a waste of public funding, and to have advised against it [ 67 ]. This was considered as a sign of a collapse of public health leadership, characterized by ignorance, neoliberal authoritarianism [ 68 ]. There were also gaps in the public health capacity in different municipalities, which varied greatly, with a considerable number of Brazilian regions receiving less funding from the federal government due to political tension [ 69 ]. The epidemic has a disproportionate adverse burden on states and municipalities with high socio-economic vulnerability, exacerbated by the deep social and economic inequalities in Brazil [ 70 ].
India is another middle-income country with a high burden of COVID-19. It was one of the countries to institute strict measures in the early phase of the pandemic [ 71 , 72 ]. However, the government eased restrictions after the claim that India had beaten the pandemic, which lead to a rapid increase in disease incidence. Indeed, on 12 January 2022, India reported 36 million cumulative cases and almost 485,000 total deaths [ 15 ]. The second wave of the epidemic in India exposed weaknesses in governance and inadequacies in the country’s health and other social systems [ 73 ]. The nature of the Indian federation, which is highly centripetal, has prevented state and local governments from tailoring a policy response to suit local needs. A centralized one-size-fits-all strategy has been imposed despite high variations in resources, health systems capacity, and COVID-19 epidemics across states [ 74 ]. There were also loose social distancing and mask wearing, mass political rallies and religious events [ 75 ]. Rapid community transmission driven by high population density and multigenerational households has been a feature of the current wave in India [ 76 ]. In addition, several new variants of the virus, including the UK (B.1.1.7), the South Africa (20H/501Y or B.1.351), and Brazil (P.1), alongside a newly identified Indian variant (B.1.617), are circulating in India and have been implicated as factors in the second wave of the pandemic [ 75 , 76 ].
Heterogeneity of case-fatality rates around the world: what can explain it?
The pandemic is characterized by variable CFRs across regions and countries that are negatively associated with HDI (Fig. 1 ). The results presented in Fig. 4 show that the proportion of elderly population and rate of obesity are important factors which are positively associated with CFR. On the other hand, UHC, IHR capacity and other indicators of health systems capacity (health workforce density and hospital beds) are negatively associated with the CFR (Figs. 1 and 4 ).
Correlates of COVID-19 cases, deaths and case-fatality rates in 189 countries
The evidence from several research indicates that heterogeneity can be explained by several factors, including differences in age-pyramid, socio-economic status, access to health services, or rates of undiagnosed infections. Differences in age-pyramid may explain some of the observed variation in epidemic severity and CFR between countries [ 77 ]. CFRs across countries look similar when taking age into account [ 78 ]. The elderly and other vulnerable populations in Africa and Asia are at a similar risk as populations in Europe and Americas [ 79 ]. Data from European countries suggest that as high as 57% of all deaths have happened in care homes and many deaths in the US have also occurred in nursing homes. On the other hand, in countries such as Mexico and India, individuals < 65 years contributed the majority of deaths [ 80 ].
Nevertheless, CFR also depends on the quality of hospital care, which can be used to judge the health system capacity, including the availability of healthcare workers, resources, and facilities, which affects outcomes [ 81 ]. The CFR can increase if there is a surge of infected patients, which adds to the strain on the health system [ 82 ]. COVID-19 fatality rates are affected by numerous health systems factors, including bed capacity, existence and capacity of intensive care unit (ICU), and critical care resources (such as oxygen and dexamethasone) in a hospital. Regions and countries with high HDI have a greater number of acute care facilities, ICU, and hospital bed capacities compared to lower HDI regions and countries [ 83 ]. Differences in health systems capacity could explain why North America and Europe, which have experienced much greater number of cases and deaths per million population, reported lower CFRs than the Southern American and the African regions, partly also due to limited testing capacity in these regions (Table 1 ) [ 84 , 85 , 86 ]. The higher CFR in Southern America can be explained by the relatively lower health systems surge capacity that could not adequately respond to the huge demand for health services [ 69 , 86 ]. The COVID-19 pandemic has highlighted existing health systems’ weaknesses, which are not able to effectively prepare for and respond to PHEs [ 87 ]. The high CFRs in the region are also exacerbated by the high social inequalities [ 69 ].
On the other hand, countries in Asia recorded lower CFRs (~ 1.4%) despite sharing many common risk factors (including overcrowding and poverty, weak health system capacity etc) with Africa. The Asian region shares many similar protective factors to the African region. They have been able to minimize their CFR by suppressing the transmission of the virus and flattening the epidemic curve of COVID-19 cases and deaths. Nevertheless, the epidemic in India is likely to be different because it has exceeded the health system capacity to respond and provide basic medical care and medical supplies such as oxygen [ 88 ]. Overall, many Asian countries were able to withstand the transmission of the virus and its effect due to swift action by governments in the early days of the pandemic despite the frequency of travel between China and neighbouring countries such as Hong Kong, Taiwan and Singapore [ 89 ]. This has helped them to contain the pandemic to ensure case numbers remain within their health systems capacity. These countries have benefited from their experience in the past in the prevention and control of epidemics [ 90 ].
There are a number of issues with the use of the CFR to compare the management of the pandemic between countries and regions [ 91 ], as it does not depict the true picture of the mortality burden of the pandemic. A major challenge with accurate calculation of the CFR is the denominator on number of identified cases, as asymptomatic infections and patients with mild symptoms are frequently left untested, and therefore omitted from CFR calculations. Testing might not be widely available, and proactive contact tracing and containment might not be employed, resulting in a smaller denominator, and skewing to a higher CFR [ 82 ]. It is, therefore, far more relevant to estimate infection fatality rate (IFR), the proportion of all infected individuals who have died due to the infection [ 91 ], which is central to understanding the public health impact of the pandemic and the required policies for its prevention and control [ 92 ].
Estimates of prevalence based on sero-surveys, which includes asymptomatic and mildly symptomatic infections, can be used to estimate IFR [ 93 ]. In a systematic review of 17 studies, seroprevalence rates ranged from 0.22% in Brazil to 53% in Argentina [ 94 ]. The review also identified that the seroprevalence estimate was higher than the cumulative reported case incidence, by a factor between 1.5 times in Germany to 717 times in Iran, in all but two studies (0.56 times in Brazil and 0.88 times in Denmark) [ 94 , 95 ]. The difference between seroprevalence and cumulative reported cases might be due to asymptomatic cases, atypical or pauci-symptomatic cases, or the lack of access to and uptake of testing [ 94 ]. There is only a modest gap between the estimated number of infections from seroprevalence surveys and the cumulative reported cases in regions with relatively thorough symptom-based testing. Much of the gap between reported cases and seroprevalence is likely to be due to undiagnosed symptomatic or asymptomatic infections [ 94 ].
Collateral effects of the COVID-19 pandemic
It is important to note that the pandemic has significant collateral effects on the provision of essential health services, in addition to the direct health effects [ 96 ]. Disruptions in the provision of essential health services, due to COVID-19, were reported by nearly all countries, though it is more so in lower-income than higher-income countries [ 97 , 98 ]. The biggest impact reported is on provision of day-to-day primary care to prevent and manage some of the most common health problems [ 99 ].
The causes of disruptions in service delivery were a mix of demand and supply factors [ 100 ]. Countries reported that just over one-third of services were disrupted due to health workforce-related reasons (the most common causes of service disruptions), supply chains, community mistrust and fears of becoming infected, and financial challenge s[ 101 ]. Cognizant of the disruptive effects of the pandemic, countries have reorganized their health system.
Countries with better response to COVID-19 have mobilized, trained and reallocated their health workforce in addition to hiring new staff, using volunteers and medical trainees and mobilizing retirees [ 102 ]. Several strategies have also been implemented to mitigate disruptions in service delivery and utilization, including: triaging to identify the most urgent patient needs, and postponing elective medical procedures; switching to alternative models of care, such as providing more home-based care and telemedicine [ 101 ].
This study identifies that the COVID-19 pandemic, in terms f cases and deaths, is heterogeneous around the world. This variability is explained by differences in vulnerability, preparedness, and response. It confirms that a high level of HDI, UHCI and GHSI are essential but not sufficient to control epidemics [ 103 ]. An effective response to public health emergencies requires a joint and reinforcing implementation of UHC, health emergency and disease control priorities [ 104 , 105 ], as well as good governance and social protection systems [ 106 ]. Important lessons have been learned to cope better with the COVID-19 pandemic and future emerging or re-emerging pandemics. Countries should strengthen health systems, minimize fragmentation of public health, primary care and secondary care, and improve coordination with other sectors. The pandemic has exposed the health effects of longstanding social inequities, which should be addressed through policies and actions to tackle vulnerability in living and working conditions [ 106 ].
The shift in the pandemic epicentre from high-income to MICs was observed in the second global wave of the pandemic. This is due to in part to the large-scale provision of vaccines in HICs [ 15 ] as well as the limitations in the response in LMICs, including inadequate testing, quarantine and isolation, contact tracing, and social distancing. The second wave of the pandemic in low- and middle-income countries spread more rapidly than the first wave and affected younger and healthier populations due to factors, including poor government decision making, citizen behaviour, and the emergence of highly transmissible SARS-CoV-2 variants [ 107 ]. It has become catastrophic in some MICs to prematurely relax key public health measures, such as mask wearing, physical distancing, and hand hygiene [ 108 ].
There is consensus that global vaccination is essential to ending the pandemic. Universal and equitable vaccine delivery, implemented with high volume, speed and quality, is vital for an effective and sustainable response to the current pandemic and future public health emergencies. There is, however, ongoing concern regarding access to COVID-19 vaccines in low-income countries [ 109 ]. Moreover, there is shortage of essential supplies, including oxygen, which has had a major impact on the prevention and control of the pandemic. It is, therefore, vital to transform (through good governance and financing mechanisms) the ACT-A platform to deliver vaccines, therapeutics, diagnostics, and other essential supplies [ 109 , 110 ]. The global health community has the responsibility to address these inequalities so that we can collectively end the pandemic [ 107 ].
The Omicron variant has a huge role in the current wave around the world despite high vaccine coverage [ 111 ]. Omicron appears to spread rapidly around the world ever since it was identified in November 2021 [ 112 ]. It becomes obvious that vaccination alone is inadequate for controlling the infection. This has changed our understanding of the COVID-19 pandemic endgame. The emergence of new variants of concern and their spread around the world has highlighted the importance of combination prevention, including high vaccination coverage in combination with other public health prevention measures [ 112 ].
Overall, the COVID-19 pandemic and the response to it emphasise valuable lessons towards an effective and sustainable response to public health emergencies. We argue that the PHC approach captures the different preparedness and response strategies required towards ensuring health security and UHC [ 113 ]. The PHC approach enables countries to progressively realize universal access to good-quality health services (including essential public health functions) and equity, empower people and communities, strengthen multi-sectoral policy and action for health, and enhance good governance [ 114 ]. These are essential in the prevention and control of public health emergencies, to suppress transmission, and reduce morbidity and mortality [ 115 ]. Access to high-quality primary care is at the foundation of any strong health system [ 116 ], which will, in turn, have effect on containing the epidemic, and reducing mortality and CFR [ 117 ]. Australia is a good example in this regard because it has implemented a comprehensive PHC approach in combination with border restrictions to ensure health system capacity is not exceeded [ 56 ]. The PHC approach will enable countries to develop and implement a context-specific health strategy, enhance governance, strengthen their (public) health systems, minimize segmentation and fragmentation, and tackle upstream structural issues, including discrimination and socio-economic inequities [ 118 ]. This is the type of public health approach (comprehensive, equity-focused and participatory) that will be effective and sustainable to tackle public health emergencies in the twenty-first century [ 119 , 120 ]. In addition, it is vital to transform the global and regional health systems, with a strong IHR and an empowered WHO at the apex [ 121 ]. We contend that this is the way towards a healthier and safer country, region and world.
The COVID-19 pandemic demonstrates that the world remains vulnerable to public health emergencies with significant health and other socio-economic impacts. The pandemic takes variable shapes and forms across regions and countries around the world. The pandemic has impacted countries with inadequate governance of the epidemic, fragmentation of their health systems and higher socio-economic inequities more than others. We argue that adequate response to public health emergencies requires that countries develop and implement a context-specific national strategy, enhance governance of public health emergency, build the capacity of their health systems, minimize fragmentation, and tackle socio-economic inequities. This is possible through a PHC approach that provides universal access to good-quality health services through empowered communities and multi-sectoral policy and action for health development. The pandemic has affected every corner of the world; it has demonstrated that “no country is safe unless other countries are safe”. This should be a call for a strong global health system based on the values of justice and capabilities for health.
Availability of data and materials
Data are available in a public, open access repository: Johns Hopkins University: https://coronavirus.jhu.edu/data/new-cases , and UNDP: http://hdr.undp.org/en/2019-report ; WHO: https://www.who.int/publications/m/item/weekly-epidemiological-update%2D%2D-22-december-2020
Abbreviations
Coronavirus Disease 2019
Case-fatality rates
Human development index
Universal health coverage index
Global Health Security index
High-income countries
Middle-income countries
El Zowalaty ME, Järhult JD. From SARS to COVID-19: A previously unknown SARS-CoV-2 virus of pandemic potential infecting humans–Call for a One Health approach. One Health. 2020;9:100124. https://doi.org/10.1016/j.onehlt.2020.100124 .
Van Damme W, Dahake R, Delamou A, Ingelbeen B, Wouters E, Vanham G, et al. The COVID-19 pandemic: diverse contexts; different epidemics—how and why? BMJ Glob Health. 2020;5(7):e003098.
Article PubMed Google Scholar
World Health Organization (WHO): Coronavirus disease ( COVID-19): situation report, 150. 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200618-covid-19-sitrep-150.pdf .
Weekly epidemiological update - 22 December 2020 [ https://www.who.int/publications/m/item/weekly-epidemiological-update%2D%2D-22-december-2020 ].
Worldometer: COVID-19 coronavirus pandemic. 2020. https://www.worldometers.info/coronavirus/ .
Anand S, Sen A. Human Development Index: Methodology and Measurement. 1994. http://hdr.undp.org/en/content/human-development-index-methodology-and-measurement .
De Larochelambert Q, Marc A, Antero J, Le Bourg E, Toussaint J-F. Covid-19 mortality: a matter of vulnerability among nations facing limited margins of adaptation. Public Health. 2020;8. https://doi.org/10.3389/fpubh.2020.604339 .
de Winter JC, Gosling SD, Potter J. Comparing the Pearson and Spearman correlation coefficients across distributions and sample sizes: a tutorial using simulations and empirical data. Psychol Methods. 2016;21(3):273.
World Health Organization. Universal health coverage [ http://www.who.int/universal_health_coverage/en/ ].
Johns Hopkins Center for Health Security. Global Health Security Index [ https://www.ghsindex.org/ ].
Pol Antràs SJR. Esteban Rossi-Hansberg: how do globalisation and pandemics interact? Surprising insights from a new model. In: #LSEThinks | CEP | global development vol. 2020. London: London School of Economics; 2020.
Google Scholar
Cai P. Understanding China’s belt and road initiative; 2017.
Baldwin R, Tomiura E. Thinking ahead about the trade impact of COVID-19. Economics in the Time of COVID-19. 2020;59. https://repository.graduateinstitute.ch/record/298220?ln=en .
Organization WH: Coronavirus disease ( COVID-19): situation report, 182. 2020.
Johns Hopkins University: COVID-19 Map - Johns Hopkins Coronavirus Resource Center. In. Edited by Security JHUCfH; 2021. https://coronavirus.jhu.edu/map.html .
Wang T, Du Z, Zhu F, Cao Z, An Y, Gao Y, et al. Comorbidities and multi-organ injuries in the treatment of COVID-19. Lancet. 2020;395(10228):e52.
Article CAS PubMed PubMed Central Google Scholar
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061–9.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–13.
Hussain A, Bhowmik B, Do Vale Moreira NC. COVID-19 and diabetes: knowledge in progress. Diabetes Res Clin Pract. 2020;162:108142. https://doi.org/10.1016/j.diabres.2020.108142 . Epub 2020 Apr 9.
Covid C, COVID C, COVID C, Chow N, Fleming-Dutra K, Gierke R, Hall A, et al. Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019—United States, February 12–march 28, 2020. Morb Mortal Wkly Rep. 2020;69(13):382.
Group C-S. Characteristics of COVID-19 patients dying in Italy: report based on available data on March 20th, 2020. Rome: Instituto Superiore Di Sanita; 2020. https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf .
Guan W-j, Ni Z-y, Hu Y, Liang W-H, Ou C-Q, He J-X, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–20.
Article CAS PubMed Google Scholar
Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington state. Jama. 2020;323(16):1612–4.
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the new York City area. JAMA. 2020;323(20):2052–9. https://doi.org/10.1001/jama.2020.6775 .
Covid C, Team R. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12–march 16, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):343–6.
Article Google Scholar
Mbow M, Lell B, Jochems SP, Cisse B, Mboup S, Dewals BG, et al. COVID-19 in Africa: dampening the storm? Science. 2020;369(6504):624–6.
Kavanagh MM, Erondu NA, Tomori O, Dzau VJ, Okiro EA, Maleche A, et al. Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics. Lancet. 2020;395(10238):1735–8.
Nordling L. Africa's pandemic puzzle: why so few cases and deaths? In: American Association for the Advancement of Science; 2020.
Oran DP, Topol EJ. Prevalence of asymptomatic SARS-CoV-2 infection: a narrative review. Ann Intern Med. 2020;173(5):362–7. https://doi.org/10.7326/M20-3012 . Epub 2020 Jun 3.
Nikolai LA, Meyer CG, Kremsner PG, Velavan TP. Asymptomatic SARS coronavirus 2 infection: invisible yet invincible. Int J Infect Dis. 2020;100:112–6. https://doi.org/10.1016/j.ijid.2020.08.076 . Epub 2020 Sep 3.
Rao C, Bradshaw D, Mathers CD. Improving death registration and statistics in developing countries: lessons from sub-Saharan Africa. Southern Afr J Demography. 2004:81–99.
Mehtar S, Preiser W, Lakhe NA, Bousso A, TamFum J-JM, Kallay O, et al. Limiting the spread of COVID-19 in Africa: one size mitigation strategies do not fit all countries. Lancet Glob Health. 2020;8(7):e881–3. Published online 2020 Apr 28. https://doi.org/10.1016/S2214-109X(20)30212-6 .
Nachega J, Seydi M, Zumla A. The late arrival of coronavirus disease 2019 (COVID-19) in Africa: mitigating pan-continental spread. Clin Infect Dis. 2020;71(15):875–8.
Gwilliam K, Foster V, Archondo-Callao R, Briceno-Garmendia C, Nogales A, Sethi K. Africa infrastructure country diagnostic: roads in sub-Saharan Africa: The World Bank; 2008.
Guengant J-P. Africa’s population: history, current status, and projections. In: Africa's Population: In Search of a Demographic Dividend: Springer; 2017. p. 11–31.
Collaborators GOD, Bernabe E, Marcenes W, Hernandez C, Bailey J, Abreu L, et al. Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: a systematic analysis for the global burden of disease 2017 study. J Dent Res. 2020;99(4):362–73.
Cambaza EM, Viegas GC, Cambaza C. Manuel a: potential impact of temperature and atmospheric pressure on the number of cases of COVID-19 in Mozambique, southern Africa. J Public Health Epidemiol. 2020;12(3):246–60.
Lawal Y. Africa’s low COVID-19 mortality rate: a paradox? Int J Infect Dis. 2021;102:118–22.
Nkengasong JN, Mankoula W. Looming threat of COVID-19 infection in Africa: act collectively, and fast. Lancet. 2020;395(10227):841–2.
African Union and Africa CDC. African union and Africa CDC launches partnerships for African vaccine manufacturing (PAVM), framework to achieve it and signs 2 MoUs: African Union and Africa CDC; 2021.
