COVID-19 Response Research Articles

Political and Religious Impacts on COVID-19 Responses in Tanzanian Healthcare Facilities: A Qualitative Cross-Sectional Survey

Coronavirus disease (COVID-19), a virus-related illness that affects the respiratory system, first appeared in Wuhan province, China, in December 2019. By mid-January 2020, cases of COVID-19 were reported in numerous Asian countries, signaling the beginning of a global health crisis. Within a mere four months, the virus had spread to all continents. A qualitative cross-sectional survey was conducted from 24 August to 3 October 2022 among healthcare workers in the Dar es Salaam, Arusha, Dodoma, and Mwanza regions. A total of 96 participants were involved from 24 healthcare facilities in all four regions. Individual interviews and key informant interviews were recorded using the Kobo Toolbox and analyzed thematically. The study revealed that many participants felt that politics misled society rather than educating. The way healthcare workers in Tanzania expressed their views on the impacts of politics in fighting the outbreak of COVID-19 was found to threaten the safety of healthcare workers and general public health. A significant number of healthcare workers also expressed that religion hurt the fight against COVID-19 in their facilities and the general society. However, A few health workers believed that religion had a positive influence, while others felt that it had advantages and disadvantages depending on its application. In Tanzania, politics and religion misled the community to a large extent rather than educating it. Clean politics and good religious practices should be used when fighting pandemics such as COVID-19.

Higher frequency of interstate over international transmission chains of SARS-CoV-2 virus at the Rio Grande do Sul - Brazil state borders.

Brazil's COVID-19 response has faced challenges due to the continuous emergence of variants of concern (VOCs), emphasizing the need for ongoing genomic surveillance and retrospective analyses of past epidemic waves to reassess and fine tune containment protocols. Rio Grande do Sul (RS), Brazil's southernmost state, has international borders and trades with Argentina and Uruguay, along with significant domestic connections within Brazil. The identification of source and sink transmission chains at national and international scales can identify main hubs and pathways to target future interventions. In this study we investigated the RS state role in the national and international SARS-CoV-2 transmission chains, which has not been fully explored. Nasopharyngeal samples from various municipalities in RS were collected between June 2020 and July 2022. SARS-CoV-2 whole genome amplification and sequencing were performed using high-throughput Illumina sequencing. Bioinformatics analysis encompassed the development of scripts and tools to perform subsampling taking into account epidemiological information to reduce sequencing disparities bias among the regions/countries, genome assembly, and large-scale alignment and phylogenetic reconstruction. We sequenced a total of 1,480 SARS-CoV-2 genomes from RS, covering all major regions. Sequences predominantly represented Gamma (April-June 2021) and Omicron (January-July 2022) lineages. Phylogenetic analysis revealed a regional pattern for transmission dynamics, particularly with Southeast Brazil for Gamma, and a range of inter-regional connections for Delta and Omicron within the country. On the other hand, international and cross-border transmission with Argentina and Uruguay was rather limited. We evaluated the three VOCs circulation over two years in RS using a new subsampling strategy based on the number of cases in each state during the circulation of each VOC. In summary, the retrospective analysis of genomic surveillance data demonstrated that virus transmission was less intense between country borders than within the country. These findings suggest that while non-pharmacological interventions were effective to mitigate transmission across international RS land borders, while they were insufficient to contain transmission at the domestic level.

Evaluation of a strategic academic-government partnership to advance COVID-19 clinical practice guidelines access and uptake in South Africa

IntroductionAcademic–government partnerships are important to advance timely, responsive and relevant evidence for decision-making (policy, guideline, law and regulation) deliberations. Deliberate and strategic integrated knowledge translation (KT) approaches within such partnerships...

