COVID-19 Government Research Articles

Looking back at Covid-19 government restrictions: were local lockdown regions with tighter restrictions less adherent before the restrictions and more adherent after?

Abstract It is assumed that increases in Covid-19 cases are caused by people not adhering to advised individual transmission-reducing behaviours. Upon the implementation of restrictions, the hypothesis is that those individuals will change their behaviour. We aimed to retrospectively explore adherence to physical distancing before and after restrictions (e.g., lockdowns) were implemented in a region of Scotland. We assessed adherence, intention, and self-efficacy to physical distancing in a series of cross-sectional telephone surveys of a representative sample of adults in Scotland. We included data from before regional restrictions and after restrictions and examined whether regions with and without restrictions differed in adherence. A total of 1724 Scottish adults (675 men, M age = 52.79 years, SD = 17.92) participated (879 (51.0%) pre-restriction, 466 (27.0%) from a restricted region). ANOVA showed that none of the main effects (for region or time) nor the interaction effect were significant. There was a main effect of time on self-efficacy, such that self-efficacy was lower post-restriction measures (M = 4.13, SD = 0.81) compared to pre-restriction time (M = 4.22, SD = 0.79). There was no evidence that adherence was weaker before restrictions were implemented in regions with higher case rates. Nor was there evidence that imposing restrictions increased adherence. In a future pandemic, it is advisable to assess behaviour and beliefs about Covid-19, risk, and behaviours on an ongoing basis and to use that as indicators of the need for intervention even before cases rates start to go up.

Improving breast cancer care post-pandemic from the patient perspective

Abstract Background Since the onset of the pandemic, breast cancer (BC) services have been disrupted in most countries. The purpose of this qualitative study is to explore the unmet needs, patient-priorities, and recommendations for improving BC healthcare post-pandemic for women with BC and to understand how they may vary based on socio-economic status (SES). Methods 37 women were invited to take part in follow-up semi-structured qualitative interviews in early 2023. The interviews explored their perspectives of BC care since the easing of COVID-19 government restrictions, including unmet needs, patient-priorities, and recommendations specific to BC care. Thematic analysis was conducted to synthesize each topic narratively with corresponding sub-themes. Additionally, variation by SES was analysed within each sub-theme. Results Of the 28 women who participated in interviews, 39% were categorized as high-SES, while 61% were categorized as low-SES. Women expressed unmet needs in their BC care including routine care and mental and physical well-being care, as well as a lack of financial support to access BC care. Patient-priorities included: developing cohesion between different aspects of BC care; communication with and between healthcare professionals; and patient empowerment within BC care. Recommendations moving forward post-pandemic included: improving the transition from active to post-treatment; enhancing support resources; and implementing telemedicine where appropriate. Overall, women of low-SES experienced more severe unmet needs, which resulted in varied patient-priorities and recommendations. Conclusions As health systems are recovering from the COVID-19 pandemic, the emphasis should be on restoring access to BC care and improving the quality of BC care, with a particular consideration given to those women from low-SES, to reduce health inequalities post-pandemic. Key messages • The pandemic has impacted BC services considerably and this study has identified a range of unmet needs, patient-centered priorities, and recommendations. • Particular consideration needs to be given to those women from lower socioeconomic groups, in order to reduce health inequalities, which have been further exacerbated by the pandemic.

Provider and community perceptions of integrated COVID-19 and routine childhood immunisation programmes in Nigeria: a qualitative exploratory study

BackgroundIn Nigeria, COVID-19 vaccines were delivered through outreach activities, as well as integrated within routine immunisation. However, evaluations of integrated approaches for novel vaccines are scarce. We aimed to understand the perceived benefits and challenges of integrating the COVID-19 vaccine within routine immunisation in Nigeria, and identify ways to strengthen this approach.MethodsWe conducted 30 semi-structured interviews with community members and healthcare workers in primary healthcare facilities (PHCs) in Jigawa (n = 16) and Oyo (n = 14) states, Nigeria from 08 August to 13 September 2022. Participants were selected purposively from PHCs. We obtained information on participants’ perception about routine immunisation, and perceived benefits and challenges associated with integrated COVID-19 vaccine delivery. Healthcare worker and community interviews were analysed separately following a thematic analysis approach.ResultsWe identified four themes that describe the community and healthcare workers’ responses, perceived impact, and the health system adaptions to the challenges associated with the integrated vaccine delivery approach. Community members expressed concern that children might be given COVID-19 vaccines instead of routine immunisations, while others appreciated the integrated approach due to their trust in the efficacy of COVID-19 vaccines, government, and healthcare providers. Healthcare providers perceived the integrated approach as improving vaccination coverage and awareness but noted additional problems of increased workload, vaccine scarcity, and prolonged clinic visits. Insufficient resources were subsisting barriers to effective integration in both states, but the provider’s gender was also a challenge in Jigawa state. Additionally, the use of incentives to generate demand had ambiguous effects in Jigawa state.ConclusionTaking an integrated approach to deliver COVID-19 vaccines was acceptable by healthcare providers but community members expressed concerns. Given existing vaccination programmes have persistent challenges, it is pertinent to address these barriers to enhance effectiveness of an integrated approach.