Forbes. What Do Countries With The Best Coronavirus Responses Have In Common? Women Leaders [ https://www.forbes.com/sites/avivahwittenbergcox/2020/04/13/what-do-countries-with-the-best-coronavirus-reponses-have-in-common-women-leaders/#603bd9433dec ].
University of Notre Dame. What can we learn from Austria’s response to COVID-19? [ https://keough.nd.edu/what-can-we-learn-from-austrias-response-to-covid-19/ ].
Stoller JK. Reflections on leadership in the time of COVID-19. BMJ Leader. 2020. https://doi.org/10.1136/leader-2020-000244 .
Houston Public Media. What 6 Of The 7 Countries With The Most COVID-19 Cases Have In Common [ https://www.npr.org/sections/goatsandsoda/2020/07/31/896879448/the-nations-with-the-most-to-lose-from-covid-19 ].
Hale T, Petherick A, Phillips T, Webster S. Variation in government responses to COVID-19. Blavatnik school of government working paper. 2020;31. https://en.unesco.org/inclusivepolicylab/sites/default/files/learning/document/2020/4/BSG-WP-2020-031-v3.0.pdf .
The Editors. Dying in a leadership vacuum. N Engl J Med. 2020;383(15):1479–80.
The Cable News Network. US and UK are bottom of the pile in rankings of governments' handling of coronavirus pandemic [ https://edition.cnn.com/2020/08/27/world/global-coronavirus-attitudes-pew-intl/index.html ].
Huston P, Campbell J, Russell G, Goodyear-Smith F, Phillips RL, van Weel C, et al. COVID-19 and primary care in six countries. BJGP Open. 2020;4(4):bjgpopen20X101128. https://doi.org/10.3399/bjgpopen20X101128 .
Goodyear-Smith F, Kinder K, Eden AR, Strydom S, Bazemore A, Phillips R, et al. Primary care perspectives on pandemic politics. Glob Public Health. 2021;16(8-9):1304–19. https://doi.org/10.1080/17441692.2021.1876751 . Epub 2021 Jan 24.
Rutledge PE. Trump, COVID-19, and the war on expertise. Am Rev Public Adm. 2020;50(6-7):505–11.
Ugarte DA, Cumberland WG, Flores L, Young SD. Public attitudes about COVID-19 in response to president trump's social media posts. JAMA Netw Open. 2021;4(2):e210101.
Article PubMed PubMed Central Google Scholar
Lal A, Erondu NA, Heymann DL, Gitahi G, Yates R. Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage. Lancet. 2021;397(10268):61–7. https://doi.org/10.1016/S0140-6736(20)32228-5 . Epub 2020 Dec 1.
Tromberg BJ, Schwetz TA, Pérez-Stable EJ, Hodes RJ, Woychik RP, Bright RA, et al. Rapid scaling up of Covid-19 diagnostic testing in the United States—the NIH RADx initiative. N Engl J Med. 2020;383(11):1071–7.
Marwaha J, Halamka J, Brat G. Lifesaving ventilators will sit unused without a national data-sharing effort; 2020.
Kidd MR. Five principles for pandemic preparedness: lessons from the Australian COVID-19 primary care response. Br J Gen Pract. 2020;70(696):316–7. https://doi.org/10.3399/bjgp20X710765 . Print 2020 Jul.
Hsu LY, Tan M-H. What Singapore can teach the US about responding to COVID-19. STAT News. 2020. https://www.statnews.com/2020/03/23/singapore-teach-united-states-about-covid-19-response/ .
Horton R. Offline: COVID-19 is not a pandemic. Lancet (London, England). 2020;396(10255):874.
Article CAS Google Scholar
Raisi-Estabragh Z, McCracken C, Bethell MS, Cooper J, Cooper C, Caulfield MJ, et al. Greater risk of severe COVID-19 in black, Asian and minority ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25 (OH)-vitamin D status: study of 1326 cases from the UK biobank. J Public Health. 2020;42(3):451–60.
Hamidianjahromi A. Why African Americans are a potential target for COVID-19 infection in the United States. J Med Internet Res. 2020;22(6):e19934.
Tangcharoensathien V, Bassett MT, Meng Q, Mills A. Are overwhelmed health systems an inevitable consequence of covid-19? Experiences from China, Thailand, and New York State. BMJ. 2021;372. https://doi.org/10.1136/bmj.n83 .
Organization WH: COVID-19 health system response monitor, Thailand. 2020.
Narkvichien M. Thailand’s 1 million village health volunteers-“unsung heroes”-are helping guard communities nationwide from COVID-19. Nonthaburi: World Health Organization; 2020.
Kupferschmidt K, Cohen J. Can China's COVID-19 strategy work elsewhere? In: American Association for the Advancement of Science; 2020.
Al Saidi AMO, Nur FA, Al-Mandhari AS, El Rabbat M, Hafeez A, Abubakar A. Decisive leadership is a necessity in the COVID-19 response. Lancet. 2020;396(10247):295–8.
Forman R, Atun R, McKee M, Mossialos E. 12 lessons learned from the management of the coronavirus pandemic. Health Policy. 2020;124(6):577–80. https://doi.org/10.1016/j.healthpol.2020.05.008 .
Barberia LG, Gómez EJ. Political and institutional perils of Brazil's COVID-19 crisis. Lancet. 2020;396(10248):367–8.
Ortega F, Orsini M. Governing COVID-19 without government in Brazil: ignorance, neoliberal authoritarianism, and the collapse of public health leadership. Global Public Health. 2020;15(9):1257–77.
Ezequiel GE, Jafet A, Hugo A, Pedro D, Ana Maria M, Carola OV, et al. The COVID-19 pandemic: a call to action for health systems in Latin America to strengthen quality of care. Int J Qual Health Care. 2021;33(1):mzaa062.
Rocha R, Atun R, Massuda A, Rache B, Spinola P, Nunes L, et al. Effect of socioeconomic inequalities and vulnerabilities on health-system preparedness and response to COVID-19 in Brazil: a comprehensive analysis. Lancet Glob Health. 2021;9(6):e782–92. https://doi.org/10.1016/S2214-109X(21)00081-4 . Epub 2021 Apr 12.
Lancet T. India under COVID-19 lockdown. Lancet (London, England). 2020;395(10233):1315.
Siddiqui AF, Wiederkehr M, Rozanova L, Flahault A. Situation of India in the COVID-19 pandemic: India’s initial pandemic experience. Int J Environ Res Public Health. 2020;17(23):8994.
Article CAS PubMed Central Google Scholar
Taneja P, Bali AS. India’s domestic and foreign policy responses to COVID-19. Round Table. 2021;110(1):46–61.
Choutagunta A, Manish G, Rajagopalan S. Battling COVID-19 with dysfunctional federalism: lessons from India. South Econ J. 2021;87(4):1267–99.
Mallapaty S. India's massive COVID surge puzzles scientists. Nature. 2021;592(7856):667–8.
Thiagarajan K. Why is India having a covid-19 surge? In: British Medical Journal Publishing Group; 2021.
Fisman DN, Greer AL, Tuite AR. Age is just a number: a critically important number for COVID-19 case fatality. Ann Intern Med. 2020;173(9):762–3.
Sudharsanan N, Didzun O, Bärnighausen T, Geldsetzer P. The contribution of the age distribution of cases to COVID-19 case fatality across countries: a 9-country demographic study. Ann Intern Med. 2020;173(9):714–20. https://doi.org/10.7326/M20-2973 . Epub 2020 Jul 22.
Think Global Health. The Myth of South Asian Exceptionalism. In: He Myth of South Asian Exceptionalism: South Asia's young population conceals the effects that COVID-19 has on its older and more vulnerable people. vol. 2020; 2020.
Ioannidis JP, Axfors C, Contopoulos-Ioannidis DG. Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters. Environ Res. 2020;188:109890.
Kim D-H, Choe YJ, Jeong J-Y. Understanding and interpretation of case fatality rate of coronavirus disease 2019. J Korean Med Sci. 2020;35(12):e137. https://doi.org/10.3346/jkms.2020.35.e137 .
Rajgor DD, Lee MH, Archuleta S, Bagdasarian N, Quek SC. The many estimates of the COVID-19 case fatality rate. Lancet Infect Dis. 2020;20(7):776–7.
Sorci G, Faivre B, Morand S. Explaining among-country variation in COVID-19 case fatality rate. Sci Rep. 2020;10(1):1–11.
Sen-Crowe B, Sutherland M, McKenney M, Elkbuli A. A closer look into global hospital beds capacity and resource shortages during the COVID-19 pandemic. J Surg Res. 2021;260:56–63.
Li M, Zhang Z, Cao W, Liu Y, Du B, Chen C, et al. Identifying novel factors associated with COVID-19 transmission and fatality using the machine learning approach. Sci Total Environ. 2021;764:142810.
Undurraga EA, Chowell G, Mizumoto K. COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, march–august 2020. Infect Dis Poverty. 2021;10(1):1–11.
Taylor L. How Latin America is fighting covid-19, for better and worse. BMJ. 2020;370:m3319. https://doi.org/10.1136/bmj.m3319 .
Bhuyan A. Covid-19: India looks to import oxygen as cases surge, overwhelming hospitals. In: British Medical Journal Publishing Group; 2021.
An BY, Tang S-Y. Lessons from COVID-19 responses in East Asia: institutional infrastructure and enduring policy instruments. Am Rev Public Adm. 2020;50(6-7):790–800.
Chen H, Shi L, Zhang Y, Wang X, Sun G. A cross-country core strategy comparison in China, Japan, Singapore and South Korea during the early COVID-19 pandemic. Glob Health. 2021;17(1):1–10.
Kahathuduwa CN, Dhanasekara CS, Chin S-H. Case fatality rate in COVID-19: a systematic review and meta-analysis. J Prev Med Hyg. 2021;62(2):E311–20. https://doi.org/10.15167/2421-4248/jpmh2021.62.2.1627 . eCollection 2021 Jun.
Meyerowitz-Katz G, Merone L. A systematic review and meta-analysis of published research data on COVID-19 infection-fatality rates. Int J Infect Dis. 2020.
Seoane B. A scaling approach to estimate the COVID-19 infection fatality ratio from incomplete data. PLoS One. 2021;16(2):e0246831. https://doi.org/10.1371/journal.pone.0246831 . eCollection 2021.
Byambasuren O, Dobler CC, Bell K, Rojas DP, Clark J, McLaws M-L, et al. Comparison of seroprevalence of SARS-CoV-2 infections with cumulative and imputed COVID-19 cases: systematic review. PLoS One. 2021;16(4):e0248946.
Shakiba M, Nazemipour M, Salari A, Mehrabian F, Nazari SSH, Rezvani SM, et al. Seroprevalence of SARS-CoV-2 in Guilan Province, Iran, April 2020. Emerg Infect Dis. 2021;27(2):636.
Blanchet K, Alwan A, Antoine C, Cros MJ, Feroz F, Guracha TA, et al. Protecting essential health services in low-income and middle-income countries and humanitarian settings while responding to the COVID-19 pandemic. BMJ Glob Health. 2020;5(10):e003675.
Thome J, Coogan AN, Fischer M, Tucha O, Faltraco F. Challenges for mental health services during the 2020 COVID-19 outbreak in Germany. Psychiatry Clin Neurosci. 2020;74(7):407. https://doi.org/10.1111/pcn.13019 . Epub 2020 May 26.
Riley T, Sully E, Ahmed Z, Biddlecom A. Estimates of the potential impact of the COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. Int Perspect Sex Reprod Health. 2020;46:73–6.
World Health Organization (WHO): Maintaining essential health services: operational guidance for the COVID-19 context: interim guidance, 1 June 2020. In.: World Health Organization; 2020. https://www.who.int/publications/i/item/WHO-2019-nCoV-essential_health_services-2020.2 .
World Health Organization (WHO): Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report, 27 August 2020. In.: World Health Organization; 2020. https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-EHS_continuity-survey-2020.1 .
World Health Organization (WHO): Second round of the national pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report, 22 April 2021. In.: World Health Organization; 2021. https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS-continuity-survey-2021.1 .
Organization WH. COVID-19: operational guidance for maintaining essential health services during an outbreak: interim guidance, 25 march 2020: World Health Organization; 2020.
Chen Y-Y, Assefa Y. The heterogeneity of the COVID-19 pandemic and national responses: an explanatory mixed-methods study. BMC Public Health. 2021;21(1):1–15.
World Health Organization (WHO). Thirteenth general programme of work 2019–2023. The seventy-first world health assembly. Geneva (Switzerland): World Health Organization; 2018.
Mahjour J, Mirza Z, Rashidian A, Atta H, Hajjeh R, Thieren M, et al. " promote health, keep the world safe, serve the vulnerable" in the eastern Mediterranean region. East Mediterr Health J. 2018;24(4):323–4.
Rollston R, Galea S. COVID-19 and the social determinants of health. Am J Health Promot. 2020;34(6):687–9. https://doi.org/10.1177/0890117120930536b .
Nachega JB, Sam-Agudu NA, Masekela R, van der Zalm MM, Nsanzimana S, Condo J, et al. Addressing challenges to rolling out COVID-19 vaccines in African countries. Lancet Glob Health. 2021;9(6):e746–8. https://doi.org/10.1016/S2214-109X(21)00097-8 . Epub 2021 Mar 10.
Skegg D, Gluckman P, Boulton G, Hackmann H, Karim SSA, Piot P, et al. Future scenarios for the COVID-19 pandemic. Lancet. 2021;397(10276):777–8.
Nhamo G, Chikodzi D, Kunene HP, Mashula N. COVID-19 vaccines and treatments nationalism: challenges for low-income countries and the attainment of the SDGs. Global Public Health. 2021;16(3):319–39.
Figueroa JP, Bottazzi ME, Hotez P, Batista C, Ergonul O, Gilbert S, et al. Urgent needs of low-income and middle-income countries for COVID-19 vaccines and therapeutics. Lancet. 2021;397(10274):562–4.
He X, Hong W, Pan X, Lu G, Wei X. SARS-CoV-2 omicron variant: characteristics and prevention. Med Comm (2020). 2021;2(4):838–45. https://doi.org/10.1002/mco2.110 .
Karim SSA, Karim QA. Omicron SARS-CoV-2 variant: a new chapter in the COVID-19 pandemic. Lancet. 2021;398(10317):2126–8.
Sanders D, Nandi S, Labonté R, Vance C, Van Damme W. From primary health care to universal health coverage—one step forward and two steps back. Lancet. 2019;394(10199):619–21.
Hone T, Macinko J, Millett C. Revisiting Alma-Ata: what is the role of primary health care in achieving the sustainable development goals? Lancet. 2018;392(10156):1461–72.
Redwood-Campbell L, Abrahams J. Primary health care and disasters—the current state of the literature: what we know, gaps and next steps. Prehospital Disaster Med. 2011;26(3):184–91.
Bitton A, Ratcliffe HL, Veillard JH, Kress DH, Barkley S, Kimball M, et al. Primary health care as a foundation for strengthening health systems in low-and middle-income countries. J Gen Intern Med. 2017;32(5):566–71.
Dunlop C, Howe A, Li D, Allen LN. The coronavirus outbreak: the central role of primary care in emergency preparedness and response. BJGP Open. 2020;4(1):bjgpopen20X101041. https://doi.org/10.3399/bjgpopen20X101041 .
Assefa Y, Gilks CF, van de Pas R, Reid S, Gete DG, Van Damme W. Reimagining global health systems for the 21st century: lessons from the COVID-19 pandemic. BMJ Glob Health. 2021;6(4):e004882.
Loewenson R, Accoe K, Bajpai N, Buse K, Abi Deivanayagam T, London L, et al. Reclaiming comprehensive public health. BMJ Glob Health. 2020;5(9):e003886.
Rawaf S, Allen LN, Stigler FL, Kringos D, Quezada Yamamoto H, van Weel C, et al. Lessons on the COVID-19 pandemic, for and by primary care professionals worldwide. Eur J Gen Pract. 2020;26(1):129–33.
Gostin LO, Friedman EA. A retrospective and prospective analysis of the west African Ebola virus disease epidemic: robust national health systems at the foundation and an empowered WHO at the apex. Lancet. 2015;385(9980):1902–9.
Download references
Acknowledgements
Not applicable.
No funding was obtained for this study.
Author information
Authors and affiliations.
School of Public Health, the University of Queensland, Brisbane, Australia
Yibeltal Assefa, Charles F. Gilks, Simon Reid & Dereje Gedle Gete
Institute of Tropical Medicine, Antwerp, Belgium
Remco van de Pas & Wim Van Damme
You can also search for this author in PubMed Google Scholar
Contributions
YA conceived the idea of the research, collected and analysed the data, and prepared the first and subsequent drafts. DG participated in data collection and analysis. CFG, SR, RVDP, DG and WVD provided comments during subsequent drafts. All authors read and approved the final manuscript.
Corresponding author
Correspondence to Yibeltal Assefa .
Ethics declarations
Ethics approval and consent to participate, consent for publication, competing interests.
The authors declare that they have no competing interests.
Additional information
Publisher’s note.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Reprints and Permissions
About this article
Cite this article.
Assefa, Y., Gilks, C.F., Reid, S. et al. Analysis of the COVID-19 pandemic: lessons towards a more effective response to public health emergencies. Global Health 18 , 10 (2022). https://doi.org/10.1186/s12992-022-00805-9
Download citation
Received : 04 August 2021
Accepted : 14 January 2022
Published : 04 February 2022
DOI : https://doi.org/10.1186/s12992-022-00805-9
Share this article
Anyone you share the following link with will be able to read this content:
Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative
- Heterogeneity
Globalization and Health
ISSN: 1744-8603
- Submission enquiries: Access here and click Contact Us
- General enquiries: [email protected]
International Journal of Public Administration
Free access
Governments’ Responses to the COVID-19 Pandemic
- Download citation
- https://doi.org/10.1080/01900692.2021.1936964
Common themes and questions
Articles included in this issue, issue #11 includes, issue #12 includes, introduction.
- Full Article
- Figures & data
- Reprints & Permissions
- View PDF PDF View EPUB EPUB
“COVID-19” or “the pandemic” is often referred to as a “novel Coronavirus” because almost everything about it has been startlingly new – “novel.” When COVID-19 was first identified late in 2019, scientists around the globe knew almost nothing about it. The disease’s origins, seriousness of infection, methods or rates of transmission, how to prevent or treat it, its long-term health side effects, if contracting the disease would create immunity or how long immunity would last for different degrees of infection were mysteries (Dabrowska et al., Citation 2020 ). Therefore, at the outset, government officials had almost no basis for developing and implementing public health policy approaches and even less ability to propose “balanced” public health-economic public policy approaches (Moon, Citation 2020 ).
As scientists began to learn about the danger that COVID-19 infection represented to individuals, and about “community spread” through airborne and surface transmission, public health strategies became apparent: social distance, wearing masks, using hand sanitizer, and regularly washing hands. As scientists began to learn about different rates of infection and consequences of infection in certain sub-populations, public officials started to know where they should emphasize public health interventions (International Monetary Fund, Citation 2020 ). Testing and tracing were core strategic policy tools (Ritchie & Roser, Citation 2020 ).
But these public health approaches required changes in individuals’ and families’ behaviors – changes that many people in countries world-wide deemed unwanted and unneeded. Many did not believe that the COVID-19 was a serious threat to them or their communities, and many understood that effective public health policy approaches would have serious negative impacts on personal freedoms and economic activity. People wanted “a silver bullet” solution – not interference in their lives and livelihoods. Governments around the world had to make policy decisions with little knowledge and considerable public opposition (Bouckaert et al, Citation 2020 ; Christensen & Laegreid, Citation 2020 ). Inevitably, different national and local governments took widely differing approaches to dealing with COVID-19 (BallotPedia, Citation 2021 . Bremmer, Citation 2020 ; Dzigbede et al., Citation 2020 ).
