Government Response Research Articles

Lockdown and Unrest: Inequality, Restrictions and Protests During COVID-19

This paper analyses how pre-pandemic levels of inequality across US counties have shaped the impact of the COVID-19 pandemic on the incidence of protests. The results from difference-in-differences and instrumental variable models using high-frequency weekly data show that more stringent measures to contain the pandemic increased the incidence of protests, but only in US counties with high levels of inequality before the start of the pandemic where grievances may have been initially stronger. The impact of government responses to COVID-19 on protests is largely explained by adverse changes in economic conditions in counties with the highest levels of pre-pandemic inequality. Policy stringency measures were also associated with more protests in the most unequal counties which voted for the Republican party in the 2016 elections and exhibited, at the start of the pandemic, lower levels of trust in the president and lower satisfaction with democracy.

The Great Lockdown and Economic Voting: Estimating the Impact of the COVID-19 Recession on the 2020 US Presidential Election

The 2020 US presidential election was won by Democrat challenger Joseph Biden over Republican incumbent Donald Trump and was contested during the global Coronavirus Disease 2019 (COVID-19) pandemic. Unemployment increased sharply during the pandemic but was followed by a large federal relief package. We investigate whether there was economic voting in the 2020 election, that is, whether the increased unemployment rate and the subsequent government response during the pandemic affected Trump’s vote negatively or positively overall. We examine 48 states (by excluding Alaska, Hawaii, and DC). Using a triple-differences (DDD) model (that is, examining changes in a candidate’s county-level vote-share depending on the change in unemployment and historical Republican-Democrat partisanship), we predict what would have happened if the increase in unemployment rate in between March and October 2020 had been more modest. Although many states show significant negative expected impacts on the Trump vote, we predict that only when when the unemployment rates experience little change during the pandemic would overall results have swung in the incumbent’s favour – and only then in Arizona and Georgia.

Perpetrators as Victims? Inclusivity and Proximity in Post-Genocide Cambodia and Rwanda

ABSTRACT In post-genocide Cambodia and Rwanda, low-level perpetrators often identify as victims of the genocidal regimes alongside those they tortured and killed. However, state and societal responses to these claims appear to have varied dramatically. In Cambodia, the government and civil society organizations seem to view former Khmer Rouge cadres’ claims to victim status as socially acceptable and politically useful, while in Rwanda, the government and civil society organizations have firmly rejected perpetrators’ efforts to claim space as victims. What accounts for these different societal responses in Cambodia and Rwanda? At present, there is ample literature on how authoritarian government actors in both contexts have shaped their nation’s post-genocide transitional justice responses to prevent future bloodshed, while simultaneously reinforcing their regimes’ sometimes tenuous political legitimacy. However, this article offers complementary insights by exploring two otherwise under-researched factors that we argue further inform these polar-opposite reactions to perpetrators’ claims to victim status: (1). post-genocide governments’ offers of inclusivity in defining who is part of each nation’s ideal post-genocide ingroup; and (2). the social proximity of perpetrators and their victims during and after the genocides. Our focus on inclusivity and social proximity related to the Cambodian and Rwandan genocide advances scholarly understandings of the various factors that shape government and social responses to perpetration in the aftermath of genocide internationally.

Coordinating public and government responses to air pollution exposure: A multi-source data fusion approach

Aligning public demand with government supply of clean air aids in efficient air pollution control and enhancement of public happiness. However, comparative empirical analyses of public and government attention to air quality changes are still sparse due to data and methodological constraints. Here, we adopt multi-source data fusion approaches to assess the impacts of air pollution exposure on public and government attention. Specifically, remote and social sensing data, alongside keywords extracted from textual data, are utilized to quantify air pollution exposure and corresponding public and government attention levels in 273 Chinese cities from 2011 to 2019, and a two-stage least squares regression model is employed to tackle reverse causality issues underlying the exposure-response relationship. Our findings reveal that, on average, a unit increase in PM2.5 levels would result in a 17.7% growth in public attention and a 12.7% rise in government attention, respectively, suggesting that demand-driven public attention tends to be more sensitive to air quality changes than policy-driven government attention. Results for the spatial-temporal heterogeneity further demonstrate that public attention varies across time and space, whereas government attention remains relatively consistent. Additionally, we have identified 116 cities exhibiting disparities between the public and government responses to air quality changes, calling for environmental policy refinements to better serve the needs of residents. This study emphasizes the necessity of public engagement in environmental governance and offers rich policy implications for air pollution control in China.

