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Informed by the social ecological model, which asserts that health behaviors and beliefs are the result of multiple levels of influence, we examined factors related to parents' support for in-school COVID-19 mitigation strategies. Using data from a survey of 567 parents/caregivers of public elementary and middle school students in eight Maryland counties, we employed regression models to examine relationships between parent-, child-, family-, school-, and community-level factors and acceptability of mitigation strategies. Acceptance of COVID-19 mitigation strategies was positively correlated with child- and family-level factors, including child racial identity (parents of Black children were more accepting than those of White children, odds ratio [ OR ]: 2.5, 95% confidence interval [CI] = [1.5, 4.1]), parent receipt of the COVID-19 vaccine (OR : 2.4, 95% CI = [1.5, 3.7]), and parent Democrat or Independent political affiliation (compared with Republican affiliation, OR : 4.2, 95% CI = [2.6, 6.7]; OR : 2.2, 95%CI = [1.3, 3.8], respectively). Acceptance was also positively associated with parents' perceptions of their school's mitigation approach, including higher school mitigation score, indicating more intensive mitigation policies (OR : 1.1, 95% CI = [1.0, 1.1]), better school communication about COVID-19 (OR : 1.7, 95% CI = [1.4, 1.9]) and better school capacity to address COVID-19 (OR : 1.9, 95% CI = [1.5, 2.4]). Community-level factors were not associated with acceptance. Child- and parent-level factors identified suggest potential groups for messaging regarding mitigation strategies. School-level factors may play an important role in parents' acceptance of in-school mitigation strategies. Schools' capacity to address public health threats may offer an underappreciated and modifiable setting for disseminating and reinforcing public health guidance. [ABSTRACT FROM AUTHOR]

Objective: A Phase II trial was conducted to determine if nasal disinfection with a commercial Good Manufacturing Practice‐manufactured 0.5% povidone‐iodine nasal spray (Nasodine®) may be a useful adjunct in the management of COVID‐19 by reducing viral shedding and prevention of transmission of SARS‐CoV‐2. The aim was to confirm the results from a human single‐dose pilot study by assessing repeated and frequent doses on nasal shedding of SARS‐CoV‐2 from adult subjects with confirmed COVID‐19. Methods: A multicenter, randomized, double‐blinded, placebo‐controlled Phase II clinical trial involving adults with early COVID‐19 symptoms. Baseline nasal swabs were collected to quantify pretreatment SARS‐CoV‐2 nasal viral load, followed by Nasodine treatment eight times daily over 3 calendar days. Daily nasal swabs were collected post‐dose to assess the impact of treatment on nasal viral load, measured by log10 TCID50 in quantitative culture. Results: Nasodine subjects exhibited significantly improved reduction in viral load (log10 TCID50) on Days 2–4 compared to placebo recipients (p = 0.028), rate of nasal clearance of viable virus (p = 0.032), and complete (100%) nasal and throat clearance of the virus by Day 5. No difference was seen in antigen shedding as measured by time transition from Rapid Antigen Test (RAT) positivity to RAT negativity. Conclusion: A total of 20 doses of Nasodine® nasal spray administered over 2.5 days significantly reduced the titers of viable SARS‐CoV‐2 virus in the nasal passages of COVID‐19 subjects. This is the first study demonstrating the efficacy of a tolerable intranasal formulation of povidone‐iodine on viral shedding in COVID‐19 subjects. Nasal disinfection may diminish viral transmission to others. Level of Evidence: 2 Laryngoscope, 134:3947–3952, 2024 [ABSTRACT FROM AUTHOR]