Then, as medical scientists and public officials were starting to learn about the disease and effective strategies for containing it in late 2020 and in the early months of 2021, several new variants were identified. These new variants, which are commonly known by where they were first recognized, including the U.K., South Africa and Brazil variants, began gaining footholds in countries around the world. These variants – and others as time passes – are more transmissible, possibly more deadly, and are not as well protected against by currently-approved vaccines. These new variants are causing huge surges in new cases and are taking huge tolls in human lives.
At the time that this special issue of The International Journal of Public Administration was written, the trajectory of the disease and its variants, and governments’ responses to them had taken many different shapes and forms. “Pandemic fatigue” and widespread availability of vaccines in some countries have caused relaxed government restrictions on social distancing and other preventive public health strategies nearly universally despite continuing waves of new cases, hospitalizations, and deaths. For example, California, the most populous state in the US, has “unveiled a sweeping reopening plan for June 15” (Money & Rong-Gong Lin, Citation 2021 ).
There are multiple other reasons why governments’ responses have varied. For example, while acknowledging that “democracies” and “authoritarian states” are only points on a continuum, it holds that some authoritarian-leaning governments have been able to impose restrictions on behaviors in their populations that most democratic-leaning governments could not – or at least not for very long. Differences in government structures and ideologies, however, only begin to explain why countries have taken vastly different approaches, particularly to “closing down” and testing and tracing (Serikbayeva et al., Citation 2021 , included in this issue). And it is premature to assert the outcomes of the dramatically different government approaches. Preliminary data are becoming available about the effectiveness of different policy approaches, but the story is still in its infancy. As the issue is being assembled, spikes are recurring is areas where the disease had been waning (Webeck & Angst, Citation 2020 ). We will not be able to know true outcomes for years.
… surprise management theory as the only conceivable way to building degrees of capacity in advance with anticipation of unknowns, surprises, and more surprises.” The problem is human nature and social systems dynamics … that does not allow humans and institutions to stay in such a state of homeostasis long enough to persevere, adapt to, and overcome unfolding and evolving challenges such as COVID-19 or any other similar threats. We humans simply forget, or easily overlook, celebrate success too soon, and institutions --like American federal government and its leadership or other institutions across the globe--do not like to live with an “inconvenient state of mind” or conditions where institutions and organizations operate--we want to get out so fast to forget it was there in the first place (Farazmand, Citation 2020 ).
Few governments have proven adept at “surprise management.” With the pandemic, elected, appointed, and permanent officials have had to make unpopular decisions with minimal and often-changing input about the nature of the disease and which steps would yield the most beneficial results efficiently. Indeed, there has been considerable disagreement about which measures best represent “successful” government interventions, to a large degree because of the disease’s impacts on the public health and the economy, citizen resistance, and because knowledge about the disease is still limited (Wallace-Wells, Citation 2021 ). A partial list of possible measures of successful responses would include:
Number of cases
Number of cases per population
Changes over periods of time in the number of cases
Number of hospitalizations
Number of hospitalizations per population
Number of hospitalizations per the number of cases
Changes in the number of hospitalizations
Infection rate (% of tests positive)
Change in % of tests positive
Number of ICU patients
Number of ICU patients per population
Change in number of ICU patients
Number of recovered patients
Number of recovered patients per population
Number of recovered patients per cases
Number of people with “long haul” symptoms (Komaroff, Citation 2020 )
Impact of the long-haul symptoms on recovery
Impact of long-haul symptoms on longevity
And, of course also:
Number of (COVID-related) deaths
Number of deaths per cases
Number of deaths per population
Number of cases and number of cases per population : The number of cases depends heavily on the number of tests conducted, the accuracy of the tests, and which populations are tested (e.g., only older people; no people with underlying health conditions; few or no minority populations).
Infection rate and change in % of tests positive . Same as for number of cases and number of cases per population.
Number of (COVID-related) deaths and number of deaths per cases . If a patient with COVID-19 AND other diseases (e.g., history of heart or lung disease) dies, was COVID-19 or the other disease the primary cause of death? Can this be determined accurately without significant effort? And, if the measure is number of deaths per cases , the same problems arise as mentioned in the first sub-paragraph above. The validity of the number depends on the accuracy of the number of cases and the accuracy of the number of deaths.
Few – or perhaps no – metrics are without limitations and critics – even those that initially appear unassailable. In addition to the measurement problems mentioned above, different metrics represent the effectiveness of different parts of a government’s response system. Governments often emphasize their accomplishments using metrics that show their approach in the best light.
The articles in this issue present divergent viewpoints from multiple nations, yet there are common themes and questions. One recurrent theme is the need for individuals to decide for themselves how they will approach the often-frightening reality of COVID-19. Not all communities have equal capacity to manage their relationships with the disease.
As has been mentioned, different types of governance raise different questions about disease management. Governments of all “flavors” ultimately need to develop citizen consensus and cooperation in order to achieve long-term success to control the pandemic (Kettle, Citation 2020 ).
A second common factor is the value of community solidarity versus the primacy of individualism within a society. Some response decisions are driven by a motive to protect others in the wider community, including concern for the elderly, people with compromised immune systems, and front-line essential workers who cannot shelter in place because they provide the food, provide health care, and drive public transit vehicles. Their incidence of disease has been higher than among those who can safely work from home with lower exposure to the circulating virus. Yet other people express concerns about their liberty, the right to go where they please, when they please, and to not wear a mask. In some places these have become major political issues that have resulted in stark individualism, leading to, for example, massive spring break beach parties and summer motorcycle rallies, which caused resurgences of contagion just when it was thought they had begun to subside.
Many people strictly have adhered to public health guidelines to protect their loved friends and family. The focus has been on keeping contagion at bay in their household and among extended families and friendship groups. Thus, many religious and secular holidays have been celebrated in solitude or by Zoom, raising stress levels and the sense of loneliness. Many people have remained in strict isolation out of fear of the disease and its impact on themselves. The result of both motivations has been strict quarantines that have brought parts of the economy to a halt, while stimulating new lines of commerce, like meal delivery, on-line shopping and its concomitant Amazon deliveries.
A third factor is the state’s capacity to provide pandemic mitigation services (Centers for Disease Control, Citation 2020 ). Initially all nations had inadequate capacity for testing, but a number of smaller nations quickly implemented community testing and contact tracing, using both community solidarity and communication technology to try to get ahead of the disease, including an app that notified phone users when they had been near someone who tested positive (Moon, Citation 2020 ). In most societies, social distancing has not been possible for the homeless, the poor living in crowded conditions, prisoners and people in long-term care facilities. Many of these became early victims of COVID-19 and therefore early recipients of the vaccine in nations with an adequate vaccine supply. An international effort was needed to share the vaccine with nations without their own medical research infrastructure. Definitive medical care for those who become infected had to be developed as the disease was being studied (The Economist, Citation 2020 ). Novel approaches like having patients lie face down to take the pressure off their lungs, and dosing the ill with the plasma of those who had survived the disease, have proven relatively effective. A variety of off-label uses of existing medications have had varied outcomes, with remdesivir shortening time to recovery in hospitalized patients (Beigel et al., Citation 2020 ), and dexamethasone demonstrating effectiveness in countering cytokine storms in COVID-19 patients (Harvard Medical School, Citation 2021 ), while others showed no benefit.
In wealthier Western nations there has been a larger capacity for managing the disease from a technical perspective, but in many of these countries, citizens have refused to accept limitations on their lives. Many have not believed that the likelihood of disease prevention is high enough to justify their personal sacrifice of liberty. Others have not believed that there is compelling scientific evidence of the effectiveness of the mandated activities: wear a mask, keep six feet apart, and wash hands. Still others have developed or believed conspiracy theories about nefarious reasons why the government closed down the economy, closed the schools and churches and restricted public gatherings. There have been endless debates over baseless “beliefs” in the virus, in the pandemic, in the efficacy of the restrictions (Johnson Citation 2020 ).
“High tell tactics” have been used together with “high sell tactics” (developing community consensus) effectively in many nations. In Japan, for example, community solidarity has led to high levels of compliance without strong enforcement measures, yet there have been resisters even there (Aoki, in this issue). In Iran, culture and religion-based compliance has been high, but economy-driven social resistance has emerged (Farazmand and Danaeefard, in this issue). In free-spirited California, health officers and city councils have used existing laws to act quickly (“high tell”) with Santa Clara County having the first lock-down in the nation (Brown and Edwards, in this issue). These local officials worked to develop a consensus later as the evidence about disease severity and virulence developed at local medical research centers. Mask wearing and social distancing have been widely practiced based on “common sense,” yet resistance is still found, notably among the younger.
The role of social capital versus economic determinism has been another determining factor in community responses to COVID-19. Many people could work from home, continue their income and thereby make compliance with public health orders easy. The result has been a relatively low incidence of illness among these mostly middle class and above populations. In contrast, many essential workers have often been unable to comply with social distancing, being exposed to too many sick people in medical and long-term care settings, driving buses and delivery vehicles, or planting, harvesting, and distributing food. The incidence of infection and death has been much higher among these essential workers as demonstrated by a 2020 study at University of California at Merced (Nuttle, Citation 2021 ).
Most homeless individuals have lacked the capability to comply with prevention protocols. Fearing that the pandemic would sweep through encampments and crowded shelters, many local governments have taken over community centers and convention centers to create socially-distanced indoor shelters for the homeless. Yet many homeless people have refused to live indoors, and shelter use has never been made compulsory. Clean-ups of camps have mostly stopped in the U.S., and sanitation and trash removal are being provided to the remaining outdoors homeless encampments. The incidence of COVID-19 among the housed and unhoused homeless population remains surprisingly low (Mosites et al., Citation 2020 ).
Is “clear policy communication” the best strategy – such as led Ghana through the crisis (Boasiako & Nyarko, in this issue)? Does a history of individualism cause disease management failure, or does community solidarity make the difference, sometimes created by a social history as in Japan (Aoki, in this issue) or common threat/enemy as in Iran (Farazmand & Daneefard, in this issue)? Western nations have a history of individualism, distrust of strong central governments (tyranny), economically driven policies, rational decision-making based on commonly accepted norms. The Japanese, Iranian and California cases in this special issue of IJPA are only three of many that exhibit similarities in governments’ responses – strong leadership, early lockdowns and appeals to community solidarity – that have resulted in high levels of compliance with masks, distancing and hand washing. All of the articles in this issue support testing and vaccine administration.
Because of lack of knowledge and consensus about the disease and its prevention and treatment, there has not been common agreement across nations/states on response strategies as they have faced the disease. The primacy of self (socializing vs. economic priorities) has left many crowded cities and rural villages in ebbing and flowing incidences of COVID-19. Data collection, analysis and sharing will take years to adequately fill the metrics. Only when solid verifiable numbers are available will researchers be able to state with assurance which factors and response strategies have contributed to the best outcomes against COVID-19.
At the time that this special issue is being assembled, the Coronavirus pandemic is far from eradicated or even contained in most countries. Its physical, emotional, and economic devastation continues. New variants are spreading in many parts of the world, in most cases more quickly than the distribution of vaccinations. Therefore, this special issue cannot offer final conclusions, only interim findings and interpretations. We believe you will find the articles selected for inclusion fascinating and informative, but we will know much more about the virus, the efficacy of treatments, and the effectiveness of governments’ responses a year or two from now. It will be interesting to look back at these articles, and perhaps to learn how little we know at this point in time.
The articles in this Special Issue on Governments’ Responses to the COVID-19 Pandemic are divided into two issues of The International Journal of Public Administration : #11 and #12. Both issues contain three types of articles: analytical studies, most of which are multi-site comparative analyses; framework articles that attempt to address underlying causes and factors that help in making sense of governments’ responses; and both single-site and multi-site case studies. The wide array of nations represented in these articles provides wonderful richness and demonstrates the wide-ranging effects of government structure and ideology, societal culture, and the economy of nations on responses to COVID-19. Each article’s focal nation or nations is noted in the title or in parentheses after the authors’ names below. Each article begins with an abstract that guides the reader to articles of greatest interest.
Obviously, the quality criteria used in selecting these different types of articles vary, but the variance does not indicate that there are different levels of academic quality among the types of articles. Case studies have rigorous quality criteria, but they differ from the quality criteria used with quantitative analytical articles.
“Digital Pandemic Response Systems: A Strategic Management Framework Against COVID-19,” by Bernd Wirtz, Wilheim M. Muller and Jen C. Weyeces (not nation-specific).
“Stay-At-Home Request or Order? A Study of the Regulation of Individual Behavior During a Pandemic Crisis in Japan,” by Naomi Aoki,
“Governmental Social Media Communication Strategies during the COVID-19 Pandemic: The Case of Egypt,” by Laila El Baradei, Mohamed Kadry and Ghadeer Ahmed,
“State Capacity in Responding to COVID-19,” by Balzhan Serikbayeva, Kanat Abdulla, and Yessengali Oskenbayev (multi-country),
“Iranian Government’s Responses to the Coronavirus Pandemic (COVID-19): An Empirical Analysis with Implications for Future Crisis Management,” by Ali Farazmand and Hasan Danaeefard, and
“One Size Does Not Fit All: Schools’ Responses to the COVID-19 Crisis,” by Paolo Fedele, Silvia Iacuzzi, and Andrea Garlatti (Italy).
“Sheltering the Homeless during COVID-19 in San Jose, California,” by Darius Brown and Frances Edwards (USA), and
“Nursing Homes and COVID-19: One State’s Experience,” by Beverly A. Cigler (USA).
“Trust in Government and Social Isolation During the COVID-19 Pandemic: Evidence from Brazil,” by Clayton Silva,
“Nonprofit Capacity to Manage Hurricane-Pandemic Threat: Local and National Perspectives on Resilience during COVID-19,” by Nicole S. Hutton, Steven W. Mumford, and John J. Kiefer (USA),
“When State Political Culture Matters: An Assessment of the Resilience of the Intergovernmental Systems in Italy and Spain Coping with COVID-19,” by Mattia Casula and Serafin Pazos-Vidal,
“Responding to the Needs of the Homeless in the COVID-19 Pandemic: A Review of Adaptations in 20 Major U.S. Cities,” by Hee Soun Jang, Lisa A. Dicke, Laura Keyes, Yu Shi and Jintak Kim (USA), and
“Flunking COVID Out of Schools: A Systematic Review of Non-pharmaceutical Interventions to Minimize Novel Coronavirus-2 in Educational Settings,” by Wakana Ishihara, Kelli Sum, Jenny Lee and Dan Nathan-Roberts (not country-specific).
“Pandemic Priorities: The Impact of South Korea’s COVID-19 Policies on Vulnerable Populations,” by Eunbin Chung and Jaehee Yi,
“Government Communication during the COVID-19 Pandemic in Ghana,” by Albert Antwi-Boasiako and Enoch Nyarko, and
“Sailing Through Troubled Waters of Pandemic by ‘Sound Governance’ Boat: Lessons from Odisha, India,” by Santap Mishra.
Disclosure Statement
No potential conflict of interest was reported by the author(s).
- BallotPedia. ( 2021, March 1 ). Federal government responses to the coronavirus (COVID-19) pandemic, 2020–21 . Retrieved 03 January 2021 . https://ballotpedia.org/Federal_government_responses_to_the_coronavirus_(COVID-19)_pandemic,_2020–2021 . [Google Scholar]
- Beigel, M. D. , John, H. , Tomashek, K. M. , Dodd, L. E. , Mehta, A. K. , Zingman, B. S. , Kalil, A. C. , Elizabeth Hohmann, H. Y. , Chu, A. L. , Kline, S. , De Castilla, D. L. , Finberg, R. W. , for the ACTT-1 Study Group Members. ( 2020 , November 5 ). Remdesivir for the treatment of Covid-19 — final report . New England Journal of Medicine . 383, 1813 – 1826 . https://doi.org/10.1056/NEJMoa2007764 [Crossref] , [PubMed] , [Web of Science ®] , [Google Scholar]
- Bouckaert, G. , Galli, D. , Kuhlmann, S. , Reiter, R. , & Steven, V. H. ( 2020 ). European coronationalism? A hot spot governing a pandemic crisis . Public Administration Review , 80(5), 765 – 773 . https://doi.org/10.1111/puar.13242 [Crossref] , [PubMed] , [Web of Science ®] , [Google Scholar]
- Bremmer, I. ( 2020 , June 12 ). The best global responses to COVID-19 pandemic . Time , https://time.com/5851633/best-global-responses-covid-19/ . [Google Scholar]
- Centers for Disease Control and Prevention. ( 2020 , September . 11 update). CDC’s response: More resources . https://www.cdc.gov/coronavirus/2019-ncov/cdcresponse/index.htm [Google Scholar]
- Christensen, T. , & Laegreid, P. ( 2020 , September–October ). Balancing governance capacity and legitimacy: How the Norwegian government handled the COVID-19 crisis as a high performer . Public Administration Review , 80(5), 774 – 779 . https://doi.org/10.1111/puar.13241 [Crossref] , [PubMed] , [Web of Science ®] , [Google Scholar]
- Dabrowska, A. , Sarata, A. K. , Gottron, F. , & Sekar, K. ( 2020, June 25 ). Development and regulation of medical countermeasures for COVID-19 (Vaccines, Diagnostics, and Treatments): Frequently asked questions . U. S. Congressional Research Service , R46427 . https://crsreports.congress.gov [Google Scholar]
- Doherty, T. , Guida, V. , Quilantan, B. , & Wanneh, G. ( 2020 , October 15 updated). Which states had the best pandemic response? Politico . https://www.politico.com/news/2020/10/14/best-state-responses-to-pandemic–429376 . [Google Scholar]
- Dzigbede, K. D. , Gehi, S. B. , & Willoughby, K. ( 2020 , July-August ). Disaster resiliency of U.S. local governments: insights to strengthen local response and recovery from the COVID-19 pandemic . Public Administration Review , 80(4), 634 – 643 . https://doi.org/10.1111/puar.13249 [Crossref] , [PubMed] , [Web of Science ®] , [Google Scholar]
- The Economist . ( 2020 , August 22 ). The outsiders inside . The Economist , 17 – 22 . https://www.economist.com/essay/2020/08/20/viruses-have-big-impacts-on-ecology-and-evolution-as-well-as-human-health [Google Scholar]
- Farazmand, A. ( 2003 ). Chaos and transformation theories: A theoretical analysis with implications for organization theory and public management . Public Organization Review , 3(4), 339 – 372 . https://doi.org/10.1023/B:PORJ.0000004814.35884.a3 [Crossref] , [Google Scholar]
- Farazmand, A. ( 2009 ). Building administrative capacity for the age of rapid globalization: A modest prescription for the twenty‐first century . Public Administration Review , 69(6), 1007 – 1020 . https://doi.org/10.1111/j.1540-6210.2009.02054.x [Crossref] , [Web of Science ®] , [Google Scholar]
- Farazmand, A. ( 2020 ). Personal communication with the author . Harvard Health Publishing. [Google Scholar]
- Harvard Medical School ( 2021, April 22 ). What helps, what doesn’t, and what’s in the pipeline . Harvard Health Publishing . https://www.health.harvard.edu/diseases-and-conditions/treatments-for-covid-19 [Google Scholar]
- International Monetary Fund. ( 2020 , October 24 ). Policy responses to covid-19: Policy tracker . https://www.imf.org/en/Topics/imf-and-covid19/Policy-Responses-to-COVID–19 . [Google Scholar]
- Johnson, M. ( 2020 , October 14 updated). The U.S. was the world’s best prepared nation to confront a pandemic. How did it spiral to ‘almost inconceivable’ failure? Milwaukee Journal Sentinel . https://www.jsonline.com/in-depth/news/2020/10/14/america-had-worlds-best-pandemic-response-plan-playbook-why-did-fail-coronavirus-covid-19-timeline/3587922001/ [Google Scholar]
- Kettle, D. F. ( 2020 , July–August ). States divided: The implications of American federalism for COVID-19 . Public Administration Review , 80(4), 595 – 602 . https://doi.org/10.1111/puar.13243 [Crossref] , [PubMed] , [Web of Science ®] , [Google Scholar]
- Komaroff, A. ( 2020 , October 15 ). The tragedy of the post-COVID “Long Haulers” . Harvard Health Publishing . https://www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers–2020101521173 [Google Scholar]
- Kopp, M. ( 2020 , September 24 updated). REG4COVID: Community network responses to the pandemic. Johannesburg, South Africa: Association for progressive communications . Association for Progressive Communications News. https://www.apc.org/en/news/reg4covid-community-network-responses-pandemic [Google Scholar]
- Money, L. , & Rong-Gong Lin, I. I. ( 2021 , May 21 ). California unveils sweeping plan for full reopening on June 15 as COVID Fades . The Los Angeles Times . https://www.latimes.com/california/story/2021-05-21/california-june-15-covid-guidelines-masks-vaccines-events [Google Scholar]
- Moon, M. J. ( 2020 , July.-August ). Fighting COVID-19 with agility, transparency, and participation: Wicked policy problems and new governance . Public Administration Review , 80(4), 651 – 656 . https://doi.org/10.1111/puar.13214 [Crossref] , [PubMed] , [Web of Science ®] , [Google Scholar]
- Mosites, E. , Parker, E. M. , Clarke, K. E. N. , Gaeta, J. M. , Baggett, T. P. , Imbert, E. , Sankaran, M. , Scarborough, A. , Huster, K. , Hanson, M. , Gonzales, E. , Rauch, J. , Page, L. , McMichael, T. M. , Keating, R. , Marx, G. E. , Andrews, T. , Schmit, K. , Morris, S. B. , Dowling, N. F. , & Peacock, G. ( 2020 , May 1 ). COVID-19 Homelessness Team. (2020, May 1). Assessment of SARS-CoV-2 infection prevalence in homeless shelters — Four U.S. Cities, March 27–April 15, 2020. Morbidity and mortality weekly report (MMWR). Atlanta, Georgia: U.S. department of health & human services . Centers for Disease Control and Prevention , 69(17), 521 522 . https://www.cdc.gov/mmwr/volumes/69/wr/mm6917e1.htm [Google Scholar]
- Nuttle, M. ( 2021 , April 30 ). Essential workers accounted for 87% of additional COVID-19 deaths in California, data shows . ABC 10 News. https://www.abc10.com/article/news/health/coronavirus/essential-workers-covid-deaths-california-data-uc-merced/103-f0717263-7e33-497d-b1e4-b01abfc95a3f [Google Scholar]
- Ritchie, H. , & Roser, M. ( 2020 , May 7 ). How are governments responding to the Coronavirus pandemic? Our World in Data . https://ourworldindata.org/government-responses-covid [Google Scholar]
- Rothwell, J. , & Makridis, C. ( 2020 , September 17 ). Politics is wrecking America’s pandemic response . Brookings . https://www.brookings.edu/blog/up-front/2020/09/17/politics-is-wrecking-americas-pandemic-response/ . [Google Scholar]
- Serikbayeva, B. , Abdulla, K. , & Oskenbayev, Y. ( 2021 ). State capacity in responding to COVID-19 . Included in this issue of IJPA . [Taylor & Francis Online] , [Google Scholar]
- Wallace-Wells, D. ( 2021 , March 15 ). How the West Lost COVID. How did so many rich countries get it so wrong? New York Magazine/Intelligencer . https://nymag.com/intelligencer/2021/03/how-the-west-lost-covid-19.html [Google Scholar]
- Webeck, E. , & Angst, M. ( 2020 ). Once models for controlling coronavirus, San Francisco and Santa Clara County Face frightening surges . Mercury News , November 20 . https://www.mercurynews.com/2020/11/20/coronavirus-deaths-rise-as-california-records-another-near-record-for-new-cases-of-covid-19/?campaign=sjmnbreakingnews&utm_email=A4EB04E37306F50454D844CDD4&g2i_eui=8wWxYl8ZofHJSaPDIDmYylZZE8AtAAeS&g2i_source=newsletter&utm_source=listrak&utm_medium=email&utm_term=https%3a%2f%2fwww.mercurynews.com%2f2020%2f11%2f20%2fcoronavirus-deaths-rise-as-california-records-another-near-record-for-new-cases-of-covid-19%2f&utm_campaign=bang-sjmn-nl-enterprise-promo-breaking-news-alerts-nl&utm_content=alert [Google Scholar]
Reprints and Corporate Permissions
Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?