Pandemic Pass? Treaty Derogations and Human Rights Practices During COVID-19

This research note asks whether states issuing pandemic-era human rights treaty derogations implemented emergency provisions as intended or used them to abuse human rights during a time of crisis. In an effort to combat the COVID-19 pandemic, many countries declared states of emergency and derogated (temporarily suspended) from their international human rights treaty obligations. Using data from the Varieties of Democracy PanDem dataset and the Oxford COVID-19 Government Response Tracker, we find that states that derogated from their international human rights obligations imposed emergency measures that were temporary and did not violate non-derogable rights. On the other hand, states that did not derogate were more likely impose discriminatory measures, enact emergency measures without time limits and violate non-derogable rights. Our results support the role that flexibility mechanisms such as derogations play in international law and show that states are being sincere about their intentions and not, generally, using these mechanisms to cover abusive behavior.

Confinement policies: controlling contagion without compromising mental health

ABSTRACT A growing literature shows that confinement policies used by governments to slow COVID-19 transmission have negative impacts on mental health, but the differential effects of individual policies on mental health remain poorly understood. We used data from the COVID-19 questionnaire of the Survey of Health, Ageing and Retirement in Europe (SHARE), which focuses on populations aged 50 and older, and the Oxford COVID-19 Government Response Tracker for 28 countries to estimate the effects of eight different confinement policies on three outcomes of mental health: insomnia, anxiety and depression. We applied robust machine learning methods to estimate the effects of interest. Our results indicate that closure of schools and public transportation, restrictions on domestic and international travel, and gathering restrictions did not worsen the mental health of older populations in Europe. In contrast, stay at home policies and workplace closures aggravated the three health outcomes analysed. Based on these findings, we close with a discussion of which policies should be implemented, intensified, or relaxed to control the spread of the virus without compromising the mental health of older populations.

Battle to Survive: The Association Between Accountability and Chinese Local Government Response to COVID-19

ABSTRACT China’s ability to sustain the zero-COVID strategy over three years has garnered global attention, but little is known about the factors contributing to its long-term adherence. Based on the political promotion tournament model, this article theorizes that China’s strict administrative accountability system, which tied local officials’ career prospects to their performance in crucial policy goals, incentivized local governments to sustain COVID-19 policies. Using data from the Oxford COVID-19 Government Response Tracker and major official Chinese media outlets, we performed interrupted time series analysis (ITSA) to examine whether the accountability events affected the local government’s COVID-19 responses. Noticeably, our analyses found that from May 4, 2020, to September 30, 2022, when an accountability event happened, officials in the affected (local effects) and unaffected (spillover effects) provinces all increased their containment responses and decreased their economic support responses. This is true even for provinces without new localized outbreaks. The effects of accountability events increased with decreasing geographical distance. These findings remain consistent after several robustness checks. The administrative accountability system is a key institutional factor in implementing China’s zero-COVID strategy, which contributed to the global literature about the pandemic policy process in centralized countries.

Containment Measures and Alcohol Consumption Among Drinking Higher Education Students Before and During the COVID-19 Pandemic: A Multilevel Analysis in 25 Countries.