Supporting young people through the COVID-19 pandemic and beyond: a multi-site qualitative longitudinal study

BackgroundThroughout the COVID-19 pandemic, youth have experienced substantial stress due to abrupt changes in education, finances, and social life, compounding pre-existing stressors. With youth (ages 15–26) often at critical points in development, they are vulnerable to long-term mental health challenges brought on by pandemic trauma.MethodsTo identify youth experiences throughout the pandemic and examine changes over time, we conducted semi-structured interviews among n = 141 youth in two Canadian provinces (Ontario and British Columbia) and across the country of Ireland at three time points over the course of more than one year (August 2020-October 2021). We conducted a qualitative longitudinal analysis using an inductive content approach.ResultsCategories identified were (1) coping with hardship; (2) opportunities for growth; (3) adapting to new ways of accessing services; (4) mixed views on the pandemic: attitudes, behaviour, and perception of policy response; (5) navigating COVID-19 information; (6) transitioning to life after the pandemic; and (7) youth-led recommendations for government and service response. The findings also reveal trends in health and wellness in accordance with prolonged periods of lockdown, changes in weather, and return to normalcy after the availability of COVID-19 vaccines. Key recommendations from youth include incorporating youth voice into decision making, communicating public health information effectively to youth, enhancing service delivery post-pandemic, and planning for future pandemics.ConclusionsThese results provide insights into the extensive longitudinal impacts of the COVID-19 pandemic on young people across three geographical locations. Actively involving youth in decision making roles for future pandemics or public health emergencies is critical.

Challenges of Collaborative Government Response to the COVID-19 Pandemic: A Study of Factors and Cases in the United States

This study examines challenges of collaborative government response to the COVID-19 pandemic in the United States. The study provides a review of theoretical issues about collaboration in disaster management and public health to identify influential factors, such as governance structure, effective leadership, public communication, and political polarization, to the collaboration. Based on the document analysis method, the study examines practical cases, academic studies and public opinion data that are related to these challenging factors. The study concludes with discussions about lessons of the COVID pandemic challenge and suggestions for future studies of collaborative governance response to public crises.

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.

Climate emotions, thoughts, and plans among US adolescents and young adults: a cross-sectional descriptive survey and analysis by political party identification and self-reported exposure to severe weather events.

Climate change has adverse effects on youth mental health and wellbeing, but limited large-scale data exist globally or in the USA. Understanding the patterns and consequences of climate-related distress among US youth can inform necessary responses at the individual, community, and policy level. A cross-sectional descriptive online survey was done of US youth aged 16-25 years from all 50 states and Washington, DC, between July 20 and Nov 7, 2023, via the Cint digital survey marketplace. The survey assessed: climate-related emotions and thoughts, including indicators of mental health; relational aspects of climate-related emotions; beliefs about who or what has responsibility for causing and responding to climate change; desired and planned actions in response to climate change; and emotions and thoughts about the US Government response to climate change. Respondents were asked whether they had been affected by various severe weather events linked to climate change and for their political party identification. Sample percentages were weighted according to 2022 US census age, sex, and race estimates. To test the effects of political party identification and self-reported exposure to severe weather events on climate-related thoughts and beliefs we used linear and logistic regression models, which included terms for political party identification, the number of self-reported severe weather event types in respondents' area of residence in the past year, and demographic control variables. We evaluated survey responses from 15 793 individuals (weighted proportions: 80·5% aged 18-25 years and 19·5% aged 16-17 years; 48·8% female and 51·2% male). Overall, 85·0% of respondents endorsed being at least moderately worried, and 57·9% very or extremely worried, about climate change and its impacts on people and the planet. 42·8% indicated an impact of climate change on self-reported mental health, and 38·3% indicated that their feelings about climate change negatively affect their daily life. Respondents reported negative thoughts about the future due to climate change and actions planned in response, including being likely to vote for political candidates who support aggressive climate policy (72·8%). In regression models, self-reported exposure to more types of severe weather events was significantly associated with stronger endorsement of climate-related distress and desire and plans for action. Political party identification as Democrat or as Independent or Other (vs Republican) was also significantly associated with stronger endorsement of distress and desire and plans for action, although a majority of self-identified Republicans reported at least moderate distress. For all survey outcomes assessed in the models, the effect of experiencing more types of severe weather events did not significantly differ by political party identification. Climate change is causing widespread distress among US youth and affecting their beliefs and plans for the future. These effects may intensify, across the political spectrum, as exposure to climate-related severe weather events increases. Avaaz Foundation.