To request a reprint or corporate permissions for this article, please click on the relevant link below:
Academic Permissions
Obtain permissions instantly via Rightslink by clicking on the button below:
If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form . For more information, please visit our Permissions help page .
- More Share Options
Related research
People also read lists articles that other readers of this article have read.
Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.
Cited by lists all citing articles based on Crossref citations. Articles with the Crossref icon will open in a new tab.
- People also read
- Recommended articles
Your download is now in progress and you may close this window
- Choose new content alerts to be informed about new research of interest to you
- Easy remote access to your institution's subscriptions on any device, from any location
- Save your searches and schedule alerts to send you new results
- Export your search results into a .csv file to support your research
Login or register to access this feature
Register now or learn more
First lessons from government evaluations of COVID-19 responses: A synthesis
While the COVID-19 pandemic has hit different countries with varying intensity, responding to the crisis has presented an unprecedented challenge to most governments. In this context, evaluations provide critical tools to support real time sharing of lessons on what is working, what is not, what could work and for whom. This paper draws lessons from evaluations that governments have carried out themselves of their COVID-19 responses. It provides a synthesis of the evidence from 67 such evaluations produced in OECD countries during the first 15 months of the pandemic. These first evaluations show that many governments came to similar conclusions, and allow us to identify important insights that can feed into ongoing policy responses to the crisis – as well as increase future resilience.
Evaluations provide critical tools to support real-time sharing of lessons on what is working, what is not, what could work and for whom. Despite the significant time and resource constraints that they were facing at the height of the COVID-19 crisis, governments understood this need to draw lessons from their policy responses to the pandemic. By April 2021, most countries in the sample analysed in this paper had already conducted evaluations on each of the key stages of the risk management cycle: preparedness, crisis management, and response and recovery.
These first evaluations show that many governments came to similar conclusions, thus allowing us to identify important insights that can both feed into ongoing policy responses to the COVID-19 crisis and iimprove future resilience. In particular, the evaluations analysed in this paper underline that:
Pandemic preparedness was generally insufficient, particularly in light of the major human and financial costs associated with global health crises similar to the COVID-19 pandemic.
Governments took swift and massive action to mitigate the economic and financial effects of the pandemic, but should carefully monitor the longer-term budgetary costs of these measures.
Trust requires transparency, not only through frequent and targeted crisis communication, but, more importantly, by engaging stakeholders and the public in risk-related decision-making.
Important gaps remain in the evidence base available to date, however, and would warrant further investigation:
There is insufficient evidence on critical sectors’ preparedness for pandemics, whereas early evaluations suggest that they were crucial to an effective crisis response.
The effectiveness of lockdown and restriction measures should probably be further assessed, given their impacts on individual liberties.
It is worth exploring the impact of lockdowns on domestic violence, alcohol consumption, youth, and mental health.
Finally, issues relating to policies’ proportionality and coherence are still largely under-explored by these first evaluations, despite their usefulness for policy debate, particularly when resources are scarce and cross-government co-ordination is crucial.
Introduction
While the COVID-19 pandemic has hit different countries with varying intensity, responding to the crisis has presented an unprecedented challenge to most governments in the OECD – both in scale and in the depth of impact on health, on the economy and on citizens’ well-being. At the same time, the pandemic has brought structural and social issues to light, including the erosion of public trust in government and in expert advice, which was compounded by a wave of mis- and disinformation. To respond to these challenges, OECD governments have deployed, relatively quickly, signficant human, financial and technical resources to manage and mitigate the impacts of the crisis.
Yet, there are many challenges still to be met if OECD countries are to successfully recover and build back better. Real-time sharing of lessons is critical for ongoing crisis response, for recovery efforts and for increasing governments’ resilience in the long run. In this context, evaluations help to understand what is working (or could work), what is not, and for whom. They also provide citizens and stakeholders information on whether public funds have achieved their intended objectives and are producing the expected results.
This paper responds to a request from OECD members to draw lessons from the evaluations that governments have carried out over the first year and a half of their COVID 19 responses. It is not the objective of this paper to evaluate countries’ COVID-19 responses. Rather, it is to provide useful insights in the hopes that these can feed into ongoing policy efforts and future resilience.
Scope, methodology and limitations
This paper synthesises available evidence produced by government institutions during the first fifteen months of the pandemic response. 1 The OECD Secretariat called upon member countries to share evaluations undertaken by government institutions on the COVID-19 response and received over 256 contributions from 31 OECD countries by May 2021. Each dataset and report was then assessed based on three main criteria: whether it was an evaluation, whether it was related to the COVID-19 crisis and whether it was published or available to read. Therefore, non-evaluative exercises such as compliance audits or monitoring reports were not included in this analysis, insofar as they do not provide information on what has worked and why. In the end, 67 evaluations contributed by 18 OECD countries. 2 were selected for this paper’s analysis.
To identify the lessons presented in this paper, the OECD Secretariat conducted a software-assisted qualitative content analysis, where recurrent themes were analysed based on a coding exercise. An initial review of the available evidence shows that most evaluations in the sample examine several topics, but that these can all be classified into three main policy areas that constitute the bulk of countries’ COVID-19 responses: pandemic preparedness, crisis management, and response and recovery measures.
The results from this analysis were then assessed in terms of whether there was sufficient and robust evaluative evidence to be able to provide interesting and useful lessons. Where possible, therefore, key insights are provided on the relevance, coherence, efficiency and effectiveness of government responses to the COVID-19 crisis. 3
For the purpose of this analysis, first lessons describe both “good practices” identified in a single evaluation or country, and “key insights”, which draw consistent assessments and recommendations from several evaluations. Key insights look at both positive and negative results, i.e., lessons on what worked (for whom, why, under what circumstances) as well as what didn’t work, in order to draw a balanced picture of the crisis response. The insights also outline what could have been done better according to the evaluations.
However, all of the insights require further investigation. The conclusions presented should be considered preliminary, as the pandemic is ongoing, the available evidence does not fully capture countries’ recovery efforts, and countries continue to evaluate their policy responses.
This paper identifies 14 key insights from the 67 evaluations.
Framing evaluations of COVID-19 responses
The OECD Recommendation of the Council on the Governance of Critical Risks identifies several major phases of any risk management cycle (OECD, 2014[1]) and recommends that governments adopt strategies for, and develop policies in, each phase of this cycle to boost their resilience to risks. To understand what was done well – or not – in preparing and responding to the COVID-19 pandemic, evaluations must therefore draw lessons on the relevance, coherence, effectiveness, efficiency and impact of policies put in place in each phase of this risk management cycle.
The Framework for Evaluating COVID-19 Responses developed for the purpose of this analysis identifies three main types of policy responses that governments need to evaluate to better understand what has worked well and what has not in managing the pandemic. These three main policy responses correspond to the major phases of the risk management cycle: pandemic preparedness, crisis management, and response and recovery (see Figure 2 ). The empirical relevance of this framework has been tested in the sample of contributing OECD countries, and evidence shows that a majority of them (11/18) have conducted at least one evaluation on each of these main types of policy response.
Source: Authors
Pandemic preparedness refers to governments’ ability to anticipate a pandemic before it materialises and prepare for a global public health emergency, by developing the right knowledge and capacities (OECD, 2015[2]) . Indeed, understanding hazards and threats, and building capacities for risk foresight and assessment, allow countries to better target prevention policies and mitigation programmes to reduce their vulnerability to risk (OECD, 2015[2]) . Additionally, risk management protocols should be set up to establish standard operating procedures and pre-defined plans for dealing with pandemics (OECD, 2015[2]) . Critical sectors, such as pharmaceutical industries and healthcare providers, also have a key role to play in improving countries’ resilience to pandemics. To understand the extent to which countries were prepared for the pandemic, this paper looks at how evaluations assess governments’ pandemic anticipation capacities and health emergency protocols, as well as the preparedness of critical sectors.
The next major phase of the risk cycle where evaluations may draw lessons is crisis management, that is, the policies and actions that governments deployed to deal with the crisis once it materialised. Crisis management entails responding appropriately, at the right time, and in a co-ordinated manner across government (OECD, 2015[2]) . Indeed, evidence from the OECD shows that managing modern, complex crises likes a pandemic involves many actors beyond emergency services. This requires co-ordination and creates governance challenges, since crisis management operations are often led and managed by centres of government but carried out at sub-national levels (OECD, 2015[2]) . Crisis management also requires clear communication to the public and transparency in decision making, particularly as large-scale crises can have a critical impact on people’s trust in government (OECD, 2015[2]) . This paper looks at what the evaluations conclude about governments’ crisis communication strategies, the governance arrangements they have put in place to manage the crisis, and the measures they have deployed to co‑ordinate a whole-of-society response.
Finally, response and recovery policies are aimed at, first, mitigating the impacts of the pandemic and economic crisis on citizens and businesses and, subsequently, supporting the economic recovery and reducing welfare losses. These policies include lockdown and restriction measures taken in order to limit the spread of the virus; economic and financial support to households, businesses and markets to lessen the impact of the economic downturn; health measures aimed at protecting and treating the population; and social policies aimed at protecting the most vulnerable populations.
The following section maps the existing evidence on these three types of policy response. The rest of the paper then offers an overview of the main insights from the evaluations.
Where do we need more evidence?
The majority of respondent countries (11/18, see Annex Table 1.A.1 in Annex 1.A ) have conducted at least one evaluation on each of these main types of policy response. However, countries have not (yet) analysed them to the same extent and in the same way. First, fewer evaluations in the sample pertain to the critical phases of the crisis, namely pandemic preparedness (28 evaluations) and the management of the crisis response (34), than evaluations relating to response and recovery measures (62). This could be because a wider range of measures were deployed in the response and recovery phase.
A more detailed analysis of the evaluations in the sample shows that several types of policy response could be further examined by countries (see Table 1 ):
There is less evidence on the preparedness of critical sectors , namely the health sector (11 evaluations). Further evidence would be useful, as the crisis has shown how crucial the health sector is to countries’ resilience to pandemics. Given that health systems are still in crisis mode, evaluations may come when times are calmer.
Measures deployed to co‑ordinate a whole-of-society response , such as mechanisms for co‑operation across different levels of government or for engaging stakeholders in key decision-making processes, have not been sufficiently analysed (16 evaluations analyse this topic). In particular, countries may wish to draw further lessons on how to work with sub-national governments and local actors, and on how well their decentralisation models are adapted to managing important shocks such as the COVID-19 pandemic.
27 evaluations analyse lockdown and restriction measures , 23 of which look at actual (rather than intended) effects. The evaluations provide some evidence about the relevance and coherence of these measures, and underline the need for more evidence on their impact – especially in areas such as the economy and the environment.
Economic and financial measures are the most evaluated in the sample (45 evaluations in total). These evaluations focus mostly on process, adequacy and intermediate effects and do not measure impacts.
Countries’ health policies have been assessed in 27 evaluations, mostly in terms of procedural issues related to measures for controlling infection and monitoring intensive care capacities during the acute phase of the crisis. Several of these evaluations suggest more evidence is needed on the impacts of the pandemic on health . Moreover, other important health issues are not mentioned at all in the sample of 67 evaluations: for example the impact of the pandemic on mental health , especially that of young people , perhaps because these impacts may not be apparent for a number of years.
Whilst 35 evaluations look at social policies, they contain little evidence on the social impacts of the crisis, whether it be on poverty levels or inequality . In particular, topics such as the educational impact of school shut downs which are mentioned only in passing need to be further explored.
Note: n= 67 evaluations, of which 36 ex post evaluations and 17 ex durante . A red cell in the evaluation column signifies that less than 25% of the 67 evaluations address this topic, e.g. only 16% of evaluations addressed the topic of "Preparedness of Critical Sectors". Orange cells refer to the range 25-34%, yellow to 35-44%, light green to 45-54% and dark green cells to over 54% of evaluations addressing the respective topic.
Source: OECD
As countries are still in the early stages of evaluating their COVID-19 policy responses, more evidence on these topics may become available in the coming months and years. The following sections present the broad lessons that can be drawn from these evaluations for each of the three policy areas.
What lessons can we draw from evaluations of COVID-19 responses?
pandemic preparedness.
Most countries in the sample (13 out of 18) have examined the extent to which the government was adequately prepared to manage such a global shock. Specifically, the evaluations on this topic focused on three main types of policy or measure that contribute to pandemic preparedness:
Risk management protocols to follow during pandemics (i.e. ‘pandemic management protocols’);
government capacity for risk anticipation, through foresight and risk assessment (i.e. ‘risk anticipation capacities’);
the overall preparedness of critical sectors for pandemics (i.e. ‘critical sector preparedness’, see Figure 3 ).
Note: n =67. 67 evaluations were conducted across 18 countries. 11 evaluations examined at least one issue related to the preparedness of critical sectors to pandemics, in particular relating to the preparedness of the health sector. 22 evaluations examined at least one aspect of issues related to pandemic management protocols. 21 evaluations examined at least one issue related to risk anticipation capacities, either forecast and assessment, such as early warning systems, or national and sectoral risk assessments, and emergency planning.
Source: OECD
Pandemic management protocols
Around one-third of all evaluations (22) analysed pandemic management protocols. These evaluations place a strong emphasis on the existence of procedures and guidelines to follow in the event of a pandemic ( Box 2 ). Indeed, as pointed out in several evaluations, both clearly defined responsibilities – especially in terms of leadership – and risk management frameworks, are essential for preparing for major unknown and unexpected risks such as pandemics. This is why the 2005 World Health Organisation’s International Health Regulations mandate countries to have preparedness plans for public health crises, and to regularly evaluate and update them. OECD data shows that, in general, pandemic protocols were at the heart of pandemic response capacities in governments (OECD, 2021[3]) . For example, the Office of the Auditor General in Canada examines the role of such protocols in the Public Health Agency Canada’s overall preparedness to pandemics (see Box 1 ).
Risk anticipation capacities
21 evaluations were conducted on government capacities to anticipate risks, whether through early warning systems, risk assessment exercises, foresight, or building critical material stocks (e.g. personal protective equipment). While pandemics featured prominently in national risk assessments prior to 2020 (OECD, 2018[4]) , preliminary lessons show that countries nonetheless had insufficient capacity to anticipate shocks of this magnitude. This is, in part, due to data collection and expertise deficiencies (see Box 2 ).
Data from the 2018 OECD report on Assessing Global Progress in the Governance of Critical Risks suggests that early warning systems and other anticipation tools, while costly, are crucial for risk management (OECD, 2018[5]) . OECD countries may wish to further invest in evaluating this area to improve risk anticipation capacities.
Critical sectors preparedness
Finally, data from respondent countries suggest that robust evidence is still lacking on the effectiveness of critical sectors’ preparedness for risk (see Figure 3 ). As early as 2011, OECD identified the need for countries to improve their national critical infrastructures in anticipation of global pandemics (OECD, 2011[6]) . Nevertheless, only a few OECD countries (7 out of 34) considered “health care and public health sector” as critical infrastructure sectors when surveyed in 2018 (OECD, 2018[5]) . There are no doubt many lessons still need to be learned from the COVID-19 pandemic on this issue.