Hazardous alcohol use tends to be more prominent among higher education students. The COVID-19 pandemic severely altered student life, raising questions on its impact on students' alcohol use patterns. The current study examined cross-country variations in drinking behaviors (weekly drinking and binge drinking), and the extent to which these variations were associated with containment measures implemented during the first wave of the COVID-19 pandemic. Data were obtained from the COVID-19 International Student Well-being Study, covering students in 25 middle- and upper-high income countries. Data on government responses were retrieved from the Oxford COVID-19 Government Response Tracker. Multilevel multinomial logistic regression analyses were performed on weekly drinking (n = 44,212) and binge drinking (n = 32,785). Considerable cross-country variation existed for weekly drinking and binge drinking. In the majority of countries, a self-reported decrease in weekly drinking and a substantial self-reported decrease in binge drinking were observed. Closings of schools were associated with decreases in weekly drinking, while limitations on social gatherings were associated with increases in weekly drinking. The stringency index was associated with reporting decreased binge drinking. The study findings demonstrate a number of small yet significant associations between containment measures and changes in student drinking behaviors. Future studies are required to uncover why some students increased their alcohol consumption, particularly in countries with stricter limitations on social gatherings.

Compliance with COVID-19 government guidance and rules by disabled people and people from minoritised ethnic groups: Qualitative findings from the CICADA study.

Within the 2020/21 CICADA (Coronavirus Intersectionalities: Chronic Conditions or Disabilities and Migrants and other Ethnic minorities) study, we explored full, partial or noncompliance with government COVID-19 infection-containment measures by people from minoritised ethnic groups with a disabling health condition or impairment. We used an assets-based intersectional approach and purposive sampling, included non-disabled and White British comparators, and trained community co-researchers to help us reach undocumented migrants and asylum seekers. We undertook 271 semi-structured qualitative interviews, followed by participatory workshops with interviewees to explore data and changes in experiences five and 10 months after the interviews. Perceiving their vulnerability to COVID-19, most participants quickly and often zealously adopted infection-containment behaviours, and continued this after restrictions were lifted. This could reduce mental wellbeing, especially in community-facing cultures, and could create family conflict. Various structural inequities impeded compliance. Many, especially undocumented migrants, felt imprisoned. The intersection of gender, citizenship, socioeconomic status and culture impacted disclosures of COVID-19 infection, support seeking and use. Many were unclear what was safe as well as unsafe. People complained that disability and cultural considerations were omitted from policymaking. Participants mostly had taken the COVID-19 vaccine by October 2022, but ethnic minority participants needed time to deliberate and trusted, community-embedded information whereas White British participants were mostly influenced by mass media. The intersection of health condition or impairment, poverty, and living alone led to more non-compliance with general rules, and more vaccine hesitancy than did misinformation spread through ethnic community channels. Many participants were reluctant to reintegrate in May 2022 because of continued perceived vulnerability to COVID-19 but by September 2022 = seemed more concerned about the economic crisis. We add two new 'types' to existing compliance typologies: deliberators (who eventually decide to follow the rules), and 'necessity-driven non-compliers' who are totally unable to comply because of their disabilities.

Impact of non-pharmaceutical interventions on COVID-19 incidence and deaths: cross-national natural experiment in 32 European countries

PurposeNon-pharmaceutical interventions (NPIs) have been the cornerstone of COVID-19 pandemic control, but evidence on their effectiveness varies according to the methods and approaches taken to empirical analysis.We analysed the impact of NPIs on incident SARS-CoV-2 across 32 European countries (March-December 2020) using two NPI trackers: the Corona Virus Pandemic Policy Monitor – COV-PPM, and the Oxford Covid-19 Government Response Tracker – OxCGRT.MethodsNPIs were summarized through principal component analysis into three sets, stratified by two waves (C1-C3, weeks 5–25, and C4-C6, weeks 35–52). Longitudinal, multi-level mixed-effects negative binomial regression models were fitted to estimate incidence rate ratios for cases and deaths considering different time-lags and reverse causation (i.e. changing incidence causing NPIs), stratified by waves and geographical regions (Western, Eastern, Northern, Southern, Others).ResultsDuring the first wave, restrictions on movement/mobility, public transport, public events, and public spaces (C1) and healthcare system improvements, border closures and restrictions to public institutions (C2) were associated with a reduction in SARS-CoV-2 incidence after 28 and 35-days. Mask policies (C3) were associated with a reduction in SARS-CoV-2 incidence (except after 35-days). During wave 1, C1 and C2 were associated with a decrease in deaths after 49-days and C3 after 21, 28 and 35-days. During wave 2, restrictions on movement/mobility, public transport and healthcare system improvements (C5) were also associated with a decrease in SARS-CoV-2 cases and deaths across all countries.ConclusionIn the absence of pre-existing immunity, vaccines or treatment options, our results suggest that the observed implementation of different categories of NPIs, showed varied associations with SARS-CoV-2 incidence and deaths across regions, and varied associations across waves. These relationships were consistent across components of NPIs derived from two policy trackers (CoV-PPM and OxCGRT).