The complexity of addressing equity in COVID-19-related global health governance and population health research priorities in Canada: a multilevel qualitative study

BackgroundSince COVID-19 emerged in 2020, the promotion of health equity, including in research, has further been challenged worldwide by both global health governance (GHG) processes and decisions, and national public health control measures. These global and national decisions have also led to the ‘covidization’ of health research agendas where resources have been massively channelled to address COVID-19, especially during the first years of the pandemic. This situation could potentially result in current and future population health research priorities not explicitly tackling equity as a central tenet. The study objective examined how and to what extent the COVID-19-related GHG architecture is affecting population health research priorities in Canada.MethodsWe conducted a multilevel qualitative study informed by the intersectionality-based policy analysis and multiple streams frameworks. We collected and thematically analysed data from four groups of respondents (n = 35: researchers, research funders and global and public health research institutes in Canada, and WHO/international actors) and an interactive feedback workshop (n = 40 participants).ResultsStudy findings generated four main themes. First, both global and national COVID-19 responses failed to address equity considerations, especially among populations in situations of vulnerability and marginalisation. Second, the integrated examination of funding, equity, and accountability was judged as necessary determinants of GHG and population health research priorities in Canada. Third, contrary to common beliefs about COVID-19, the consequences were not all negative, but they were also positive and unintended, and lessons can be learned. Fourth, study respondents proposed multiple recommendations to address inequities in the complex intersection between COVID-19-related GHG and population health research in Canada.ConclusionThis study provides substantial evidence of the multilayered and complex intersection between COVID-19-related GHG and population health research priorities in Canada. Although the window of opportunity was slim according to study respondents, there was still a unique collective effort to address COVID-19-related socioeconomic and health inequities by considering the numerous recommendations proposed by the four groups of study respondents. These recommendations can directly contribute to improving knowledge of global and national population health and equity research strategies in the context of an evolving pandemic and for policy- and decision-makers to adjust and rectify the course of global and public health governance.

Preparing for the next pandemic: Reflections and recommendations from Florida.

The COVID-19 emergency warrants reflection on how to improve future infectious disease pandemic preparedness and response (PPR). U.S. States took diverse approaches to COVID-19, with Florida's approach characterized by fewer restrictions on businesses and individuals. Despite the profound effects of the pandemic, there is a dearth of stakeholder-informed recommendations for PPR at the state level. This study aims to empirically examine stakeholder perspectives on PPR in Florida. 25 semi-structured interviews were conducted with former and current leaders from government, academia, and the private sector in Florida. Participants were asked about challenges encountered during COVID-19 and considerations for what should be done for future pandemics. Interview transcripts and notes were analyzed using qualitative content analysis (QCA). Results were organized into four main categories (recommendations for future actions, challenges in PPR, successes and failures during the COVID-19 response), across which six sub-categories were identified: public health systems capacities; mitigation of disease transmission; roles and relationships; messaging and information dissemination; minimizing other adverse effects of a pandemic; and public health culture. Considering the neglect of existing pandemic plans and jurisdictional tensions around decision-making during COVID-19, participants proposed implementing a pandemic playbook that delineates the responsibilities of relevant agencies and processes of waiving standard procedures. While many suggested closures and restrictions to avoid the spread of disease, others questioned the extent to which such strategies should be implemented. This study corresponds with the need for consensus-building across ideological divisions, revealing tensions among federal, state, and county-level entities, as well as across state-level agencies. Participants defined successful pandemic response as not only comprising the mitigation of disease transmission, but also the minimization of adverse social and economic effects. Participants discussed strategies for a unified, well-coordinated approach to future pandemics that balances health and economic concerns.

Structural Supports and Challenges for Community Health Worker Models: Lessons from the COVID-19 Response in Orange County, California

Structural Supports and Challenges for Community Health Worker Models: Lessons from the COVID-19 Response in Orange County, California

Experiences of COVID-19 Pandemic: Insights for Better Preparation and Action

This is an introduction to a special issue on ‘Experiences of COVID-19 Pandemic: Insights for Better Preparation and Action’. First, it summarises the main recommendations of the Australian Government’s COVID-19 Response Inquiry Report and then introduces six articles from five countries. The analysis presented in these articles has implications for managing some aspects of future pandemics.