One report by Canada’s Auditor General assessed the overall preparedness of the Public Health Agency of Canada, which is the lead federal organisation for planning and co‑ordinating the national response to infectious diseases that pose a risk to public health. The evaluation recognises how the agency has been able to learn from the 2009 H1N1 pandemic by taking steps to develop protocols and national guidance for potential pandemics. The evaluation encourages the Public Health Agency to continue the practice of updating its protocols to prepare for future pandemics.
Source: (Canadian Office of the Auditor General, 2021[7])
Yet, as several respondent countries underline, standard operating procedures in crisis management plans are not enough to manage events such as global pandemics and must be complemented by other tools, such as inter-agency co‑operation mechanisms, staff lending, or emergency training or drills (OECD, 2018[5]) (OECD, 2015[2]) . In this regard, the OECD’s upcoming work on “Delivering results across agencies” may offer insights on how countries have co‑operated across agencies to reinforce emergency response capacities and have collaborated across government.
The COVID-19 pandemic was not an unexpected ‘black wwan’ event, as most national risk assessment frameworks had anticipated some form of pandemic. Yet, many OECD countries overlooked lessons that could have been drawn from previous global virus outbreaks, such as SARS or H1N1, and as a result, were not adequately prepared. Pandemic preparedness requires risk anticipation and assessment, as well as strategic foresight capacities. Well-developed emergency plans and procedures also allow governments to prepare and to equip critical sectors when a risk materialises.
Several evaluations point to the need for better risk anticipation capacities and more systematic horizon scanning, to better anticipate shocks of this magnitude. This requires, in particular, having the necessary data infrastructure to monitor infection rates and other key health indicators, as well as having the necessary expertise inside government to review this data and provide advice to decision-makers (Danish Parliamentary Committee on COVID-19, 2021[8]) (US Government Accountability Office, 2021[9]) (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Canadian Office of the Auditor General, 2021[7]) .
Another important aspect of andemic preparedness was the critical stock of equipment , such as personal protective equipment (PPE) or testing capacities. Evaluations examined the relevance of the existing stock of masks and the efficiency of distribution, but results among countries are very heterogeneous (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) (Swiss Federal Chancellery, 2020[11]) (Belgian Health Care Knowledge Centre, 2020[12]) (UK National Audit Office, 2020[13]) (New Zealand Controller and Auditor General, 2021[14]) (Australian National Audit Office, 2020[15]) (US Government Accountability Office, 2020[16]) (US Government Accountability Office, 2021[17]) (US Government Accountability Office, 2021[9]) (US Government Accountability Office, 2020[18]) . Recommendations regarding PPE include diversifying supply sources, constituting stocks based on thorough risk assessments and monitoring national production capacities and stocks regularly (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) (Swiss Federal Chancellery, 2020[11]) (UK National Audit Office, 2020[13]) (New Zealand Controller and Auditor General, 2021[14]) (Australian National Audit Office, 2020[15]) .
Respondents also underline countries’ overall lack of emergency response planning and training , in particular with regard to pandemic response (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Canadian Office of the Auditor General, 2021[7]) ; (Danish Parliamentary Committee on COVID-19, 2021[8]) (New Zealand Controller and Auditor General, 2021[14]) (Australian NAO, 2020[19]) (US Government Accountability Office, 2020[16]) . In France, for instance, risk assessments had focussed particularly on terrorist attacks and few pandemic response drills had been conducted in recent years (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) . Respondents also generally stress the need to have detailed and up-to-date operational plans and processes that describe the roles of different actors in responding to national health emergencies. The evaluations recommend that these plans be developed in co‑operation with the main crisis response stakeholders (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Canadian Office of the Auditor General, 2021[7]) ; (Danish Parliamentary Committee on COVID-19, 2021[8]) (New Zealand Controller and Auditor General, 2021[14]) .
Note: Key insights synthesise evidence and early lessons from the 36 ex post and 17 ex durante evaluations. The insights summarised in these boxes aim to facilitate collective learning to build resilience to future shocks. All lessons in this box come from the material listed above and are supported by multiple evaluations.
Crisis management
At least one aspect of government management of the COVID-19 crisis response has been analysed in 12 countries in the sample. These evaluations have focused on three main types of policies or measures:
the governance arrangements put in place to manage the crisis (i.e. ‘governance arrangements’);
crisis communication strategies and tools (i.e. ‘crisis communication’);
and mechanisms to promote a whole-of-society response in managing the pandemic, encompassing stakeholders, citizens, sub-national governments, the private sector, etc. (i.e. ‘whole-of-society response’, see Figure 4 ).
Note: n =67. 67 evaluations were conducted across 18 countries. 11 evaluations focused on at least one aspect of the governance arrangements related to the crisis response. 20 evaluations examined at least one aspect of crisis communication. 16 on issues related to whole-of-society response.
Governance arrangements
22 evaluations in the sample looked at how governments have organised their management of the crisis, whether by setting up structures to co‑operate among agencies and to gather scientific advice on the pandemic, or by deploying tools to facilitate internal communication. Overall, these evaluations underscore the rapidity and agility with which governments have put these mechanisms in place. Nonetheless, there is scope to streamline some of these structures and tools and make their decision-making processes more transparent and accountable (see Box 3 , Box 5 , and Box 6 for more detail on key insights on these topics).
Data collected by the OECD shows that there is ample evidence regarding the effectiveness of inter-agency co‑operation in managing the crisis (see Box 3 ) (OECD, 2020[20]) . Many evaluations outline the ways in which governments set up specific bodies or committees to lead inter-agency co‑operation in managing the crisis on specific policy topics.
Given that government responses to the crisis have required the mobilisation of resources in virtually all policy domains and involved a wide range of actors in different policy areas, co‑operation among government institutions and agencies has been vital to ensure a coherent response. Governments put in place, if needed, structures and mechanisms to ensure a co‑ordinated response (almost half of OECD countries deployed new institutional arrangements to manage the pandemic (OECD, 2021[3]) ), and developed protocols to clarify the responsibilities of each actor in managing the crisis response. Overall, the structures used by governments to manage the pandemic illustrate the complexity of this shock, in which traditional crisis management authorities, such as the centre of government, must contend with multiple stakeholders with potentially overlapping responsibilities (OECD, 2020[20]) .
Respondent institutions note the flexibility and rapidity shown by many governments in activating and setting up governance arrangements to facilitate inter-agency co‑operation to manage the crisis. These committees, teams and tasks forces were often multi-disciplinary and represented several ministries, but may have focused on one aspect of the crisis response, such as health or economic measures (Australian National Audit Office, 2020[21]) (French mission to control the quality of the management of the health crisis, 2020[22]) (Danish Parliamentary Committee on COVID-19, 2021[8]) .
On top of existing crisis management arrangements, many countries created ad hoc structures that played a co ‑ ordination role on specific topics . The multiplicity of structures meant that there could be an overlap in staff attending each meeting, which improved communication across the different groups/ committees (Danish Parliamentary Committee on COVID-19, 2021[8]) (Australian National Audit Office, 2020[23]) (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Canadian Office of the Auditor General, 2021[7]) . On the other hand, this overlap meant that division of labour and chains of command were not always clear to the major stakeholders involved (Australian National Audit Office, 2020[23]) .
As a result, evaluations underline the importance of clarifying responsibilities and mandates of each of these crisis management groups at the outset. This includes making the decision-making processes of these groups clear, as well as their relative hierarchies (who has the final say and who is responsible for the decisions) and their organisational charts (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) (Swiss Federal Chancellery, 2020[11]) (US Government Accountability Office, 2021[24]) .
Several evaluations highlight the need to send high-level civil servants and senior staff to these crisis management groups, to ensure their ministries are engaged in decision-making (Australian National Audit Office, 2020[21]) (French mission to control the quality of the management of the health crisis, 2020[22]) . Crisis management structures benefit from strong leadership. Having a high level of seniority helps give more weight to the discussions, ensures stronger accountability and facilitates speedier decision-making (Belgian Health Care Knowledge Centre, 2020[12]) .
Note: Key insights synthesise evidence and lessons from the 36 ex post and 17 ex durante evaluations. The insights summarised in these boxes aim to facilitate collective learning to build resilience to future shocks. All lessons in this box come from the material listed above and are supported by multiple evaluations.
These evaluations show varying results regarding the effectiveness of these measures (see Box 4 ). Mostly, the evaluations underline the need to streamline these structures to avoid overlapping roles, and to ensure a high level of representation from relevant agencies to give their decisions greater authority. These recommendations are very much in line with the OECD Recommendation of the Council on the Governance of Critical Risks, which recommends that Members should:
“assign leadership at the national level to drive policy implementation, connect policy agendas, and align competing priorities across ministries and between central and local government through the establishment of multidisciplinary, interagency approaches (e.g. national co‑ordination platforms) that foster the integration of public safety across ministries and levels of government.” (OECD, 2018, p. 125[5]) .
In Australia, the Department of Industry, Science, Energy and Resources and the Department of Health co‑operated to manage an increase in the national medical stockpile. The departments used a flexible taskforce approach to manage the procurement and engage executive management in decision-making. They established a process for managing conflicts of interest in both departments, which was deemed fit-for-purpose by the Australian National Audit Office.
The French government created an Inter-ministerial Crisis Unit in March 2020 to co‑ordinate the actions of various ministries in their collective response to the pandemic. In spite of its inter-ministerial nature, the Unit was perceived as being under the tutelage of the Ministry of the Interior. As a result, many ministries either did not participate in the Unit’s meetings or chose to send ‘junior’ colleagues who were unable to make commitments on behalf of their ministries.
The evaluation by the “Mission on the quality control of the management of the health crisis” recommended that all ministries participate at a proper level of seniority to allow for better inter-agency co‑operation within the Inter-ministerial Crisis Unit.
In Belgium, the Hospital & Transport Surge Capacity (HTSC) committee was set up in March 2020. As an ad hoc working group of the standing Risk Management Group (RMG), its mission was to “monitor the number and type of COVID-19 patients admitted to acute hospitals […] and to propose decisions to the RMG on the organisation of adequate hospital care” (Belgian Health Care Knowledge Centre, 2020[12]) . As part of its mission, the HTSC intensively interacted with other bodies and working groups that were involved in the management of the COVID-19 crisis.
According to the evaluation conducted by the Belgian Health Care Knowledge Centre, various factors contributed to the successful functioning of the committee: respect of confidentiality rules by participants, strong leadership, agreement about what was communicated and respecting these agreements.
Source: (Australian National Audit Office, 2020[15]) (Belgian Health Care Knowledge Centre, 2020[12]) ; (French mission to control the quality of the management of the health crisis, 2020[22])
Another important policy issue assessed by contributing countries and institutions is that of internal communication among agencies and different levels of government (see Box 5 ).
Effective internal communication is a key component for successful inter-agency co‑operation. This includes communication among actors who may not be used to working together during normal times. During the COVID-19 crisis, government agencies had to work with many different public or quasi-public entities to build a coherent response to the pandemic.
Communication among national agencies and actors was generally positively assessed for those who had previous experience in working together. Several evaluations reported that this communication sometimes relied more on personal relationships than established communication channels, nevertheless (Swiss Federal Chancellery, 2020[11]) (US Government Accountability Office, 2021[9]) .
However, evaluators reported that conveying relevant information in a timely manner to the local or regional level and to frontline staff was a major challenge encountered by governments in their response to the crisis (Swiss Federal Chancellery, 2020[11]) (French mission to control the quality of the management of the health crisis, 2020[22]) (UK National Audit Office, 2020[13]) . Indeed, managing the crisis required national governments to co‑ordinate with a variety of national, regional and local actors that have different mandates and do not usually collaborate. Some countries, such as France (French mission to control the quality of the management of the health crisis, 2020[22]) , took a decentralised approach to passing on key health information and instructions to local governments and health actors. This resulted in loss of information and signficant delays. This particular evaluation points to the need to simplify information channels and chains of command in times of crisis by having the national government talk directly to the local level. OECD data suggest that, overall, dynamic and interactive forms of internal information are most effective. Indeed, while it is important to “push information out” through, for example, emails or internal websites, using both traditional and new digital platforms for internal communication can lead to greater buy-in from stakeholders (OECD, 2021[25]) .
Several evaluations underlined the important challenges encountered by national governments in collecting data from multiple health actors involved in the crisis response (national agencies, sub-national governments, hospitals). These challenges included the lack of clear standards and homogeneous processes for reporting data to the national government, the variety of information technology systems used by these different actors, and the fact that surveys did not reflect the realities of the field (Swiss Federal Chancellery, 2020[11] ; Belgian Health Care Knowledge Centre, 2020[12] ; Canadian Office of the Auditor General, 2021[7]) (US Government Accountability Office, 2021[9]) .
Reports showed the value of building data standards and processes together with local health actors , to make sure that they are understood by all relevant stakeholders and adapted to operational realities. For example, the GAO recommended that the Department of Health and Human Services establish an expert committee made up of health care professionals and public agencies to review and inform data collection and reporting standards for key health indicators (US Government Accountability Office, 2021[9]) . Having a clear point of contact in the national administration for questions about data standards (for example to understand the definition of ICU bed availability) was also recommended in several evaluations. These conclusions are in line with the 2021 OECD Recommendation on Enhancing Access to and Sharing of Data, which recommends promoting inclusive representation and engaging relevant stakeholders in the data ecosystem.
Contributors also emphasised the interoperability of IT systems among health actors, or between emergency crisis response actors at the national and local levels, as an important issue for further investigation (Swiss Federal Chancellery, 2020[11] ; French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) . The report by the Swiss Federal Chancellery on “Crisis management during the COVID-19 pandemic” mentioned that such IT systems should be built so that they can be used for internal management and not just for reporting purposes (this is especially important given time constraints during crises).
The final topic related to the governance of crisis management responses examined in the evaluations is the role of experts and scientific bodies in providing advice to governments during the ‘sense-making’ period when scientific information and advice feeds into the decision-making process (OECD, 2020[20] ; OECD, 2018[5]) . In the sample of evaluations analysed, 13 evaluations by 8 countries studied scientific advice, notably from public health experts, during the COVID-19 crisis response phase. According to the French national mission to control the quality of the management of the COVID-19 crisis, for example, the dispersion of scientific expertise across public health bodies may have made it more difficult to pool knowledge and skills. The evaluation also suggests that the creation of an agile and responsive scientific council would offset existing institutional rigidities (French mission to control the quality of the management of the health crisis, 2020[22]) . Overall, the evaluations noted that scientific and expert committees provided important advice to governments on complex matters, but that a wider range of expertise – in particular that of practitioners and civil society – could be reflected in these bodies (see Box 6 ).
The crisis has put governments in a challenging situation where they had to ensure clear, trusted and legitimate decision-making processes informed by the best available evidence, while there were many “unknown unknowns” and very little time for dialogue and gathering information. Governments were also faced with the need to review and synthesise information from multiple sources, and to use it to feed into governments’ responses to the COVID-19 crisis. In many cases, putting in place ad hoc structures to gather scientific advice was seen as the best approach given such a high level of uncertainty (OECD, 2020[20]) .
Many respondent countries created ad hoc scientific committees to provide advice to the government on managing the COVID-19 pandemic, sometimes as early as January 2020 (New Zealand Parliament, 2021[26]) (US Government Accountability Office, 2021[9]) (Belgian Health Care Knowledge Centre, 2020[12] ; Swiss Federal Chancellery, 2020[11]) . The evaluations generally assess this approach as having improved government decision-making on complex issues. In some cases, these committees have also filled an expertise and analysis gap in government institutions (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) . However, several evaluations note that these scientific committees or groups had difficulties accesssing data or information (French mission to control the quality of the management of the health crisis, 2020[22]) (New Zealand Parliament, 2021[26]) (US Government Accountability Office, 2021[9]) . Furthermore, prior to the COVID-19 pandemic, countries had already recognised the need to strengthen their domestic capacities for scientific advice in crises, by developing national mechanisms for providing scientific advice to governments in emergencies – in particular for sense-making in complex and novel crises. (OECD, 2018[27])
Several evaluations also point to the fact that representation from the field or civil society organisations was lacking in these committees (Belgian Health Care Knowledge Centre, 2020[12] ; Swiss Federal Chancellery, 2020[11] ; French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) . Openness about evidence bases and decision-making processes is crucial when authorities are dealing with health risks characterised by great uncertainty, which includes formalising processes for consulting scientific committees or advice (Danish Parliamentary Committee on COVID-19, 2021[8]) .
Crisis communication
The evaluations in the sample also provide good-quality evidence on how governments communicated to a variety of stakeholders during the crisis. Indeed, issues related to government communication of COVID-19 responses have been examined in 20 out of 67 evaluations from 11 countries.
Many governments in OECD countries made unprecedented use of communication channels and information technologies to reach out to citizens about the spread of the virus and the policies undertaken to control infection, and to share instructions on how to comply with lockdown and social distancing requirements (OECD, 2020[28] ; OECD, 2020[29] ; Wendling, 2013[30]) . Some governments also worked with local actors and civil society organisations to communicate on the pandemic. For example, the Government of Canada worked with the leaders of Indigenous peoples and other ethnic minorities to deliver the government’s messages to their respective communities.
Governments may have wanted to pay special attention to the impact of these new communication channels and methods on the effectiveness of their crisis management and on the acceptability of measures rolled out to mitigate the impact of the crisis. This is the case, for example, in Switzerland, where the Swiss Federal Chancellery examined the impact of its communication strategy during the height of the crisis (see Box 7 ). This is an important exercise, as 58% of centres of government that responded to the OECD 2020 Understanding Public Communication Survey identified crisis communication as the most challenging communication competency, namely due to human resource and co-ordination-related issues. A majority of countries stated in the same survey that they deploy surge capacity or staff to support their communication during crises.
The Swiss government used various external communication channels to provide information to its citizens about the current situation and infection control measures. In addition to frequent press conferences by the Federal Council and experts, the federal administration used poster campaigns, webpages, social media and the “ALERTSWISS” app to disseminate information. For example, during the highest alert level, the Federal Council gave three press conferences per week, complemented by press briefings with specialists every second week.
The evaluation by the Swiss Federal Chancellery concludes that using a variety of communication channels allowed the govenrment to reach a large portion of the population and was particularly effective.
Source: (Swiss Federal Chancellery, 2020[11])
Evaluations relating to crisis communication looked at the consistency of the information communicated by governments (13 evaluations), whether the information was well received by the public (10 evaluations), and what efforts governments made to target specific or hard-to-reach populations (12 evaluations).
Overall, the evaluations concluded that governments have made considerable efforts to provide easily available information to the public, but that information was not always timely, consistent and comprehensive (see Box 8 ).
A clear and consistent communication strategy was quickly recognised by many governments as crucial for responding to the crisis. The general population’s acceptance of decisions has direct consequences for compliance with mitigation measures, particularly in contexts where mis- and dis-information spreads rapidly (OECD, 2020[29]) . Governments greatly increased the frequency of their external communication to the public and relied on a variety of channels to do so, from press conferences to social media and online databases. Well-established risk communication practice (OECD, 2016[31]) highlights the importance of communicating about the actions each person can take to reduce his or her own risk exposure and that of others.
Several evaluations deemed external communication to have been swift and regular enough, relying on a variety of both traditional and digital communication channels, and that the mix of high-level and technical messaging particularly contributed to increasing trust and acceptance within the population (Swiss Federal Chancellery, 2020[11]) (US Government Accountability Office, 2021[17]) (Danish Parliamentary Committee on COVID-19, 2021[8]) . In fact, data from the OECD Survey on Understanding Public Communication indicate that most countries defined crisis communication protocols, which may explain why crisis communication was effective in many countries during the COVID-19 pandemic.