Pediatric suicide attempts lagged during the COVID-19 pandemic: a European multicenter study

BackgroundElevated rates of suicidal behavior were reported during the COVID-19 pandemic. However, information is scarce on patients’ profiles during this period. Studies evoke the potential adverse effects of the mandatory lockdown, but they remain relatively speculative.MethodsWe monitored fluctuations in suicide attempts (SA) in six European countries. We gathered data, retrospectively for under 18-year-old SA episodes (1 January 2018 to 31 December 2021), through records of psychiatric emergency services. We collected clinical profiles individually. We extracted environmental indicators by month, as provided by Oxford COVID-19 Government Response Tracker (OxCGRT). We used the Pruned Exact Linear Time (PELT) method to identify breakpoints in SA episodes reported for each country, and logistic regressions to estimate changes in patients’ characteristics after the breakpoints. Finally, we used a univariate and multivariate negative binomial model to assess the link between SA and OxCGRT indicators, accounting for the delay (lag) between the interventions and their impact on SA.ResultsThe study comprised 2,833 children and adolescents (mean age = 15.1 years (SD 1.6); M: F sex-ratio = 1:5.4). A significant increase in SA was found either 6 or 10 months after the beginning of the pandemic, varying by country. Patients were more likely to be girls (aOR = 1.77 [1.34; 2.34]) and used SA methods “other than self-poisoning” (aOR = 1.34 [1.05; 1.7]). In the multivariate model, an association was found between SA and the contact tracing indicator with an 11 months delay, and the number of COVID-19 deaths with a 3-months delay.ConclusionsFindings confirmed a delayed increase in SA during the COVID-19 pandemic in children and adolescents as well as changes in patients’ profiles. The duration and severity of the pandemic emerged as the strongest predictor in the rise of SA. If faced with a similar pandemic in the future, the gap between the onset of pandemic and the increase in suicide attempts presents an opportunity for prevention.

Corporate narrative reporting on Industry 4.0 technologies: do the COVID-19 pandemic and governance structure matter?

PurposeThis research examines the impact of the COVID-19 pandemic and governance structure on corporate narrative reporting (CNR) concerning Industry 4.0 (I4.0) technologies in Jordanian commercial banks. The study aims to explore how these factors influence the extent and nature of disclosures in annual reports.Design/methodology/approachThe study uses a comprehensive manual content analysis method to investigate the annual reports from all 15 Jordanian commercial banks from 2010 to 2022. This approach allows for the detailed examination of I4.0 disclosures, using a specially developed index to measure various disclosure dimensions. An ordinary least squares model is used to assess the determinants of CNR on I4.0, considering factors such as the pandemic’s impact and various governance attributes.FindingsThe findings indicate that both the COVID-19 pandemic and specific governance factors (e.g. board size and audit committee size) significantly enhance the disclosure of I4.0 technologies. The study reveals that during the pandemic, banks significantly increased their level of detailed disclosures about I4.0 strategies, challenges and benefits, reflecting a strategic response to the pandemic’s disruption.Originality/valueThis study introduces a novel I4.0 Reporting Index for banks, measuring disclosures across strategy implementation, business model transformation, challenges and benefits. It adds to the existing literature by offering insights into narrative reporting practices concerning I4.0 technologies within the banking sector and illuminates the impact of the COVID-19 pandemic on these practices.

COVID-19 AND GOVERNMENT RESPONSES: HAS THE PANDEMIC AFFECTED THE KUALA LUMPUR COMPOSITE INDEX?

This study aims to determine the impact of the COVID-19 pandemic and government responses on the Malaysian stock market. Usingthe Kuala Lumpur Composite Index (KLCI) from 1st March 2020 to 31st December 2020, the study discovered several findings. First, thenumber of daily new COVID-19 cases affected the index. Nevertheless, the new cases turned out to be positive at a later stage. This finding inferred that investors grew apathetic towards COVID-19 over the long run. Second, daily new COVID-19 deaths negatively impacted the stock index. Third, the Movement Control Order (MCO) harmfully influenced the index. Fourth, the Recovery Movement Control Order RMCO and most government stimulus packages positively impacted the index. In conclusion, the government’s responses to COVID-19 have managed to mitigate several negative impacts of the pandemic on the stock market. The stimulus packages provided the much-needed impetus for market recovery during the pandemic.