Background: As a measure to slow down the transmission of Coronavirus disease (COVID-19), governments around the world placed their countries under various stringent lockdown measures. Uganda is one of the countries that had a strict lockdown in Africa. This qualitative study explored the social and economic impacts of the COVID-19 lockdown in both an urban (Kampala) and rural (Wakiso) setting in Central Uganda. Methods: The study used focus group discussions (FGDs), household interviews, and key informant interviews (KIIs). 14 FGDs were conducted among several stakeholders including community health workers, health professionals, and members of the community. 40 household interviews were conducted among low, middle, and high-income households, while 31 KIIs were held among policy makers, non-governmental organisations, and the private sector. Data were analysed thematically in NVivo 2020 (QSR International). Results: Findings from the study are presented under six themes: family disruption; abuse of children's rights; disruption in education; food insecurity; impact on livelihoods; and violation of human rights. The study found that the COVID-19 lockdown led to family breakups, loss of family housing, as well as increased both caring responsibilities and gender-based violence especially towards females. Children's welfare suffered through increased child labour, sexual exploitation, and early marriages. The extended closure of schools led to delayed educational milestones, poor adaptation to home-based learning, and increased school drop-out rates. Increased food insecurity led to changes in feeding patterns and reduced food varieties. Livelihoods were negatively affected hence people depleted their savings and capital. Unlawful detention and beating by law enforcement officers increased during the lockdown. Conclusion: Future pandemic planning needs to consider the consequences of lockdown on the social and economic wellbeing of communities hence put in place appropriate mitigation measures during and after the outbreak. [ABSTRACT FROM AUTHOR]

While many studies have explored the impact of COVID-19 on healthcare workers, there is limited information on the experiences of social workers. This study aimed to examine how social service employees perceived the workplace's pandemic response to identify well-received initiatives and areas for improvement. Data was collected using an anonymous online 21-question survey on REDcap. The forty-participant sample identified as female (57.5%), Asian (85%), and aged 18–34 (55%). Participants worked remote (42.5%), hybrid (40%), or in-person (15%). The organization's pandemic response was perceived positively as effective (40%) or very effective (45%). Factors of pandemic response with the highest efficacy were provision of PPE (55%) and immediacy of efforts (50%). Remote workers had a significantly higher positive assessment of the organization's communication than hybrid or in-person employees (p = 0.0223). Safety was the primary concern among the entire workforce (88.2%). The most frequent source of COVID-19 information was the CDC (35%), and medical professionals (2.5%) were the least. This qualitative study's overall positive evaluation of the pandemic response provides insight into effective measures to prepare organizations for future public health emergencies. Future research investigating an organization's pandemic response can enhance employee well-being and advance quality improvement in pandemic response efforts. [ABSTRACT FROM AUTHOR]

Introduction: We sought to describe the demographic characteristics, clinical features, and outcomes of a cohort of patients who presented to our emergency departments with mpox (formerly known as monkeypox) infection between May 1–August 1, 2022.Case Series: We identified 145 patients tested for mpox, of whom 79 were positive. All positive cases were among cisgender men, and the majority (92%) were among men who have sex with men. A large number of patients (39%) were human immunodeficiency virus (HIV) positive. There was wide variation in emergency department (ED) length of stay (range 2–16 hours, median 4 hours) and test turnaround time (range 1–11 days, median 4 days). Most patients (95%) were discharged, although a substantial proportion (22%) had a return visit within 30 days, and 28% ultimately received tecrovirimat.Conclusion: Patients who presented to our ED with mpox had similar demographic characteristics and clinical features as those described in other clinical settings during the 2022 outbreak. While there were operational challenges to the evaluation and management of these patients, demonstrated by variable lengths of stay and frequent return visits, most were able to be discharged.