Some governments paid special attention to producing communication material in multiple languages (whether in the form of social media posts, podcasts, or apps) and to targeting specific audiences, such as hard-to-reach populations (US Government Accountability Office, 2020[16]) (US Government Accountability Office, 2021[9]) (Australian National Audit Office, 2020[21]) (Danish Parliamentary Committee on COVID-19, 2021[8]) . Evaluations stress that this is a good practice insofar as messaging should be inclusive and tailored for each audience to ensure that crisis communication is effective.
Yet, governments encountered important issues linked to the consistency and clarity of messages relating to critical health issues . The increased frequency of communication and rapidly changing narratives may have led to mixed messages and hindered mitigation and recovery efforts (US Government Accountability Office, 2021[17]) (US Government Accountability Office, 2021[32]) (Belgian Health Care Knowledge Centre, 2020[12]) (Danish Parliamentary Committee on COVID-19, 2021[8]) . For instance, rapid changes in guidance on wearing masks or use of PPE, meant that frontline staff did not always comply with them (UK National Audit Office, 2020[13]) (US Government Accountability Office, 2021[17]) (Belgian Health Care Knowledge Centre, 2020[12]) . Evaluations underline that clear and consistent communication is essential during emergencies. Some evaluations note that limited and targeted messages may be more effective than large outreach strategies (US Government Accountability Office, 2021[32]) (Danish Parliamentary Committee on COVID-19, 2021[8]) . This was also considered important for promoting public uptake of COVID-19 vaccines (US Government Accountability Office, 2021[32]) . Furthermore, governments could consider implementing more collaborative forms of crisis communication, moving away from a one-way, top-down approach, and engaging in conversations with a variety of stakeholders to co-construct messages and learn from their concerns and experiences.
Some evaluations also point out that the media may have received scientifically incorrect information from the government, which created uncertainties and may have affected the uptake of mitigation measures (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) (Swiss Federal Chancellery, 2020[11]) (US Government Accountability Office, 2021[17]) . This was the case regarding the effectiveness of masks as personal protective equipment, or the efficacy of hydroxychloroquine as a treatment for COVID-19 patients. In order to reduce confusion and increase trust in government responses, evaluations highlight the importance of disclosing the scientific rationale for health guidelines. The OECD Principles of Good Practice for Public Communication Responses to Help Counter Mis- and Disinformation stress the importance of transparency and honesty in communication (OECD, forthcoming[33]) .
Several evaluations point to the usefulness of publicising health and infection data on a single national dashboard to communicate the current status of the pandemic across different areas and show the scientific rationale for policy responses to the crisis (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) (US Government Accountability Office, 2021[9]) .
Whole-of-society response
16 evaluations looked at how governments have involved the ‘whole-of-society’ in their COVID-19 responses. These evaluations examine how different levels of government have worked together to manage the pandemic response, how citizens and stakeholders have been engaged in decision-making processes related to crisis response, and what measures could have helped safeguard democratic rules.
Federal respondent countries (Australia, Belgium, Canada, Switzerland, the United States) put a greater emphasis than non-federal countries on evaluating the co‑operation among levels of government, 4 for example, regarding the distribution of responsibilities between national and sub-national governments during different stages of the crisis. Yet, OECD data suggest that sub-national governments everywhere were often at the front line of the COVID-19 crisis, as they are typically responsible for healthcare, social and transportation services. Co‑operation with local administrations was thus both essential and complex, given that national governments had to contend with the varying local realities of sub-national governments (OECD, 2020[34]) . In many countries, the quality of co-ordination among levels of government has been a key determinant in the effectiveness of the response to the health and economic crisis (OECD, 2020[34]) . This is the case in Austria, for example, where the National Crisis and Disaster Management Committee (SKKM) co‑ordinated the COVID-19 response among federal ministries, provinces, rescue organisations and the media. Further efforts to gather evidence on the effectiveness of multi-level governance response to crises may be required, especially since preliminary lessons suggest that countries encountered important challenges in this regard (see Box 9 ).
Evaluations also suggest that governments need to make more of a concerted effort to involve stakeholders and citizens in decision making for crisis management, particularly considering that democratic accountability mechanisms may have been impaired in most countries during the acute phase of the pandemic (see Box 9 ). Making information widely available to citizens can enable and empower other public actors to reuse it for the benefit of citizens. For example, in Canada, the civil society organisation ‘COVID-19 Canada Open Data Working Group’ created a single interactive dashboard to communicate data released by public authorities to citizens (COVID-19 Canada Open Data Working Group, 2021[35]) . Governments can also look at interesting examples from sub-national governments that have conducted online deliberative processes during the pandemic, such as in the US state of Oregon, where a citizen assembly was convened to discuss the COVID-19 recovery.
The pandemic has affected every sector of society and every level of government. First, sub-national authorities are responsible for crucial aspects of pandemic management, such as containment measures, healthcare, social services, and economic development (OECD, 2020[34]) . Businesses and civil society organisations also supported national efforts in many countries – whether by repatriating citizens from abroad or distributing personal protective equipment to citizens. At the same time, in many countries, emergency measures have been accompanied by a restriction of civic freedoms and rights (OECD, 2020[28]) . Indeed, at the start of the pandemic, 20 out of 38 OECD countries declared a state of emergency to give the executive special powers to prevent the spread of COVID-19 and to mitigate its effects on society. To address this range of issues, governments have sought to engage all relevant stakeholders in the effective design and delivery of programmes – with varying levels of success.
Several contributing countries encountered major difficulties in ensuring a co ‑ ordinated response among all actors of the health sector and supply chain (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) (US Government Accountability Office, 2021[17]) . Indeed, health strategies such as vaccine delivery, for example, involve co‑operation between national and sub-national governments, as well as with practitioners, the private sector, civil society organisations, and/or the media. A lack of clarity in roles and responsibilities may have led to duplication, confusion, or gaps in delivery (Swiss Federal Chancellery, 2020[11] ; French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Canadian Office of the Auditor General, 2021[7]) .
Several evaluations recommend establishing clear response strategies and processes for engaging with these stakeholders on pandemic responses in the future (US Government Accountability Office, 2021[9]) (US Government Accountability Office, 2021[17]) (Canadian Office of the Auditor General, 2021[7]) .
Several evaluations highlight the need to put in place mechanisms to mitigate the loss of democratic accountability relating to legislation passed by Parliaments that were given extraordinary powers (New Zealand Parliament, 2021[26]) (Danish Parliamentary Committee on COVID-19, 2021[8]) . These evaluations do not question the necessity of these extraordinary power measures but suggest increasing the publicity of the underlying evidence for measures or allowing more time for evaluation of these measures ex post .
Evaluations also underline the importance of involving citizens in decision-making , including in Parliamentary scrutiny committees (New Zealand Parliament, 2021[26]) and in scientific expert committees (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Belgian Health Care Knowledge Centre, 2020[12]) .
Response and recovery
Evaluations on response and recovery measures constitute the bulk the evidence on COVID-19 responses received by the OECD. Response and recovery measures encompass policies aimed at mitigating the economic, financial, social and health effects of the COVID-19 pandemic, as well as those related to lockdowns and restrictions. Policies relating to these measures were assessed in one way or another in 62 evaluations (93% of the sample), and all but one country have evaluated measures aimed at mitigating the effects of the crisis.
Most of the evaluations on response and recovery have focused on four main types of policy or measure:
economic and financial support,
social policies,
health policies,
and lockdown and restriction measures (see Figure 5 ).
Note: n =67. 67 evaluations were conducted across 18 countries. 45 evaluations examined at least one aspect of economic and financial support.
Economic and financial support
Most of the evaluations related to response and recovery measures focus on the measures that government rolled out in support of the economy (45 evaluations from 15 countries). Indeed, most OECD governments took swift and massive actions to financially support households and businesses following the shutdown of economic activities. At this stage, these evaluations tend to focus on the relevance and efficiency of these measures, with some assessing intermediate effects. Most evaluations agree that it is too early to measure the impacts of these policies. More evidence on this topic may also become available in the future, as most OECD member countries state that they intend to evaluate the economic and financial emergency measures that were taken at the onset of the pandemic (Working Party of Senior Budget Officials, 2020[36]) , but might not have had, as yet, the resources or time to do so.
In their evaluations of economic and financial policies to mitigate the effects of the COVID-19 crisis, countries have examined three main types of measure:
tax-based measures,
balance-sheet measures,
spending measures.
Sixteen evaluations looked at tax-based measures , which included lowering tax rates, deferring tax payments and providing tax credits. At this stage, evaluations of tax-based measures have mainly focused on process and efficiency, as it is challenging to assess their additional effects at this stage of the crisis (see Box 10 ). The Government Accountability Office in the United States has produced one such evaluation, examining how increased volumes of federal tax returns could be managed by the Internal Revenue Service to improve the overall effectiveness of the government’s economic support to households and businesses, as part of the tax provisions within the CARES Act (United States Government Accountability Office, 2020[37]) .
Overall, the evaluations suggest that countries encountered administrative difficulties in rolling out tax schemes. Data from government officials in OECD and partner countries indicate that rapid delivery and minimising the risk of missing deserving recipients took priority over maximising the efficiency of targeting relief measures (OECD, 2021). This necessary prioritisation provides some context for the results obtained from early evaluations of the impact of tax measures.
Tax-based measures were an important part of governments’ efforts to directly support households and businesses during the crisis (OECD, 2020[38]) . These measures have taken various forms across countries, including tax payment deferrals and more flexible tax repayment schedules, the removal of import duties and value-added taxes on medical products, and enhanced tax refunds and loss-offset provisions. These measures mostly sought to support corporate and household liquidity, employment and investment.
Several evaluations underline administrative difficulties with rolling out tax schemes. In particular, evaluations mention the problems faced by countries in identifying eligible recipients for the support schemes, as the tax data and records used to identify eligible individuals and businesses were based on previous fiscal years (2019 and prior). According to some implementing authorities, limiting the schemes only to taxpayers with current and previous records was important to reduce the risks of fraud. However, this led to both the exclusion of potential beneficiaries and the inclusion of ineligible individuals in a number of countries (US Government Accountability Office, 2021[17] ; UK National Audit Office, 2020[13]) . Moreover, using tax records to identify eligibility did not appear to have reduced fraud in the countries that carried out these evaluations. Matching tax records with other government data became particularly important to avoid improper or duplicate payments (National Audit Office, 2020[39] ; New Zealand Controller and Auditor General, 2021[14] ; OAG of Canada, 2021[40]) .
Evaluations also mention that these measures were associated with significant budget costs . The United States Joint Committee on Taxation estimated that tax credits put in place to mitigate the cost of emergency paid sick leave, along with expanded family medical leave that certain employers had to provide under the Families First Coronavirus Response Act and the employee retention tax credits for employers under the Coronavirus Aid, Relief, and Economic Security Act of March 2020, would result in around USD 172 billion in lost revenue for fiscal years 2020-2030 (US Government Accountability Office, 2020[16]) . The Australian Taxation Office also estimated the revenue foregone for the various tax-based measures under its responsibility (Australian National Audit Office, 2020[23]) .
Yet, evaluations agree that it is too early to know the true budgetary effects and impacts of these measures, or the potential cost of inaction . For instance, in the United States, the GAO indicates that, for several tax measures, the uptake by beneficiaries cannot be quantified yet (US Government Accountability Office, 2021[17] ; US Government Accountability Office, 2020[16]) . Evaluators in Norway indicated some concern that the use of short-term tax measures could weaken the tax base and affect the stability of the tax system if these changes become permanent, while acknowledging that it is too early to provide a robust assessment (Commission "Norway Towards 2025", 2021[41]) .
In addition, 16 evaluations examined the impact of government balance sheet measures . These types of measures have a delayed impact on the cash deficit as they generate assets in the form of loans or equity shares and liabilities in the form of guarantees. For instance, several countries, including Italy and Norway, have put state guarantees in place so that businesses can access credit markets. Evaluations on this topic point out that it is too early to assess the impact of these measures, but that they may be associated with increased budgetary risks for governments (see Box 11 ).
Besides traditional spending and tax-based support, emergency fiscal packages have relied heavily on unconventional fiscal policy instruments such as government loans, guarantees and equity injections. In some countries, these measures made up the largest share, in nominal terms, of the government fiscal response (Moretti, Braëndle and Leroy, 2021[42]) . The need to keep businesses afloat, especially SMEs, was the overarching concern of most countries (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; US Office of Management and Budget, 2020[43] ; Commission "Norway Towards 2025", 2021[41] ; Bank of Italy, 2020[44]) . Governments provided access to liquidity and/or guaranteed loans to reduce the risk of insolvencies. Some countries also emphasised the contribution of these measures to employment support (Bank of Italy, 2020[44] ; US Office of Management and Budget, 2020[43]) . These measures tended to be aimed at specific sectors, such as aviation, agriculture, municipalities, or education.
Evaluations underline the rapid implementation of balance sheet-based policies . In the United States, the Small Business Administration launched the Paycheck Protection Programme of forgivable loans within a week after the CARES Act passed (US Office of Management and Budget, 2020[43]) . In France, the National Independent Mission on the assessment of the COVID-19 crisis management and on the anticipation of pandemic risks stressed how swiftly the loan guarantee scheme was implemented (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) .
This speed may have come at the price of effective targeting. According to the United States Government Accountability Office (GAO), for instance, the lack of guidance and the complexity of the regulations on loan forgiveness under the Paycheck Protection Programme seem to have prevented the disbursement of loans to some recipients in need (US Government Accountability Office, 2020[16]) . Loans worth USD 4 million were also approved even though borrowers had not yet received essential information regarding the eligibility for loan forgiveness.
Contributors emphasised the risk and uncertainty around the longer-term budgetary costs of these measures. Unlike additional expenditures or tax-based support, balance sheet-based policies have a delayed fiscal impact. There are no immediate cash outflows for guarantees and immediate future cash inflows for loans. In France, the evaluation highlights the significant future risk to public finances of the loan guarantee scheme, citing estimates of a default rate on state-guaranteed loans of 5% (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) . In the United States, the cost of the Paycheck Protection Programme was deemed difficult to calculate due to the conditionality of loan forgiveness and changes in the level of loan forgiveness (US Government Accountability Office, 2020[16]) .
Evaluations identified positive short-term impacts , such as allowing employees to return to work and businesses to reopen (US Office of Management and Budget, 2020[43]) or limiting the number of bankruptcies (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) . Some institutions warn that estimating the impact of a given measure may be difficult given multiple forms of government support (UK National Audit Office, 2020[13]) .
Spending measures, which are those that have an immediate effect on the cash deficit and debt of a country, were analysed in 36 evaluations. In fact, evaluations relating to government expenditure make up most of the evaluations related to economic and financial measures. Key insights from these evaluations can be found in Box 12 , Box 13 and Box 14 .
Evaluations in the sample show that these three main types of measure – tax-based, balance-sheet based, and spending - sought to target different groups of beneficiaries (see Figure 6 ), such as households, businesses, and employees.
Twenty-nine evaluations looked at economic measures aimed at households . Such measures often support specific target groups by providing additional financial resources. In Colombia, for example, an unconditional cash transfer aimed at vulnerable households was rolled out to mitigate the economic effects of the crisis. The country’s Department of National Planning conducted an impact evaluation of this “ Ingreso Solidario ” measure, which was published in May of 2021 (Department of National Planning, Colombian government, 2021[45]) . The evaluation concludes that Ingreso Solidario increased the probability that households maintained some source of income during the pandemic and that it did not create disincentives for participation in the labour market. Evaluations of economic measures aimed at households are generally positive about their intermediate effects (see Box 12 ). These evaluations mention that a closer look at long-term effects and impacts might be needed (see also Box 15 ).
Economic measures targeting households seek to mitigate the impact of the crisis on income and purchasing power. They are often targeted at vulnerable groups, who face increased risks of income loss and insecurity as a result of the crisis. These measures are usually temporary and often rely on existing welfare systems (for funding or disbursement), and thus are dependent on the systems’ overall efficiency.
Evaluations show that automatic stabilisers in the form of countries’ standard social protection systems had to be complemented with specific temporary measures to target those whose income and purchasing power suffered most from the shock (Commission "Norway Towards 2025", 2021[41] ; French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) .
State-funded job retention schemes , cash transfers, tax credits, income support for the self-employed, and extention of sick leave protections were seen as effective in limiting income losses incurred by households during the crisis (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Italian Ministry of Economy and Finance, 2020[46] ; Australian National Audit Office, 2020[21] ; Belgian National Social Security Institut for Self-employed Workers, 2020[47] ; UK Department of Health and Social Care, 2020[48] ; National Insurance Institute of Israel, 2020[49] ; National Planning Department of Colombia, 2020[50] ; US Office of Management and Budget, 2020[43]) . Specifically, these measures were seen as generally successful in compensating the income loss of more vulnerable workers, and the households they live in, including self-employed workers, young people, large families and those below the poverty line, as well as in reducing their risks of poverty and liquidity problems (UK Department of Health and Social Care, 2020[48] ; Italian Ministry of Economy and Finance, 2020[46] ; US Government Accountability Office, 2021[17] ; France Stratégie, 2020[51]) .
Evaluations recommended, however, that some households receive further state support in order to support their consumption levels (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Italian Ministry of Economy and Finance, 2020[46] ; US Government Accountability Office, 2020[18]) . This is particularly the case for households that were socio-economically fragile before the crisis and less well-protected by the existing social security system (Italian Ministry of Economy and Finance, 2020[46] ; France Stratégie, 2020[51]) . Indeed, according to several evaluations, these measures sometimes still excluded some of the most vulnerable groups of the population (such as unemployed youths, isolated elderly people or single-parent families), either due to their limited scope or to a lack of capacity to identify them (France Stratégie, 2020[51] ; National Audit Office, 2020[39]) . Evaluations recommend improving the scope and reliability of the data collected to identify households eligible for income-protection schemes in order to avoid excluding them in the future (National Audit Office, 2020[39] ; US Government Accountability Office, 2021[17]) .
Non-recourse to emergency support was another issue reported by some countries. To ensure that eligible beneficiaries effectively access the offered support, application procedures should be simplified and access to rights should be more automatised (France Stratégie, 2020[51] ; US Government Accountability Office, 2021[9] ; Contraloría General de la República, 2020[52]) . Awareness could also be raised through better outreach and communication efforts (US Government Accountability Office, 2021[17] ; National Audit Office, 2020[39] ; Belgian National Social Security Institut for Self-employed Workers, 2020[47] ; National Planning Department of Colombia, 2020[50]) , which could be targeted by tracking and reporting the number of eligible beneficiaries who were notified of the existing support and who have yet to file for it (US Government Accountability Office, 2021[17] ; US Government Accountability Office, 2020[18]) .
Twenty-seven evaluations examined economic and financial measures aimed at businesses . Such measures mostly aim to support employment (e.g. job retention schemes) or ensure liquidity through loan guarantee schemes or tax-based support (e.g. tax reduction or deferrals). Measures may apply to businesses in general or be targeted to specific sectors that were heavily affected by the pandemic (e.g. tourism, aviation). Evaluations underline the fact that countries massively and rapidly supported businesses that were not always well targeted. However, it is too early to assess the impact of these policies – whether positive of negative (see Box 13 ). For example, in March 2020, Belgium amended a 2016 law to temporarily introduce income support measures for the self-employed. A public policy institute ( Institut national d’assurances sociales pour travailleurs indépendants ) found that the measures would be more effective if they were better targeted (Geeraert and De Maesschalk, 2020[53]) .
While a number of countries had automatic stabilisers in place to contain an large part of the economic shock resulting from the pandemic, governments had to adopt other measures as well, given the sudden, global nature and severity of the crisis. A number of businesses faced labour force and supply chain interruptions, mandatory closures, and other serious challenges. Across OECD countries, businesses thus benefited from various and sometimes overlapping measures: furlough and wage subsidy schemes, tax deferrals, asset write-offs, and mechanisms to offset additional paid sick leave expenditures or guaranteed loans. These measures were aimed at preserving employment and investments, providing job security and ensuring corporate liquidity and solvency (Demmou et al., 2021[54] ; Demmou et al., 2021[55]) .