Appraisal of policy measures at the beginning of a pandemic: Empirical evidence from the first four months and 12 months of the COVID-19 pandemic

PurposeThe rapid spread of the COVID-19 pandemic upended societies across the world, with billions forced into lockdowns. As countries contemplated instating and rolling back lockdown measures, and considered the impact of pandemic fatigue on policy measures, and furthermore to prepare for the improved management of future pandemics, this study examines the effectiveness of policy measures in limiting the spread of infections and fatalities.Design/methodology/approachThe methodological approach in the study centres on a fixed effects panel regression analysis and employs the COVID-19 Government Response Stringency Index, which comprises eight containment measures and three health campaigns, with progressive degrees of stringency, in order to investigate the efficacy of government policies.FindingsFindings suggest that some government policies were effective at reducing implicit mortality rates, infection cases and fatalities during the first four months of the COVID-19 pandemic. Solid stringency measures to reduce mortality rates include public gathering restrictions on more than 100 attendees, and international travel limits for developed countries and islands. Fatalities can further be reduced through the closing of public transport, whereas infection cases also experience benefits from public information campaigns. Comparable results are observed in a robustness test across 12 months.Originality/valueSome non-pharmaceutical policies are shown to be more effective than others at reducing the spread of infections, fatalities and mortality rates, and support policymakers to manage future pandemics more effectively.

The Impact of COVID-19 on Māori Patients Attending Diabetes Annual Review.

Māori, the indigenous population of New Zealand, represent 17.1% of the country's population (Statistics New Zealand 2021) and are over-represented in all negative indices. In particular, Māori are underprivileged in terms of socioeconomics and health due to the residualeffects of colonization. The global COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has been one of the most significant public health crises in modern history. Vulnerable populations, such as the elderly and those with underlying health conditions, wereand remainat higher risk of severe outcomes. In the New Zealand context and given the health statistics, Māori were identified as a group that was at high risk from COVID-19.Using a mixed method approach, we attempt to identify the reasons why a cohort of New Zealand Māori with type II diabetes mellitus (DM II) and a history of regular attendancefailed their Diabetes Annual Review (DAR) post-COVID-19. Twelve Māori participants were recruited (> 18 years) from a Māori Diabetes database of an urban General Practitioners (GP) Clinic in Northland. A 9-point questionnaire and an unstructured telephone conversation utilizing a Kaupapa Māori (Māori philosophy) approach were utilized, and data were collated. Findings suggest the New Zealand government's COVID-19 vaccine mandates served to exacerbate Māori distrust of health professionals. Trust is the foundation of every successful relationship whether it be business, professional, health, or personal. Health delivery and uptake are based on this foundation. Whatever the reason for the loss of trust in the medical profession, historical colonial trauma, swayed by conspiracy theory, or otherwise, considering this factor should influence the structure and approach of public health initiatives directed toward Indigenous people internationally.

Time series analysis of COVID-19 stringency measures on the spatio- temporal dynamics of air pollution

Introduction: Execution of COVID-19 lockdown measures caused variations in air pollution worldwide. This paper investigates the impact of COVID-19 stringency measures on the spatio-temporal dynamics of air pollution in Mumbai, India, using a comprehensive two-and-a-half-year pandemic period dataset. Materials and methods: We classified the pandemic period into 7 phases and 21 sub-phases based on the severity of the Oxford COVID-19 Government Response Tracker (OxCGRT) Stringency Index (SI). Optimized Hotspot analysis (OHS) and Ordinary Least Square Regression models explored the spatio-temporal fluctuations and the effect of stringency measures on air quality. Results: The R2 value varied; with the best model R2 of 0.61 for Particulate Matters (PM10) and Nitrogen dioxide (NO2) and lowest of 0.23 for Sulfur dioxide (SO2). A 10-point increase in SI caused a 3-7% reduction in air pollutants. Substantial reduction in average PM10, PM2.5, NO2, and Carbon monoxide (CO) was observed throughout the COVID-19 phases. Meteorology and SI collectively caused maximum reduction of 82.6%, 72.7%, 53.8%, 52.2%, 49.1%, 28.4% for NO2, PM2.5, PM10, NH3, CO, and SO2 respectively, during complete or extreme lockdown phases. Except SO2, seasonality significantly influenced the pollutant concentrations. Winter was the worst period while monsoon was the best. OHS identified central Mumbai wards as hotspots and areas close to the national park as coldspots. Conclusion: PM10, NO2 and CO were more affected by SI measures than NH3 and SO2. For a rapid emergency response to high PM10, implementation of SI, very high (≥ 80 score) and above is advised. Findings of this study have significant public health policy implications, especially among global south nations.