"China’s Holistic Approaches to Security: A Text-Mining Analysis of Shifting Priorities in COVID-19 Responses"

"China’s Holistic Approaches to Security: A Text-Mining Analysis of Shifting Priorities in COVID-19 Responses"

Low-connectivity Educational Technology: A Case Study of Supporting Learning during Covid-19 via SMS with ‘Keep Kenya Learning’

The use of Short Messaging Service (SMS) for education has grown in recent years, drawing particular attention to supporting school-level learners, due to the Covid-19 pandemic. This renewed interest has prompted questions about how this form of educational technology could be used in the longer term. However, despite being used in many Covid-19 responses, there are few documented examples of innovative applications in this field during the pandemic, which represents a gap in the literature. As a medium for education, SMS offers potential benefits such as being cost-effective and having positive impacts on learning. In this paper, we present a case study of an educational programme rapidly implemented during the pandemic as part of the ‘Keep Kenya Learning’ program, to support learners remotely in terms of literacy, numeracy, and social and emotional learning topics. Through the case study, we describe the innovative process used to rapidly develop content for SMS, and draw upon usage statistics, quiz scores and user feedback to gain insights into its implementation with learners and caregivers in Kenya. The case study demonstrated that educational television content can be effectively adapted to mobile delivery. Furthermore, we present practical reflections on the development and implementation of SMS educational technology which will help inform future initiatives. These include considering timing in relation to school terms when planning a supporting intervention, and designing content in a modular way to allow flexibility for learners in navigating through courses.

Future-Proofing Dentistry: A Qualitative Exploration of COVID-19 Responses in UK Dental Schools.

The COVID-19 pandemic had extensive influence on dental education. UK dental schools were compelled to respond with substantial adaptations to clinical training approaches and environments to mitigate educational impact. The Surveying Pandemic Education Response in Higher Education Dental Schools (SPEARHEAD) study aimed to retrospectively evaluate the diverse responses of UK dental schools to the COVID-19 pandemic. All UK dental schools were invited to participate in semi-structured interviews to ascertain institutional responses, with transcripts subjected to thematic framework analysis. Ten UK dental schools contributed to the study and three main themes were identified: student education, environment, and procedures and equipment. The most common approach to student education was the reduction of student numbers in clinical areas; however, this increased supervisory demands. While there was widespread acknowledgement of the need for enhanced ventilation, implementing the necessary modifications was frequently constrained by building configurations and financial implications. Numerous procedural adjustments were implemented, accompanied by widespread adoption of enhanced personal protective equipment. Fallow periods were common, although differing durations underscored the need for data-driven guidance. Many schools transitioned towards electric speed-controlled handpieces, but the need to reflect real-world scenarios often led to a reversion to air turbines. UK dental schools showed initiative, resilience, and ingenuity in safeguarding students from enduring irretrievable educational setbacks amidst the challenges posed by the COVID-19 pandemic. Validating a data-driven strategy for addressing future threats would facilitate a unified response, minimising the educational repercussions and bolstering the resilience of dental training.

SARS-CoV-2 testing, test positivity and vaccination in social housing residents compared with the general population: a retrospective population-based cohort study

BackgroundThe consideration of unique social housing needs has largely been absent from the COVID-19 response, particularly in tailoring strategies to improve access to testing and vaccine uptake among vulnerable and...

Embracing Controversy: A Second Look at CDC Reform Efforts in the Wake of COVID-19.