While schemes were, overall, rapidly implemented and timely (French Court of Accounts, 2021[56] ; Belgian National Social Security Institut for Self-employed Workers, 2020[47] ; US Government Accountability Office, 2021[9]) , their efficiency and relevance were found to be more limited . Evaluations stress that governments had to adapt the objectives and modalities of these schemes often to account for changes in restriction measures or to respond to initial design failures and better target those in need (National Audit Office, 2020[39] ; French Court of Accounts, 2021[56] ; OAG of Canada, 2021[40] ; Australian National Audit Office, 2020[23] ; Belgian National Social Security Institut for Self-employed Workers, 2020[47]) . As a result, some evaluations mention that these changes blurred messages about businesses’ eligibility and therefore diminished the measures’ effectiveness (Belgian National Social Security Institut for Self-employed Workers, 2020[47] ; US Government Accountability Office, 2020[16] ; New Zealand Controller and Auditor General, 2021[57]) (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Commission "Norway Towards 2025", 2021[41] ; Belgian National Social Security Institut for Self-employed Workers, 2020[47]) .
Evaluators found that it was too early to assess the total impact of these schemes (National Audit Office, 2020[39] ; US Government Accountability Office, 2020[16] ; French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) . While they noted strong evidence that unemployment, output losses and business bankruptcies were contained, they also suggested that support schemes might have sustained non-viable firms (Commission "Norway Towards 2025", 2021[41] ; National Audit Office, 2020[39] ; OAG of Canada, 2021[40]) or firms that were not in need of support and exploited the rules (National Audit Office, 2020[39] ; New Zealand Controller and Auditor General, 2021[57]) , perhaps due to the speed of implementation and low conditionality (Commission "Norway Towards 2025", 2021[41] ; OAG of Canada, 2021[40]) .
Anticipating a wave of insolvencies, some evaluations also suggested adapting and adjusting bankruptcy and restructuring laws and procedures (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Commission "Norway Towards 2025", 2021[41]) to facilitate the restructuring of firms in temporary distress. For example, the French National Independent Mission on the assessment of the COVID-19 crisis management and the anticipation of pandemic risks recommended that the Finance and Justice Ministries study the trajectory of distressed companies to assess the impact of collective procedures on business bankruptcies or survivals and adjust these procedures accordingly.
Finally, 29 evaluations looked at economic and financial measures aimed at supporting jobs and workers . Measures related to employment have a special role to play, as they support several recipient groups at the same time. Support measures for the self-employed affected by the pandemic, for instance, are often designed to support both their businesses and their household income. Since self-employed workers are also one of the more vulnerable groups in times of crisis, many of the evaluations in the sample focused on this population.
For example, learning from the 2008 global financial crisis, when the country did not have a short-time work or partial furlough scheme to support employment, the UK created the Coronavirus Job Retention and Self-Employment Income Support schemes in March 2020. In October 2020, the UK National Audit Office (NAO) published a report examining the relevance, efficiency and effectiveness of these schemes and concluded that they were deployed quickly and were largely successful in protecting employment during lockdown. Nevertheless, the NAO observed that deployment was made more challenging by the lack of existing similar schemes (UK National Audit Office, 2020[13]) .
In general, evaluations assessing policies to support self-employed workers during the crisis looked at their relevance and coherence, the efficiency with which the institutions in charge disbursed the support, and their short-term effects (see Box 14 ).
The term ‘self-employed workers’ describes people who work for themselves and are registered as a business. This diverse group makes up a considerable part of the labour force in OECD countries (16.6% in the OECD countries on average in 2019) (OECD, 2020[58]) . As this group is usually not eligible for unemployment insurance, they are one of the most financially vulnerable groups in times of crisis.
Support to the self-employed has taken various forms across countries. Some countries extended their existing social security benefits to this group, e.g. by giving them access to unemployment insurance (Office of the Auditor General, Canada, 2021[59]) (US Government Accountability Office, 2020[16]) . Other countries extended existing support systems for self-employed workers (Belgian National Social Security Institut for Self-employed Workers, 2020[47]) , while others set up new programmes or tax deferments to compensate for loss of revenue due to the pandemic or restrictive measures (French mission to control the quality of the management of the health crisis, 2020[22]) (UK National Audit Office, 2020[13]) (Italian Ministry of Economy and Finance, 2020[46]) (Office of the Auditor General, Canada, 2021[59]) ; (Belgian National Social Security Institut for Self-employed Workers, 2020[47]) .
Overall, the employment support schemes for the self-employed were assessed positively, as they provided quick income support to self-employed people with encouraging short-term effects (UK National Audit Office, 2020[13]) (US Government Accountability Office, 2020[16]) (Office of the Auditor General, Canada, 2021[59]) . Several contributions stress, however, that it is too early to evaluate long-term effects and impact. The UK National Audit Office claims that the UK’s scheme provided an effective bridge during the early phases of the pandemic to allow some people to return to work once the national lockdown eased. It supported 77% of potentially eligible recipients and the average grant came close to fully compensating beneficiaries for the effects of the pandemic. The HM Revenue and Customs also made their self-employment income support scheme available two weeks before schedule (UK National Audit Office, 2020[13]) .
However, many evaluations underline that the trade-off for rapid rollout was simplified eligibility procedures , which may have resulted in some self-employed workers being accidentally excluded from these measures (UK National Audit Office, 2020[13]) (US Government Accountability Office, 2021[17]) (Office of the Auditor General, Canada, 2021[59]) (New Zealand Controller and Auditor General, 2021[14]) . Indeed, multiple contributing countries used tax data from previous fiscal years to verify claims by different recipient groups and to calculate the amount to pay (UK National Audit Office, 2020[13]) (US Government Accountability Office, 2021[17]) (New Zealand Controller and Auditor General, 2021[14]) . This has excluded some self-employed workers who recently opened their businesses and who had not previously submitted tax returns. This also meant that post-payment controls were preferred to pre-payment controls and an increased risk of incorrect payments and fraud had to be consciously accepted (Office of the Auditor General, Canada, 2021[59]) (UK National Audit Office, 2020[13]) .
In order to minimise fraud and reach the right beneficiaries, some countries have adapted their measures several times – thus introducing greater complexity and minimising clarity for the public (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Belgian Health Care Knowledge Centre, 2020[12]) .
Some evaluations conclude with the need to improve the protection system for the self-employed for future economic shocks , both in terms of national solidarity and economic efficiency (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Belgian Health Care Knowledge Centre, 2020[12]) .
Source: In the text.
A more detailed analysis of evaluations on economic and financial measures show that there is less evidence on the effectiveness of tax-based support and balance-sheet measures for these target groups, than that on expenditure-based measures for these groups (see Figure 6 ). Specifically, the evaluations that mention tax-based support and balance-sheet measures mostly looked at their effects on businesses. This focus is consistent with the main goal of balance-sheet measures, which was to ensure corporate liquidity and support credit markets, suggesting that there is a good evidence base on these measures to date. Still, the impacts of economic and financial measures on households, employees and businesses need to be further evaluated in the coming months and years.
Note: n=67. There are 67 evaluations among 18 OECD countries. 29 evaluations assessed spending/expenditure measures directed at households.
Finally, evaluations also looked at infrastructure measures, measures to support financial markets and measures to support longer-term recovery – but such assessments are, so far, less common.
Social policies
Social measures were also mentioned in quite a few evaluations of COVID-19 responses (35 evaluations over 13 countries). However, 8 of these evaluations were ex ante assessments that looked at the predicted and potential impacts of the crisis on poverty and inequality . For example, the National Council for the Evaluation of Social Development Policy (CONEVAL) in Mexico conducted an ex ante evaluation to assess the impacts of the pandemic on poverty and how the existing social protection mechanisms in place could help mitigate these impacts. It underlines the need for increased social protection for the most vulnerable population groups.
Many ex post or ex durante evaluations on this topic note that the pandemic may have had impacts of inequality and poverty without providing an assessment of how and why this might be the case. There are, however, several evaluations that analyse these effects. These evaluations looked at topics such as the distribution of school meals, emergency housing during lockdown and confinement periods, or how governments have supported household income to fight against poverty (see Box 15 ). Interestingly, all three upper-middle-income countries in the sample (Colombia, Costa Rica, and Mexico) have focused their early evaluations solely on social, household and employment issues.
Over the longer term, more countries may wish to look at the social impacts of the pandemic. Some countries have already begun doing so, for instance when it comes to the impacts of the pandemic on young people (OECD, 2020[60]) . In Canada, the government is examining how government spending and policies, including emergency aid and recovery measures for the COVID-19 crisis, will affect women and men differently through the lenses of its Gender-Based Analysis Plus (GBA+) framework. The framework is used to assess the impact of policies and programmes across social groups, acknowledging intersecting identity factors such as gender and age. In general, the impact of general lockdown measures and increased unemployment on domestic violence and the general effects of the crisis on youth have not been mentioned in any of the evaluations in the sample and may be worth exploring in the future.
Additionally, among the 67 evaluations covered in this report, few cover education (16), and, specifically, the effect of school closures . Surprisingly, few national statistical offices or education ministries undertook special data collections related to the pandemic and its effects using probability samples. This reflects the sudden and unexpected nature of the COVID-19 pandemic and the fact that the restrictions associated with lockdowns created less than ideal conditions for conducting survey-based research (Thorn, W. and S. Vincent-Lancrin, 2021[61]) .
Nevertheless, in Germany, Ireland, France, the United Kingdom and the United States, data based on probability samples, and thus representative of some well-identified national populations, were collected on a variety of inputs and outcomes. The picture offered by those statistical studies shows that distance and remote education were put in place at short notice and allowed education to continue at home for the majority of children, coupled with a form of in‑person instruction for children with special needs (Thorn, W. and S. Vincent-Lancrin, 2021[61]) . While those arrangements represented an imperfect substitute for normal classes, they nonetheless ensured that most, though not all, children continued to have a connection with their teachers and schools.
At this point, however, the evidence regarding the impact of the first wave of school closures on academic progress is generally inconclusive. Looking ahead, a more thorough and long-term monitoring of the consequences of the pandemic on children’s schooling and well‑being is needed. High-quality data collection may have become easier for the subsequent waves of school closures and should provide researchers and analysts with a better understanding of what occurred during this period and of the behaviour and views of those involved and affected by the disruption to school education.
The crisis has affected all parts of the population but its adverse effects are felt more strongly in vulnerable social groups, including people living in poverty, the elderly, homeless persons, children and young people (OECD, 2020[60]) . To prevent social disruption and avoid an increase in poverty, inequality and exclusion, governments have expanded their social protection systems and implemented policies targeted at the most disadvantaged groups in society.
Particular attention has been paid to poverty and inequality reduction . In Colombia, Israel and Italy, government interventions were seen as having had a positive impact on the poorest people and mitigating the impact of the crisis on overall inequality indexes (NPD and IADB, 2021[62]) (National Insurance of Israel, 2020[63]) (MEF, 2020[64]) . However, several evaluations point to the challenges of identifying and protecting vulnerable beneficiaries under short time constraints (Contraloría General de la República, 2020[52] ; Cour des Comptes, 2021[65]) . In Costa Rica, for example, some people who qualified for the benefit did not receive the Bono Proteger programme, thus preventing it from having the desired impact on poverty levels (Contraloría General de la República, 2020[52]) .
Several evaluations point out that assessing the impact of the crisis on poverty and inequality could also allow governments to identify gaps in their social protection systems (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) (US Government Accountability Office, 2020[18]) . These findings are also in line with the recommendations from the OECD policy paper on “Youth and COVID-19” which suggests that tools to measure intergenerational impacts could also allow governments to anticipate the impact of response and recovery measures across different age groups and avoid exacerbating intergenerational inequalities, which have been accentuated by the crisis (OECD, 2020[60]) .
Policies aimed at mitigating the social impacts of the crisis also paid particular attention to the effects of remote learning and school closures, which were undertaken by a large number of countries to reduce the spread of the virus (UK NAO, 2021[66] ; Knesset Research and Information Center, 2020[67] ; Commission "Norway Towards 2025", 2021[41] ; Cour des Comptes, 2021[68]) . Ensuring continuous learning for students was a particular challenge for countries. The most vulnerable groups were particularly affected by such measures (HM Government, 2020[69] ; Commission "Norway Towards 2025", 2021[41] ; US Office of Management and Budget, 2020[43] ; UK Department of Health and Social Care, 2020[48] ; Knesset Research and Information Center, 2020[67] ; Cour des Comptes, 2021[68]) . At home for instance, vulnerable groups suffered from higher rates of infection and COVID-19 related deaths, more temporary layoffs in lower status occupations, a relatively greater loss of income compared to the general population, and a higher incidence of mental health issues. For disadvantaged children, schooling in this environment translated into more difficulty with devices and connectivity and more loss of contact with school and teachers (Thorn, W. and S. Vincent-Lancrin, 2021[61]) . Generally, school closures also have a high cost in terms of student performance, well-being, physical and mental health, motivation and insertion in the labour market (HM Government, 2020[69] ; Commission "Norway Towards 2025", 2021[41] ; Cour des Comptes, 2021[68] ; UK NAO, 2021[66]) .The few evaluations available on this topic concluded that it was essential to keep schools open as much as possible (Danish Parliamentary Committee on COVID-19, 2021[8] ; HM Government, 2020[69] ; Cour des Comptes, 2021[68]) (GAO, 2020[70]) .
Health measures
Health measures put in place by OECD countries in response to COVID-19 were examined in 27 evaluations across 12 countries. These evaluations look at issues related to measures for infection control, as well as intensive care and regular health care capacities during the acute phase of the crisis. The evaluations that focus on health measures look mostly at issues related to process, such as that of data collection or supply of vaccines. Several of these evaluations suggest that more in-depth analysis of the impacts of the pandemic on health is needed (see Box 16 ). For instance, there is little evidence available on the effectiveness of countries’ vaccination policies at this stage, or on the impact of telemedicine on key health indicators. Other issues are not mentioned at all in the sample of evaluations, such as the impact of the pandemic on mental health, especially that of youth, and on alcohol consumption. Yet, evidence from the OECD suggests that the COVID‑19 crisis has heightened the risk factors generally associated with poor mental health and alcohol consumption (OECD, 2021[71] ; OECD, 2021[72]) .
In order to control the spread of the virus, OECD countries introduced more or less stringent infection control measures (mandatory use of protective masks, social distancing, quarantine measures, etc.) and deployed massive testing and tracing strategies. In addition, vaccination campaigns were launched starting from the end of 2020 to immunise the population. Multiple actors, both public and private, have been involved in these efforts. The pandemic not only had an impact on intensive care, but also on regular health care insofar as hospitals were overwhelmed with treating COVID-19 patients during the peak of the pandemic.
A major challenge pinpointed by evaluations was the lack or poor quality of real-time data on intensive care unit beds available in hospitals in some countries (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) (Belgian Health Care Knowledge Centre, 2020[12]) . Yet, these data are crucial to assess hospital capacity and take steps to surge or de-surge this capacity, to decide on new admissions of COVID-19 patients, to create additional capacity, or assess the need for inter-hospital transport. Evaluations pointed to the importance of developing an inventory of critical care capacities both at the national and regional level, to assess capacities in normal times, and to better understand how to extend them in times of crisis. Evaluations also suggest working on shared IT systems among the health ministry, local health authorities and hospitals to allow for real-time reporting (US Government Accountability Office, 2021[9]) (see also Box 5 ).
Evaluations underline that national governments encountered important challenges in deploying testing and tracing efforts, in particular as they required a high level of co ‑ ordination with local actors . As a result, the detection of large-scale outbreaks and the subsequent isolation of infected people was extremely difficult (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) . Evaluations recommend that governments establish clear protocols for authorities to work together to test and trace, in order to improve pandemic response capacities. Evaluations also highlighted the insufficient checks on quarantine and self-isolation orders imposed on infected people and travellers, given the lack of compliance with quarantine and testing requirements and public health agencies’ difficulty in performing controls. Some evaluations mention that a nationwide quarantine could be a solution to improve compliance with these rules (Canadian Office of the Auditor General, 2021[7] ; Holden Expert Group, n.d.[73]) .
Evaluations emphasised that deploying vaccination strategies has posed important logistical challenges as they required the concerted effort of many stakeholders. Evaluations recommend a clear communication of vaccination plans to all involved entities to ensure that they have sufficient time to prepare and organise distribution (GAO, 2020[70]) (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) .
Evaluations observe a reduction in medical consultation and in-person visits to clinics and hospitals for non-COVID-19 patients, and indicate that communications around regular health care were not clear in several countries (Danish Parliamentary Committee on COVID-19, 2021[8] ; Cour des Comptes, 2021[74]) . Online medical consultations were not always seen as an effective solution to maintain good levels of care for patients (State Comptroller of Israel, 2020[75] ; Corona Investigative Committee, 2020[76] ; Dutch Ministry of Sports and Health, 2020[77]) . Evaluations pointed to the potential long-term negative consequences for population health outcomes due to challenges in maintaining care continuity, and suggest a further evaluation of the impacts of the pandemic in this regard (State Comptroller of Israel, 2020[75] ; Corona Investigative Committee, 2020[76] ; Dutch Ministry of Sports and Health, 2020[77]) .
Lockdown and restriction
Restrictions on the movement of people were assessed in 27 evaluations conducted by 10 countries. OECD data indicates that school restrictions (16 evaluations), curfews and bans on public gatherings (14), and travel restrictions (13) were important concerns for countries. There is no correlation between the number of evaluations published on lockdown and restrictions measures and the average score of a stringency index, as calculated by the COVID-19 Government Response Tracker of the University of Oxford (University of Oxford, 2020[78]) . For example, Norway published 7 evaluations that examined lockdown and restriction policies on peoples’ behaviour despite a relatively low score of 47 (on a scale of 100) on this index. Evaluations in the sample suggest that lockdown and restriction measures came at a high cost for society, but recommend pursuing efforts to evaluate the costs and benefits associated with these measures, in order to optimise them in the future. Several evaluations do recognise that this balance will be difficult to assess, given the far-reaching implications of these types of measures. In terms of process, lockdown measures were seen as not always coherent or well implemented ( Box 17 ).
The lockdown and restriction measures implemented by countries generally include border closures and controls, travel restrictions, school closures, curfews and bans on public gatherings. Countries limited mobility within and across borders to curb the spread of the virus and indirectly diminish the detrimental economic, social and health impacts of the crisis.
Evaluations mention that governments generally acted relatively quickly to close borders when it became apparent that the pandemic was no longer under control, although these findings may be very country-dependent. In general, border restrictions on international travel are beneficial in the short term to contain the spread of the virus, but their effectiveness lessens once the virus starts spreading within countries (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Canadian Office of the Auditor General, 2021[7] ; Commission "Norway Towards 2025", 2021[41] ; Danish Parliamentary Committee on COVID-19, 2021[8]) (Italian Ministry of Economy and Finance, 2020[46]) . Countries tried to reallocate resources where to repatriate citizens residing abroad or at least ensure that their needs were met at a distance by swiftly and regularly informing them about the health situation and existing support (US Government Accountability Office, 2021[17] ; Cour des Comptes, 2021[79]) . Evaluations also show that countries within the European Union were able to co‑operate fruitfully to implement these measures (Commission "Norway Towards 2025", 2021[41] ; French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10]) .
Evaluations mention, however, that there were challenges with compliance with lockdown measures , party because they were sometimes difficult to understand for citizens or inconsistent. Evaluations recommend clearer provisions, more accurate control of their implementation, with a consideration for vulnerable groups that might be disproportionately affected by such measures (Canadian Office of the Auditor General, 2021[7] ; UK Department of Health and Social Care, 2020[48]) .