Abstract Background As a measure to slow down the transmission of Coronavirus disease (COVID-19), governments around the world placed their countries under various stringent lockdown measures. Uganda is one of the countries that had a strict lockdown in Africa. This qualitative study explored the social and economic impacts of the COVID-19 lockdown in both an urban (Kampala) and rural (Wakiso) setting in Central Uganda. Methods The study used focus group discussions (FGDs), household interviews, and key informant interviews (KIIs). 14 FGDs were conducted among several stakeholders including community health workers, health professionals, and members of the community. 40 household interviews were conducted among low, middle, and high-income households, while 31 KIIs were held among policy makers, non-governmental organisations, and the private sector. Data were analysed thematically in NVivo 2020 (QSR International). Results Findings from the study are presented under six themes: family disruption; abuse of children’s rights; disruption in education; food insecurity; impact on livelihoods; and violation of human rights. The study found that the COVID-19 lockdown led to family breakups, loss of family housing, as well as increased both caring responsibilities and gender-based violence especially towards females. Children’s welfare suffered through increased child labour, sexual exploitation, and early marriages. The extended closure of schools led to delayed educational milestones, poor adaptation to home-based learning, and increased school drop-out rates. Increased food insecurity led to changes in feeding patterns and reduced food varieties. Livelihoods were negatively affected hence people depleted their savings and capital. Unlawful detention and beating by law enforcement officers increased during the lockdown. Conclusion Future pandemic planning needs to consider the consequences of lockdown on the social and economic wellbeing of communities hence put in place appropriate mitigation measures during and after the outbreak.

The COVID-19 outbreak has impacted many daily activities and services we depend on. Due to changes in waste quantity and types, solid waste management (SWM) services such as waste collection, transportation, and treatment/disposal suffered. Global rules and mandates were issued to address these changes and the COVID-19 pandemic. This mini review examines seven countries and summarises the pandemic’s effects on municipal solid waste (MSW) and medical waste (MW) generation in terms of amount and composition, the SWM sector’s challenges, and government or other SWM guidelines and management measures. The data are analysed to provide suggestions for stakeholders on SWM worker protection, waste segregation, and recycling. This article identified that extending MW incineration, separating infectious waste at the source, and discontinuing recycling for infection control are the best ways to manage solid waste. The waste management system’s readiness was crucial to the pandemic response. Thus, countries like China, which has a robust SWM system, were able to contain the crisis and restrict danger, while others with weaker systems struggled. Additionally, the study highlights the importance of revising waste management policies and developing crisis response strategies that integrate flexible, innovative solutions to adapt quickly to changing waste demands and ensure public health and environmental protection during global health crises.

Abstract Background Over the past two decades, Canadian provinces and territories have introduced a series of primary care reforms in an attempt to improve access to and quality of primary care services, resulting in diverse organizational structures and practice models. We examine the impact of these reforms on family physicians’ (FPs) ability to adapt their roles during the COVID-19 pandemic, including the provision of routine primary care. Methods As part of a larger case study, we conducted semi-structured qualitative interviews with FPs in four Canadian regions: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario. During the interviews, participants were asked about their personal and practice characteristics, the pandemic-related roles they performed over different stages of the pandemic, the facilitators and barriers they experienced in performing these roles, and potential roles FPs could have filled. Interviews were transcribed and a thematic analysis approach was applied to identify recurring themes in the data. Results Sixty-eight FPs completed an interview across the four regions. Participants described five areas of primary care reform that impacted their ability to operate and provide care during the pandemic: funding models, electronic medical records (EMRs), integration with regional entities, interdisciplinary teams, and practice size. FPs in alternate funding models experienced fewer financial constraints than those in fee-for-service practices. EMR access enhanced FPs’ ability to deliver virtual care, integration with regional entities improved access to personal protective equipment and technological support, and team-based models facilitated the implementation of infection prevention and control protocols. Lastly, larger group practices had capacity to ensure adequate staffing and cover additional costs, allowing FPs more time to devote to patient care. Conclusions Recent primary care system reforms implemented in Canada enhanced FPs’ ability to adapt to the uncertain and evolving environment of providing primary care during the pandemic. Our study highlights the importance of ongoing primary care reforms to enhance pandemic preparedness and advocates for further expansion of these reforms.