Unveiling public perceptions at the beginning of lockdown: an application of structural topic modeling and sentiment analysis in the UK and India

BackgroundThe appearance of the COVID-19 virus in December 2019, quickly escalated into a global crisis, prompting the World Health Organization to recommend regional lockdowns. While effective in curbing the virus’s spread, these measures have triggered intense debates on social media platforms, exposing widespread public anxiety and skepticism. The spread of fake news further fueled public unrest and negative emotions, potentially undermining the effectiveness of anti-COVID-19 policies. Exploring the narratives surrounding COVID-19 on social media immediately following the lockdown announcements presents an intriguing research avenue. The purpose of this study is to examine social media discourse to identify the topics discussed and, more importantly, to analyze differences in the focus and emotions expressed by the public in two countries (the UK and India). This is done with an analysis of a big corpus of tweets.MethodsThe datasets comprised of COVID-19-related tweets in English, published between March 29th and April 11th 2020 from residents in the UK and India. Methods employed in the analysis include identification of latent topics and themes, assessment of the popularity of tweets on topic distributions, examination of the overall sentiment, and investigation of sentiment in specific topics and themes.ResultsSafety measures, government responses and cooperative supports are common themes in the UK and India. Personal experiences and cooperations are top discussion for both countries. The impact on specific groups is given the least emphasis in the UK, whereas India places the least focus on discussions related to social media and news reports. Supports, discussion about the UK PM Boris Johnson and appreciation are strong topics among British popular tweets, whereas confirmed cases are discussed most among Indian popular tweets. Unpopular tweets in both countries pay the most attention to issues regarding lockdown. According to overall sentiment, positive attitudes are dominated in the UK whilst the sentiment is more neutral in India. Trust and anticipation are the most prevalent emotions in both countries. In particular, the British population felt positive about community support and volunteering, personal experiences, and government responses, while Indian people felt positive about cooperation, government responses, and coping strategies. Public health situations raise negative sentiment both in the UK and India.ConclusionsThe study emphasizes the role of cultural values in crisis communication and public health policy. Individualistic societies prioritize personal freedom, requiring a balance between individual liberty and public health measures. Collectivistic societies focus on community impact, suggesting policies that could utilize community networks for public health compliance. Social media shapes public discourse during pandemics, with popular and unpopular tweets reflecting and reshaping discussions. The presence of fake news may distort topics of high public interest, necessitating authenticity confirmation by official bloggers. Understanding public concerns and popular content on social media can help authorities tailor crisis communication to improve public engagement and health measure compliance.

Preparing for pandemics needs a dose of public health and a booster of “complex thought” (Errare humanum est, perseverare diabolicum)