Epidemic outcomes following government responses to COVID-19: Insights from nearly 100,000 models.

Government responses to COVID-19 are among the most globally impactful events of the 21st century. The extent to which responses-such as school closures-were associated with changes in COVID-19 outcomes remains unsettled. Multiverse analyses offer a systematic approach to testing a large range of models. We used daily data on 16 government responses in 181 countries in 2020-2021, and 4 outcomes-cases, infections, COVID-19 deaths, and all-cause excess deaths-to construct 99,736 analytic models. Among those, 42% suggest outcomes improved following more stringent responses ("helpful"). No subanalysis (e.g. limited to cases as outcome) demonstrated a preponderance of helpful or unhelpful associations. Among the 14 associations with P values < 1 × 10-30, 5 were helpful and 9 unhelpful. In summary, we find no patterns in the overall set of models that suggests a clear relationship between COVID-19 government responses and outcomes. Strong claims about government responses' impacts on COVID-19 may lack empirical support.

Beyond ‘Infodemic’: Complexity, Knowledge and Populism in COVID-19 Crisis Governance

ABSTRACT The concept of the ‘infodemic’ has become a popular explanation for the rejection of anti-COVID-19 crisis governance measures. In this paper, we argue that infodemic is an inherent property of society under free institutions misused to pursue an epistemically vicious political epistemology. Furthermore, we provide an alternative account of political epistemology of COVID-19 governance and popular resistance to it. Namely, we argue that 1) pandemics represent a complex problem, and some level of resistance to governance which restricts liberties while informed by ongoing scientific and political learning processes is inevitable, and 2) the resistance is exacerbated by the history of technocratization of governance and the exclusionary socio-economic inequalities which condition political and epistemic deficiencies easily exploitable by the political entrepreneurs of right-wing populism, particularly under the conditions of social media which gamifies public discourse. Thus, we argue, the correct response to the cultures of rejection of anti-COVID-19 measures is to change the underlying political and economic conditions and not to limit speech or restrict franchise as the infodemic diagnosis suggests.

COVID-19 governance and decision-making at provincial level in South Africa

COVID-19 governance and decision-making at provincial level in South Africa

An evaluation of the national testing response during the COVID-19 pandemic in England: a multistage mixed-methods study protocol

IntroductionIn 2020, the UK government established a large-scale testing programme to rapidly identify individuals in England who were infected with SARS-CoV-2 and had COVID-19. This comprised part of the UK...

THE CO-INTEGRATION AND CAUSALITY EFFECT BETWEEN GLOBAL COVID-19 PANDEMIC AND THE STOCK MARKET RETURN IN MALAYSIA: AN EXPLORATORY SEQUENTIAL MIXED METHODS APPROACH

The COVID-19 pandemic is one of the most unparalleled disasters the world has ever seen. Previously, the global community hasfaced the Middle East Respiratory Syndrome (MERS), Ebola Virus Disease (EVD), and Severe Acute Respiratory (SARS). However,the tremendous rate of infection created by the global COVID-19 pandemic is unmatchable with its rapid spread all over the world. Therefore, it is considered as a Black Swan event as created previously by the 2008 financial crisis, SARS, and 9/11 terrorist attack. All these events have triggered panic selling that affected the confidence of investors and businesses. Subsequently, stock market performance has affected the choice of investment decisions that translated into stock return. Therefore, this paper was undertaken to investigate the co-integration and causality relationship among global COVID-19 daily infected cases, COVID-19 recoveries rate, COVID-19 death rate, investor sentiment, government policy, foreign exchange rate, Malaysia gold price, and crude oil price towards the KLCI stock market return. This study employed an exploratory sequential mixed methods approach along with Johansen and Julius Co-Integration and Granger Causality in explaining the Malaysia stock market return. The empirical analysis concluded that COVID-19 daily cases, COVID-19 recoveries rate, government policy and foreign exchange have had a long-term effect in explaining the Malaysia stock return. On the other hand, all the study variables, except for government policy indicated a short-term effect on the Malaysia stock return. This study will contribute significantly to the body of finance literature on the impact of a disease outbreak, with highlights on the considerations of investors on the global COVID-19 pandemic in illuminating the variation of Malaysia stock market returns.