Addressing criticism that the agency's Covid-19 response was lacking, the US Centers for Disease Control and Prevention (CDC) has proposed internal agency reforms intended to improve its performance during the next pandemic. They are aimed at improving surveillance and analytic capacity and agency communications. This essay, via a counterfactual analysis of the CDC's proposed reforms, asks how, if completed in advance of Covid-19, they might have changed outcomes in four cases of guidance controversy during the pandemic. CDC planned reforms, though they have merit, are predicated on the ability to come to "scientific closure" in a highly charged political environment. To improve outcomes in a future pandemic, the agency should consider how it plans to communicate with the public when recovering from error and when addressing controversy spurred by criticism from credible experts. However, the ability of future presidents to limit CDC performance and communications in the next pandemic and the lack of political consensus around the value of independent public health expertise threaten the agency's reform goals.

Modeling and testing strategic interdependence and tipping in public policy implementation

We develop a game-theoretic model of strategic interdependence and tipping in public policy choices and show that the model can be estimated by probit and logit estimators. We test its validity and applicability by using daily data on state-level COVID-19 responses in the United States. Social distancing via shelter-in-place (SIP) strategies and wearing masks emerged as the most effective nonpharmaceutical ways of combatting COVID-19. In the United States, choices about these policies are made by individual states. We develop a game-theoretic model of such choices and test it econometrically, confirming strong interdependence in the implementation of these policies. If enough states engage in social distancing or mask wearing, others will be tipped to follow suit. Policy choices are influenced mainly by the choices of other states, especially those of similar political orientation and to a lesser degree by the number of new COVID-19 cases. The choice of mask-wearing policies is more sensitive to peer choices than the choice of SIP policies, and Republican states are much less likely than Democratic to introduce mask-wearing policies. The choices of policies are influenced more by political than public health considerations. These findings emphasize strategic interdependence in policy choice and offer an analytical framework for these complex dynamics.

Integrating an Ethics Advisory Committee Into Public Health Response: A Case Study of COVID-19, Infection Prevention and Control, and Essential Work in the United States.

A lack of infection prevention and control protections for essential industries in the United States led to increased risk and incidence of COVID-19 among essential workers during the COVID-19 pandemic. When the nation deems an industry essential during a disease outbreak, an ethical obligation exists to safeguard the health of workers who are at increased risk of being exposed to disease. The Global Center for Health Security at the University of Nebraska Medical Center began work to rapidly develop and disseminate infection prevention and control guidance for essential industries, such as meat processing. The Global Center for Health Security established an ethics advisory committee to support COVID-19 response efforts. The ethics advisory committee supported the development of guidance on infection prevention and control to promote justice, reciprocity, health, safety, and equity for workers in the meat processing industry. Our experience highlighted the fundamental role of ethical analysis in public health response efforts, but ethical analysis in this case required an interdisciplinary approach, including the need for effective community-relevant solutions. The integration of an ethics committee into public health emergency response efforts can address ethical concerns for workers in industries that must remain operational during public health emergencies.

COVID-19 and Market Response: Evidence From Listed Firms in Tanzania and Kenya

This study investigates the effects of COVID-19 on the financial performance of listed firms in the financial and consumer goods industries in Tanzania and Kenya. The choice of Tanzania and Kenya as focal points is motivated by their contrasting responses to the pandemic and their roles as economic powerhouses in the region. Using data from the Dar es Salaam Stock Exchange and Nairobi Stock Exchange spanning the period from 2015 to 2022, the study employs the Dynamic panel-data model, the two-step system GMM, to quantify the impact of the pandemic. The research has two specific objectives: to analyze the effect of COVID-19 on the financial performance of listed firms in the financial industry and to assess its impact on the consumer goods industry in both countries. Key findings reveal that in the financial sector, firms showed resilience with a positive impact on profitability during the pandemic, driven by the adoption of digital financial services and effective risk management. In contrast, the consumer goods sector experienced a significant negative impact, highlighting severe disruptions in supply chains and consumer demand. Notably, firms in Tanzania outperformed those in Kenya, due to less restrictive COVID-19 measures. These findings suggest policymakers should support digital innovations, prudent leveraging, and economic growth to sustain and improve firm profitability during future disruptions.