AbstractThe COVID‐19 pandemic has triggered unprecedented governmental responses worldwide, revealing weaknesses in health systems and public health policies due to lack of “complex thought” required to manage complex adaptive systems. Understanding COVID‐19 response strategies' multiple effects is particularly important now that pandemic preparedness and response (PPR) is on top of the global health political agenda. Here, we adopt a complex adaptive systems approach to critically analyze the literature and draw lessons from the COVID‐19 response to inform future PPR strategies. We observe that in many contexts, strategies implemented in response to COVID‐19 were poorly effective, inefficient, and inequitable. We explain the limitations of these prevailing measures and propose approaches and strategies to manage pandemics arising from a “systems thinking” perspective. PPR demands the adoption of an evolving, evidenced‐informed, and context‐specific strategy based on comprehensive approaches reflecting the complexities of health crises. This means moving away from single‐focused health security paradigms to consider the full range of health problems facing populations and adopting a package of interventions chosen via participatory and deliberative processes that are context‐specific and sensitive, as well as evidence‐driven, to ensure a fair balance between various pillars of pandemic responses: health promotion, non‐pharmaceutical interventions, prophylaxis, vaccines, and treatments.

The role of discretion and street‐level deliberative practices in the COVID‐19 crisis response: Lessons from the Philippines

AbstractThis study investigates the role of frontline workers, such as the Barangay Health Emergency Response Teams (BHERTs) in the Philippines, as street‐level bureaucrats (SLBs) in implementing COVID‐19 community quarantine policies. Drawing from SLB theory and deliberative policy analysis (DPA), I explore how SLBs adapted to rapidly changing conditions by exercising discretion in interpreting and adapting the implementation of nationally formulated pandemic management policies to meet local realities. I argue that SLBs functioned as deliberative practitioners, mediating between national policies and local realities while engaging in deliberative practices with their clients. Using the experience of BHERTs in Palompon, Leyte in the Philippines as an illustrative case, I identified the policy mandates (policy‐as‐written) of the BHERTs; the challenges and constraints they faced in implementing community quarantine policies; and the discretion they exercised in implementing community quarantine policies (policy‐as‐practiced). The findings reveal that, to meet their policy mandates and address the challenges they faced, they engaged in deliberative practices and collaborated with citizens in implementing context‐specific and creative strategies. Insights from this study highlight the adaptive and deliberative potential of SLBs in crisis situations and the value of a DPA in understanding SLB theory and research. By examining SLBs’ experiences during the pandemic, this study contributes to the SLB literature and offers practical lessons to policy practitioners in facilitating deliberation and developing context‐specific solutions in times of crisis.Points for practitioners The COVID‐19 pandemic and the subsequent government response in the Philippines have increased the challenges faced by street‐level bureaucrats (SLBs), including resource scarcity, organisational and political pressure, public resistance, and the risk of exposure to the virus. SLBs have shown their capacity to apply discretion and collaborate with their clients to resolve their own and the client's challenges and limitations through negotiation, mediation, conflict management, and active listening. This cooperative approach empowers them to resolve common issues and together formulate effective strategies that are beneficial to all parties involved. Relationships outside of SLBs’ duties as state agents (i.e. socio‐cultural relationships) can be a viable pathway for SLBs to implement alternative policy strategies to meet their policy mandates and address the challenges they face as they implement their mandates. Competing value systems, knowledge claims, and emotional narratives, compounded by a governance crisis, define the complex and informal nature of the policy process in the context of a crisis like the pandemic. Although SLBs demonstrate their capacity to creatively solve the challenges they encounter through deliberative practices, this should not serve as a justification for the government's lack of action in prioritising, safeguarding, and preserving their welfare.

Erratum for the Research Article: "Epidemic outcomes following government responses to COVID-19: Insights from nearly 100,000 models".

Erratum for the Research Article: "Epidemic outcomes following government responses to COVID-19: Insights from nearly 100,000 models".

Confucian culture, public education expenditure, and economic growth

Confucian culture has been found to have significant effects on economic outcomes, yet current studies seldom delve into its impact on regional economic growth in China and the role of government behavior as a mechanism. From the perspective of government response to public demands for education, this paper examines whether Confucian culture fosters economic growth by driving up public education expenditure. Using panel data at the prefecture-level over 2003–2018 and taking the historical population density of jinshi in the Ming and Qing Dynasties as the proxy of the Confucian culture, the empirical analysis is done mainly through pooled OLS and IV analysis. Results show that Confucian culture has a significant and positive effect on economic growth, which can be partially explained by its positive influence on public education expenditure. The channel still holds after controlling human capital in regression. Further discussion of the clan culture and local governors’ cultural backgrounds suggests that higher public education expenditure results from the local government’s passive response to public demands for education. Thus, local governments are suggested to widen and improve the channels for expressing public demands and increase public education expenditure while balancing public demands and the need to boost economic growth.