The restrictions of visits in hospitals and retirement homes had high costs in terms of mental health and well-being of both patients and their relatives (US Government Accountability Office, 2020[18] ; Belgian Health Care Knowledge Centre, 2020[12]) . Evaluations therefore recommend that solutions such as building glass panes and organising more distance meetings be put in place (US Government Accountability Office, 2020[18] ; Belgian Health Care Knowledge Centre, 2020[12]) .
While restrictive measures such as bans on public gatherings in restaurants and cultural places and mandatory teleworking had high economic, social and well-being costs, they were assessed as somewhat beneficial for the environment, with reduced carbon emissions associated with reduced national and international travel (Commission "Norway Towards 2025", 2021[41] ; French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; US Government Accountability Office, 2021[32] ; GOV.UK, 2020[80] ; Italian Ministry of Economy and Finance, 2020[46]) . Continuing to evaluate the costs and benefits associated with restrictive measures, such as strict lockdowns and curfews, would help countries optimise them in the future (French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks, 2021[10] ; Commission "Norway Towards 2025", 2021[41] ; Danish Parliamentary Committee on COVID-19, 2021[8]) .
Conclusions and the way forward
Countries have deployed significant efforts to respond to this crisis, which affected all sectors of society. Despite time and resource constraints, OECD governments undertook evaluations of their COVID-19 responses. Yet, as the crisis is still ongoing and it is still early to assess the true impacts of many of the measures deployed, the evidence from these evaluations is focused on the relevance and efficiency of these policies, and much less on their effectiveness. More importantly, issues relating to policies’ proportionality and coherence are still largely underexplored – at the same time, they may be particularly useful for policy debate when resources are scarce and cross-government co‑ordination is crucial.
A mapping of the overall evidence base available to the OECD Secretariat shows that some types of policy responses, such as health and social policies, as well as lockdown and restriction measures or critical sector preparedness, still need further analysis. More importantly, the evaluations do not cover all aspects of countries’ policy responses to the crisis, suggesting that evidence is still lacking in some areas – such as the impacts of the crisis on mental health, on youth or on education levels.
Nevertheless, the existing evidence base provides decision makers with key insights to draw upon in developing both their ongoing recovery efforts and future plans to increase governments’ resilience to crises. Going forward, the OECD Secretariat will update this paper to expand on the 14 insights included in this edition, particularly with regard to response and recovery measures, as evidence of their impact may be particularly useful to inform policies as countries progressively move out of the crisis.
[19] Australian NAO (2020), Management of the Australian Public Service’s Workforce .
[15] Australian National Audit Office (2020), Planning and Governance of COVID-19 Procurements to Increase the National Medical Stockpile .
[21] Australian National Audit Office (2020), Services Australia COVID-19 Measures and Enterprise .
[23] Australian National Audit Office (2020), The Australian Taxation Office’s Management of Risks Related to the Rapid Implementation of COVID-19 Economic Response Measures , https://www.anao.gov.au/sites/default/files/Auditor-General_Report_2020-21_24a.pdf .
[44] Bank of Italy (2020), Some preliminary estimates of the effects of support measures on the labour market , https://www.bancaditalia.it/pubblicazioni/note-covid-19/2020/Scenari_impatto_COVID_19.pdf .
[12] Belgian Health Care Knowledge Centre (2020), Assessing the management of hospital surge capacity in the first wave of the COVID-19 pandemic in Belgium , https://doi.org/ D/2020/10.273/35 .
[47] Belgian National Social Security Institut for Self-employed Workers (2020), Temporary extension of the financial safety net for self-employed workers facing loss of income following the Coronavirus crisis .
[7] Canadian Office of the Auditor General (2021), Pandemic Preparedness, Surveillance, and Border Control Measures , https://doi.org/ 2561-343X .
[41] Commission "Norway Towards 2025" (2021), White Paper , https://doi.org/ 978-82-583-1475-9 .
[52] Contraloría General de la República (2020), Informe de auditoría operativa sobre la eficacia y eficiencia del Bono Proteger implementado por el Ministerio de Trabajo y Seguridad Social y el Instituto Mixto de Ayuda Social ante la emergencia sanitaria provocada por la enfermedad Covid-19 , https://cgrfiles.cgr.go.cr/publico/docs_cgr/2020/SIGYD_D/SIGYD_D_2020023096.pdf .
[76] Corona Investigative Committee (2020), The eldery care in the pandemic , http:// coronakommissionen.com/wp-content/uploads/2020/12/summary.pdf .
[68] Cour des Comptes (2021), La contribution du service public numérique éducatif à la continuité scolaire pendant la crise sanitaire , https://www.ccomptes.fr/fr/publications/le-rapport-public-annuel-2021 .
[79] Cour des Comptes (2021), L’aide au retour des Français retenus à l’étranger par la pandémie de covid 19 , https://www.ccomptes.fr/fr/publications/le-rapport-public-annuel-2021 .
[65] Cour des Comptes (2021), L’hébergement et le logement des personnes sans domicile pendant la crise , https://www.ccomptes.fr/fr/publications/le-rapport-public-annuel-2021 .
[74] Cour des Comptes (2021), Réanimation et soins critiques en général , https://www.ccomptes.fr/fr/publications/le-rapport-public-annuel-2021 .
[35] COVID-19 Canada Open Data Working Group (2021), COVID-19 in Canada , https://art-bd.shinyapps.io/covid19canada/ .
[8] Danish Parliamentary Committee on COVID-19 (2021), The handling of COVID-19 in the spring of 2020 .
[55] Demmou, L. et al. (2021), Insolvency and debt overhang following the COVID-19 outbreak: Assessment of risks and policy responses , https://doi.org/10.1787/747a8226-en .
[54] Demmou, L. et al. (2021), Liquidity shortfalls during the COVID-19 outbreak: Assessment and policy responses , https://doi.org/10.1787/581dba7f-en .
[45] Department of National Planning, Colombian government (2021), Impactos del programa Ingreso Solidario frente a la crisis del COVID-19 en Colombia , http://dx.doi.org/10.18235/0003261 .
[77] Dutch Ministry of Sports and Health (2020), An impact analysis of the COVID-19 on the regular health care .
[51] France Stratégie (2020), La lutte contre la pauvreté au temps du coronavirus , https://www.strategie.gouv.fr/publications/lutte-contre-pauvrete-temps-coronavirus .
[56] French Court of Accounts (2021), The solidarity fund for companies , https://www.ccomptes.fr/sites/default/files/2021-03/20210318-06-TomeI-fonds-solidarite-destination-des-entreprises.pdf .
[10] French independent national mission to evaluate the COVID-19 crisis management and on the anticipation of pandemic risks (2021), Final report .
[22] French mission to control the quality of the management of the health crisis (2020), Report on the quality control of the management of the health crisis , https://www.gouvernement.fr/sites/default/files/document/document/2020/11/mission_controle_qualite_de_la_gestion_de_crise_sanitaire_-_v14.pdf .
[70] GAO (2020), Covid-19: Federal Efforts Could Be Strengthened by Timely and Concerted Actions , https://www.gao.gov/products/gao-20-701 .
[53] Geeraert, M. and V. De Maesschalk (2020), “Extension temporaire du droit passerelle en tant que filet de sécurité financière pour les indépendants confrontés à une perte de revenus à la suite de la crise du coronavirus”, Revue Belge de sécurité sociale , Vol. 1, https://socialsecurity.belgium.be/sites/default/files/content/docs/fr/publications/rbss/2020/rbss-2020-1-extension-temporaire-du-droit-passerelle-en-tant-que-filet-de-securite-financiere-pour-les-independants.pdf .
[80] GOV.UK (2020), Analysis of the health, economic and social effects of COVID-19 and the approach to tiering , https://www.gov.uk/government/publications/the-health-economic-and-social-effects-of-covid-19-and-the-tiered-approach .
[69] HM Government (2020), Analysis of the health, economic and social effects of COVID-19 and the approach to tiering , https://www.gov.uk/government/publications/the-health-economic-and-social-effects-of-covid-19-and-the-tiered-approach .
[73] Holden Expert Group (n.d.), 2021 , https://www.helsedirektoratet.no/rapporter/samfunnsokonomisk-vurdering-av-smitteverntiltak-covid-19/Samfunns%C3%B8konomisk%20vurdering%20av%20smitteverntiltak%20-%20Tredje%20rapport,%20del%201.pdf/_/attachment/inline/d4970fb8-37e8-4e67-8900-835937bc80ca:c .
[46] Italian Ministry of Economy and Finance (2020), The impact of Covid-19 and government interventions on the socio-economic situation of Italian families in the first three months of the pandemic .
[67] Knesset Research and Information Center (2020), The Availability of Digital Devices and Internet Connections for Distance Learning among School-age Children , https://main.knesset.gov.il/EN/activity/mmm/TheAvailabilityofDigitalDevices.pdf .
[64] MEF (2020), L’impatto del Covid-19 e degli interventi del Governo sulla situazione socio-economica delle , https://www.finanze.gov.it/export/sites/finanze/.galleries/Documenti/Varie/Nota-tematica-n.-3-Impatto-del-Covid-19-sulla-situazione-socio-economica-delle-famiglie-italiane.pdf .
[42] Moretti, D., T. Braëndle and A. Leroy (2021), “Balance sheet-based policies in COVID‑19 fiscal packages: How to improve transparency and risk analysis?”, Journal on Budgeting , Vol. Volume 2021/Issue 2, https://doi.org/10.1787/16812336 .
[39] National Audit Office (2020), Implementing employment support schemes in response to the COVID-19 pandemic , https://doi.org/ 9781786043399 .
[49] National Insurance Institute of Israel (2020), An estimate of the impact of the corona crisis on the socio-economic situation , https://www.btl.gov.il/Publications/corona/Pages/mashber-calcali1206-5241.aspx .
[63] National Insurance of Israel (2020), The impact of the recession following the Corona crisis on living standards, poverty and inequality (Study No. 133) , https://www.btl.gov.il/Publications/corona/Pages/mechkar1330520-600.aspx .
[50] National Planning Department of Colombia (2020), The Impact of Emergency Cash Assistance During the COVID-19 Pandemic in Colombia , https://www.poverty-action.org/study/impact-emergency-cash-assistance-during-covid-19-pandemic-colombia .
[57] New Zealand Controller and Auditor General (2021), Management of the Wage Subsidy Scheme , https://oag.parliament.nz/2021/wage-subsidy/docs/wage-subsidy.pdf .
[14] New Zealand Controller and Auditor General (2021), Ministry of Health: Management of personal protective equipment in response to Covid-19 , https://oag.parliament.nz/2020/ppe .
[26] New Zealand Parliament (2021), Assessing Parliament’s response to the COVID-19 pandemic .
[62] NPD and IADB (2021), Impactos del programa Ingreso Solidario frente a la crisis del COVID-19 en Colombia , https://publications.iadb.org/es/impactos-del-programa-ingreso-solidario-frente-la-crisis-del-covid-19-en-colombia .
[40] OAG of Canada (2021), Canada Emergency Wage Subsidy , https://www.oag-bvg.gc.ca/internet/docs/parl_oag_202103_02_e.pdf .
[3] OECD (2021), Government at a Glance 2021 , OECD Publishing, Paris, https://doi.org/10.1787/1c258f55-en .
[25] OECD (2021), OECD Report on Public Communication: The Global Context and the Way Forward , OECD Publishing, Paris, https://dx.doi.org/10.1787/22f8031c-en .
[71] OECD (2021), “Tackling the mental health impact of the COVID-19 crisis: An integrated, whole-of-society response” , OECD Policy Responses to Coronavirus (COVID-19) , OECD Publishing, Paris, https://dx.doi.org/10.1787/0ccafa0b-en .
[72] OECD (2021), “The effect of COVID-19 on alcohol consumption, and policy responses to prevent harmful alcohol consumption” , OECD Policy Responses to Coronavirus (COVID-19) , OECD Publishing, Paris, https://dx.doi.org/10.1787/53890024-en .
[20] OECD (2020), “Building resilience to the Covid-19 pandemic: the role of centres of government” , OECD Policy Responses to Coronavirus (COVID-19) , OECD Publishing, Paris, https://dx.doi.org/10.1787/883d2961-en .
[58] OECD (2020), OECD Labour Force Statistics .
[38] OECD (2020), “Tax and fiscal policy in response to the Coronavirus crisis: Strengthening confidence and resilience” , OECD Policy Responses to Coronavirus (COVID-19) , OECD Publishing, Paris, https://dx.doi.org/10.1787/60f640a8-en .
[28] OECD (2020), “The Covid-19 crisis: A catalyst for government transformation?” , OECD Policy Responses to Coronavirus (COVID-19) , OECD Publishing, Paris, https://dx.doi.org/10.1787/1d0c0788-en .
[34] OECD (2020), “The territorial impact of COVID-19: Managing the crisis across levels of government” , OECD Policy Responses to Coronavirus (COVID-19) , OECD Publishing, Paris, https://dx.doi.org/10.1787/d3e314e1-en .
[29] OECD (2020), “Transparency, communication and trust: The role of public communication in responding to the wave of disinformation about the new Coronavirus” , OECD Policy Responses to Coronavirus (COVID-19) , OECD Publishing, Paris, https://dx.doi.org/10.1787/bef7ad6e-en .
[60] OECD (2020), “Youth and COVID-19: Response, recovery and resilience” , OECD Policy Responses to Coronavirus (COVID-19) , OECD Publishing, Paris, https://dx.doi.org/10.1787/c40e61c6-en .
[5] OECD (2018), Assessing Global Progress in the Governance of Critical Risks , OECD Reviews of Risk Management Policies, OECD Publishing, Paris, https://dx.doi.org/10.1787/9789264309272-en .
[4] OECD (2018), National Risk Assessments: A Cross Country Perspective , OECD Publishing, Paris, https://dx.doi.org/10.1787/9789264287532-en .
[27] OECD (2018), Scientific Advice During Crises: Facilitating Transnational Co-operation and Exchange of Information , OECD Publishing, Paris, https://dx.doi.org/10.1787/9789264304413-en .
[31] OECD (2016), Trends in Risk Communication Policies and Practices , OECD Reviews of Risk Management Policies, OECD Publishing, Paris, https://dx.doi.org/10.1787/9789264260467-en .
[2] OECD (2015), The Changing Face of Strategic Crisis Management , OECD Reviews of Risk Management Policies, OECD Publishing, Paris, https://dx.doi.org/10.1787/9789264249127-en .
[1] OECD (2014), “Recommendation of the Council on the Governance of Critical Risks” , OECD Legal Instruments , OECD/LEGAL/0405, OECD, Paris, https://legalinstruments.oecd.org/en/instruments/OECD-LEGAL-0405 .
[6] OECD (2011), Future Global Shocks: Pandemics , OECD, Paris, https://www.oecd.org/fr/gov/risques/Pandemics.pdf .
[33] OECD (forthcoming), Principles of Good Practice for Public Communication Responses to Help Counter Mis- and Disinformation .
[59] Office of the Auditor General, Canada (2021), COVID-19 pandemic: Canada Emergency Response Benefit .
[75] State Comptroller of Israel (2020), The State of Israel Response to the COVID-19 Crisis - Special Interim Report , https://www.mevaker.gov.il/sites/DigitalLibrary/Documents/2020/COVID-19/2020-COVID-19-003-preface-EN.pdf?AspxAutoDetectCookieSupport=1 .
[11] Swiss Federal Chancellery (2020), Rapport concernant l’évaluation de la gestion de crise pendant la pandémie de COVID-19 , https://www.newsd.admin.ch/newsd/message/attachments/64454.pdf (accessed on 4 July 2021).
[61] Thorn, W. and S. Vincent-Lancrin (2021), Schooling During a Pandemic: The Experience and Outcomes of Schoolchildren During the First Round of COVID-19 Lockdowns , OECD Publishing, https://doi.org/10.1787/1c78681e-en .
[48] UK Department of Health and Social Care (2020), Coronavirus Act 2020: the public sector equalities duty impact assessment , https://www.gov.uk/government/publications/coronavirus-act-2020-equality-impact-assessment/coronavirus-act-2020-the-public-sector-equalities-duty-impact-assessment .
[66] UK NAO (2021), Support for children’s education during the early stages of the Covid-19 pandemic , https://www.nao.org.uk/work-in-progress/support-for-childrens-education-during-the-covid-19-pandemic/ .
[13] UK National Audit Office (2020), Implementing employment support schemes in response to the COVID-19 pandemic , https://www.nao.org.uk/report/implementing-employment-support-schemes-in-response-to-the-covid-19-pandemic/ .
[37] United States Government Accountability Office (2020), COVID-19: Urgent Actions Needed to Better Ensure an Effective Federal Response , https://www.gao.gov/assets/gao-21-191.pdf .
[78] University of Oxford (2020), Covid-19 Government Response Tracker , https://www.bsg.ox.ac.uk/research/research-projects/covid-19-government-response-tracker (accessed on 29 June 2021).
[9] US Government Accountability Office (2021), COVID-19: Critical Vaccine Distribution, Supply Chain, Program Integrity, and Other Challenges Require Focused Federal Attention .
[17] US Government Accountability Office (2021), COVID-19: Federal Efforts Could be Strengthened by Timely and Concerted Actions .
[24] US Government Accountability Office (2021), Critical Vaccine Distribution, Supply Chain, Program Integrity, and Other Challenges Require Focused Federal Attention .
[32] US Government Accountability Office (2021), Federal Efforts Accelerate Vaccine and Therapeutic Development, but More Transparency Needed on Emergency Use Authorizations .
[16] US Government Accountability Office (2020), Covid-19: Opportunities to Improve Federal Response and Recovery Efforts .
[18] US Government Accountability Office (2020), Urgent Actions Needed to Better Ensure an Effective Federal Response .
[43] US Office of Management and Budget (2020), The Economic Impact of Coronavirus Response Funds: First Quarterly Report .
[30] Wendling, R. (2013), “The use of social media in risk and crisis communication”, OECD Working Papers on Public Governance , Vol. No. 24.
[36] Working Party of Senior Budget Officials (2020), The use of performance information during the COVID-19 crisis .
List of evaluations of COVID-19 policy response analysed in this paper
Source: In the text
Claire SALAMA (✉ [email protected] )
Government is understood in a wide sense, as calls for contributions were sent to networks from the Centres of government, from the Supreme Audit Institutions, from Parliamentary Budget Offices and Independent Fiscal Institutions.
Australia, Belgium, Canada, Colombia, Costa Rica, Denmark, France, Italy, Israel, Lithuania, Mexico, New Zealand, Netherlands, Norway, Switzerland, Sweden, United Kingdom, United States.
Ex post impact evaluations were not available in the sample.
50% of evaluations by federal countries assessed at least one aspect of whole-of-government response, compared to 15% of evaluations by the non-federal countries.
IMAGES
VIDEO
COMMENTS
The starting point for this article is that the COVID-19 global pandemic has brought normally invisible, taken-for-granted aspects of
This is a COVID-19 essay by Stuart J. Murray, published online in TOPIA.
The paper adopts the critical literature review (CLR) approach given that it entails the assessment, critique and synthetisation of relevant
this is an example of a critique paper about the covid 19 vaccination of a community in southern Philippines mindanao davao oriental critique paper about.
Download Essays (high school) - Critique Paper About The Covid-19 in the Philippines In partial fulfillment for the subject Reading, and Writing Skills.
In this article, the current knowledge of deadly, pandemic human coronavirus SARS-Cov2 (COVID-19), with special reference to its zoonosis, susceptibility
The pandemic of Coronavirus Disease 2019 (COVID-19) is a timely reminder of the nature and impact of Public Health Emergencies of
COVID-19” or “the pandemic” is often referred to as a “novel Coronavirus” ... For example, California, the most populous state in the US
By April 2021, most countries in the sample analysed in this paper had already conducted evaluations on each of the key stages of the risk