An Examination of Moderna

Understanding the COVID-19 response for Moderna, a biotechnology company based out of the United States, and compiling the current outlooks regarding vaccinations, development of a diversified product line, and garnering a competitive edge in the biotechnology space is a costly endeavor Moderna is attempting to transverse. Declining revenues, rising costs, and low sales of Moderna's current product have deteriorated the value base. The recent increase in share price is motivated by anticipation of a potential avian flu outbreak and response. This study attempts to shed light on the current financial condition of Moderna.

State Capacity and COVID-19 Responses: Comparing the US States

Abstract This article addresses the interstate differences in outcomes from the coronavirus disease COVID-19 pandemic by focusing on state capacity. State capacity refers to states’ ability to create and implement policy. We posit that states want to limit death and destruction within their borders. COVID-19 created an instance in which states had a shared, preferred outcome but had very different levels of success. Using a novel measure of state capacity that allows for subnational comparisons – and is independent of ideological political will – we show that states with greater capacity experienced fewer excess deaths during 2020 and more successfully distributed vaccines in early 2021. The findings are robust to various measures of partisanship, social capital, geography, and demographics. Our work bridges US state politics literature and comparative politics literature on state capacity, and it contributes to research on the politics of pandemics.

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

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

Motivation, Cues to Action, and Barriers to COVID-19 Vaccine Uptake: A Qualitative Application of the Health Belief Model among Women in Rural Zambia.

Vaccine hesitancy has played a major role in slowing the global COVID-19 response. Using cross-sectional, primarily qualitative data collected in four rural districts in Zambia, we aimed to explore community perceptions of COVID-19 disease and vaccines, including perceived motivators, cues to action, benefits, and barriers to vaccine uptake as guided by the Health Belief Model. In-depth interviews (IDIs) were conducted in late 2021 with women of reproductive age who were enrolled in an early childhood development study. Although two-thirds of the 106 respondents reported low perceived risk of catching COVID-19, they expressed concern that the COVID-19 pandemic had impacted their daily lives and feared effects of the disease. They had generally positive beliefs that the vaccine would be accepted among their communities when it became more widely available. Reported motivators to vaccine uptake included desire for protection against COVID-19 and understanding vaccine purpose, due to ongoing education from health personnel, neighbors, friends, radio, and church leaders. Misinformation or reported bad experiences served as cues away from vaccine uptake. Examples of misinformation included the vaccine causing COVID-19 or another disease and death and vaccines being associated with the devil and against Christian beliefs. Accounts of pain after receiving the vaccine also discouraged uptake. Perceived benefits included a desire to be protected from the disease, belief in the effectiveness of the vaccine, fear of catching COVID-19, and belief the vaccine would limit negative effects. Health system implementers and policy makers should consider recipient motivators and cues to action to further increase vaccination rates.

Navigating wicked problems: the unrecognised contribution of social pedagogy to Aotearoa New Zealand’s successful Covid-19 response

Aotearoa New Zealand’s government, alongside its Indigenous Māori and Pacific communities, spearheaded a unique and effective response to the first three years of the Covid-19 crisis that swept the world. The measures taken enabled the country to largely keep its society within its borders open and functional, minimise the impact of the pandemic on individual lives and community well-being and keep morbidity rates low. While there have been numerous studies and articles exploring this national response, to this point no examination has been undertaken through a social pedagogical lens. This article identifies key concepts from the discipline that are relevant to Aotearoa New Zealand’s context, discusses the ways in which these were (albeit unknowingly) applied during the peak of the pandemic and explores future potential for application in social and public health policy and practice. Weaving together a shared framework of Māori, Pacific and unique Aotearoa New Zealand world views and cultural practices alongside the principles of social pedagogy presents an exciting opportunity to shape a national crisis response that is effective and meets the needs of diverse communities. It is argued that making the contribution of social pedagogy visible has the potential to enhance responses to wicked problems in times of crisis and further the acceptance of the discipline in the southern hemisphere.