Anxieties about a Porous Border: Australian Government Responses to Melanesian ‘Boat People’

Starting in 1969, small groups of West Papuans have occasionally crossed the Torres Strait to Australia and sought its protection. In public discourse, these arrivals have figured as part of a narrative about Australia’s relationship with Indonesia. By contrast, in the public discourse about border control, which focuses on attempted travel across the Indian Ocean and distinct ‘waves’, they have been treated as a footnote, at most. In this article, we closely examine the Australian government’s response to West Papuan ‘boat people’ over time to demonstrate that, unlike in public discourse, border control considerations have loomed large in the government’s response. We argue that, in order to understand Australia’s approach to border control, we should see West Papuan asylum seekers in the context of border control policy and not only as a problem in Australia’s relationship with Indonesia.

Notice the comment? Chinese government responsiveness to public participation in the policymaking process

AbstractWe investigate government responsiveness in the notice and comment process, a prominent instrument of consultative authoritarianism through which policy is made in contemporary China. We conduct an extensive data collection effort, assembling draft policies, public comments, and government responses for more than one thousand instances of notice and comment policymaking over a 17‐year period. Our statistical analysis demonstrates both the promise and limitations of consultative authoritarianism in the context of the notice and comment process. Government responsiveness in salient policy areas and to lengthy and critical comments demonstrates that public scrutiny matters to policymakers. These patterns are consistent with the notion that autocrats seek to remain in power not only through repression but also by bolstering exchanges of information between state and society. Central government ministries, however, are relatively unresponsive, indicating that significant aspects of policymaking are not characterized by robust attention to public sentiment and information.

Impact of COVID-19 lockdown measures on mother and child health - the case of Ghana.

The lockdown measures in response to the coronavirus disease (COVID-19) have led to a wide range of unintended consequences for women and children. Until the outbreak of COVID-19, attention was on reducing maternal and infant mortality due to pregnancy and delivery complications. The aim of this study was to interrogate the impact of lockdown measures on women and children in two contrasting districts in Ghana - Krobo Odumase and Ayawaso West Wuogon. This study adopted the mixed-method approach using both qualitative and quantitative data. The qualitative study relied on two data collection methods to explore the impacts of COVID-19 control measures on women and children in Ghana. These were: Focus Group Discussions (FGDs; n = 12) and Key Informant Interviews (KIIs; n = 18). The study complemented the qualitative data with survey data - household surveys (n = 78) which were used to support the nutrition and school closure data; and policy data gathered from government websites consisting of government responses to COVID-19. The qualitative data was analysed using the thematic approach with codes generated apriori with the NVIVO software. The quantitative data used percentages and frequencies. Engagements with participants in the study revealed that the lockdown measures implemented in Ghana had consequences on child and maternal health, and the health care system as a whole. Our study revealed, for example, that there was a decrease in antenatal and postnatal attendance in hospitals. Childhood vaccinations also came to a halt. Obesity and malnutrition were found to be common among children depending on the location of our study participants (urban and rural areas respectively). Our study also revealed that TB, Malaria and HIV treatment seeking reduced due to the fear of going to health facilities since those ailments manifest similar symptoms as COVID 19. Government responded to COVID-19 using different strategies however the policy response resulted in both intended and unintended consequences especially for women and children in Ghana. It is recommended that national policy directions should ensure the continuous provision of child and maternal healthcare services which are essential health services during lockdowns.

A multifaceted analysis of decreasing trust in health institutions in the EU during the COVID-19 pandemic

BackgroundPublic trust is crucial during health crises, such as the COVID-19 pandemic, for the effective implementation of scientific and policy interventions. This study investigates factors contributing to the decline in trust in the health sector within the European Union during the pandemic.MethodsUsing the publicly available 2020–2022 Standard Eurobarometer dataset, we employed a "geography of trust" approach. We applied equal quantile mapping to visualise high and low trust countries and Local Spatial Autocorrelation (LISA) to identify statistically significant clusters. Using a series of one-way ANOVA, we found associations between socio-economic and other variables available in the same dataset with trust.ResultsTrust in health institutions and medical staff declined in 20 of 27 EU countries from 2020 to 2022. Clear geographical clusters of Western and Central Europe as the high-trust countries and Eastern Europe as the low-trust countries emerged through mapping. One-way ANOVA revealed that contrary to several studies, age, gender, and most demographics did not vary with trust, but trust was directly associated with the satisfaction with measures taken to fight the COVID-19 pandemic, and individual perceptions about their life and national affairs (p < 0.001).ConclusionHigh-trust Western European countries share characteristics in health systems, governance, and pandemic responses. Understanding this interplay could inform trust-building strategies. The persistent low trust in Eastern Europe may stem from slow government responses and requires nuanced approaches considering unique contexts. The decline in traditionally high-trust countries highlights challenges even in established social contexts. This study provides valuable insights for policymakers aiming to foster trust during health crises.

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.

Impact and Resilience of Mauritian SMEs: Sales Dynamics during the COVID-19 Pandemic

The COVID-19 pandemic has left an indelible mark on the global economy, significantly impacting small and medium-sized enterprises (SMEs) in Mauritius. This study investigates the sales dynamics of local SMEs during the COVID-19 pandemic. Through a quantitative survey, data was collected data on sales performance during the pandemic to gain comprehensive insights into the challenges faced and the adaptive strategies employed by these businesses. The findings underscore the challenges that the majority of participants encountered during the pandemic, with a notable decline in sales emerging as a central concern. The study reveals the diverse measures adopted by these enterprises to navigate the unprecedented economic turbulence. Notably, many turned to online sales channels, implemented cost-cutting measures, and adjusted their workforce. Furthermore, our research sheds light on the perceptions of government intervention among these businesses. A significant proportion expressed satisfaction with the government's response, believing in its effectiveness. This study offers valuable insights into the multifaceted impact of the COVID-19 pandemic on local SMEs in Mauritius and identifies the strategies adopted by these enterprises to adapt to the continually evolving economic landscape. These findings hold significance for policymakers, business proprietors, and other stakeholders as they craft and implement strategies to support and rejuvenate local businesses in the post-pandemic era.

Emotional Responses of Hospital Staff to the DASS-21 Survey During Mass COVID-19 Testing After the Relaxation of Prevention and Control Measures in Zhejiang, China, and Their Change Trajectory.

To investigate the emotional response of hospital staff to the Depression Anxiety Stress Scale-21 (DASS-21) over the COVID-19 pandemic and after the relaxation of prevention and control measures in Zhejiang Province, China, and identify influencing factors. Multicenter online cross-sectional design. From January 10, 2023, to January 20, 2023, 1054hospital employees in Zhejiang, China, were recruited using WeChat. Data was gathered via online, self-administered surveys. T-tests and one-way analyses of variance, Pearson's correlation analysis, and multiple linear stepwise regression analyses were used to examine the data. More than 90% of hospital employees were infected with COVID-19. Through regression analysis, the following variables were found to be independent predictors of emotional response to DASS-21: resilience (-13.346, P < 0.0001), sleep (14.689, P < 0.0001), friend support (-4.278, P < 0.0001), education level (2.699, P = 0.007), and marriage (-2.214, P = 0.027). The emotional responses were not as severe as predicted, but they were still well above the Chinese norm. A longitudinal comparison of DASS-21 emotional responses with similar studies showed a parabolic downward trend over time. Our results identified education level, marriage, friend support, resilience, and sleep as independent predictors of emotional responses to the DASS-21 among hospital workers in this outbreak. Improving the mental resilience and sleep status of staff is a key target. Unmarried medical personnel with higher education should be given greater attention and support by management. In addition, there is still room for further improvement in the government and societal responses to similar outbreaks. The study also found a parabolic downward trend in DASS-21 emotional responses among hospital workers during the COVID-19 outbreak over time.