The COVID-19 outbreak has impacted many daily activities and services we depend on. Due to changes in waste quantity and types, solid waste management (SWM) services such as waste collection, transportation, and treatment/disposal suffered. Global rules and mandates were issued to address these changes and the COVID-19 pandemic. This mini review examines seven countries and summarises the pandemic's effects on municipal solid waste (MSW) and medical waste (MW) generation in terms of amount and composition, the SWM sector's challenges, and government or other SWM guidelines and management measures. The data are analysed to provide suggestions for stakeholders on SWM worker protection, waste segregation, and recycling. This article identified that extending MW incineration, separating infectious waste at the source, and discontinuing recycling for infection control are the best ways to manage solid waste. The waste management system's readiness was crucial to the pandemic response. Thus, countries like China, which has a robust SWM system, were able to contain the crisis and restrict danger, while others with weaker systems struggled. Additionally, the study highlights the importance of revising waste management policies and developing crisis response strategies that integrate flexible, innovative solutions to adapt quickly to changing waste demands and ensure public health and environmental protection during global health crises. [ABSTRACT FROM AUTHOR]

In this paper, we critically analyse the response to the COVID-19 pandemic, highlighting not only the breadth of knowledge geographers have already contributed to this assessment, but also the surprisingly limited critique within geography, social sciences and the broadly defined 'Academic Left' of the authoritarian dimension of the public health policies of 2020 onwards. We conclude with a number of research questions for the aftermath of the pandemic, with the hope that they will help spur the growth of a new wave of anti-authoritarian Leftist geographical thinking that reaffirms the centrality of human rights and civil liberties to making the world a better place. [ABSTRACT FROM AUTHOR]

Background: Pakistan, with its diverse points of entry, faced several challenges with implementing the International Health Regulations (IHR) ethically during the COVID-19 pandemic. Aim: To explore the perceptions of point of entry health workers regarding the ethics challenges in implementing the IHR during the COVID-19 pandemic. Methods: From December 2022 to March 2023, this qualitative study conducted 10 focused group discussions and key informant interviews with 40 participants from 10 points of entry in Pakistan and reviewed COVID-19 containment guidelines. The data generated were transcribed, translated into English and analysed manually. The thematic analysis focused on the core ethics principles, including optimization of population health versus autonomy, distributive justice versus equity, trustworthiness versus privacy and confidentiality, and the impact of sanctions and restrictions on vulnerable populations. Results: The study identified ethics challenges relating to containment policies, public health measures (testing, quarantine and isolation), travel restrictions, equitable resource distribution, and emergency operations. These challenges were grouped under 3 main categories, according to the IHR thematic areas: prevent, detect and respond. Respondents said it was difficult to balance between the public health measures and individual rights, address discrimination and stigmatization, and ensure fairness and justice in vaccine distribution and travel restrictions. Conclusion: Navigating ethics challenges relating to IHR implementation during health emergencies requires transparent communication, cultural sensitivity, and a commitment to equity and justice. It is important to incorporate ethics considerations into national emergency response plans to guide decision-making, safeguard individual rights and promote collective wellbeing. [ABSTRACT FROM AUTHOR]

This study examines excess mortality patterns in 32 European countries during the first three years of the pandemic, offering insights into the pandemic’s toll on each country. Using data from national statistical offices, we calculated monthly excess mortality for 2020–2022. Time series decomposition was employed for trend analysis, followed by clustering countries based on their mortality trends. Then we compared total excess mortality among different clusters. We found that neighboring countries with similar characteristics experienced comparable levels of excess mortality, regardless of the differences in their pandemic trajectories identified by cluster analysis. Other factors, such as healthcare infrastructure and pre-existing health risks, appear to have had a more significant impact on total excess mortality, with various pre-existing regional factors playing significant roles in shaping the pandemic’s final toll. While the timing of peak excess mortality may have been a factor, it was not the primary driver of the overall toll. This study highlights the critical need for comprehensive public health strategies that focus on reinforcing healthcare infrastructure and mitigating pre-existing health risks, essential for effective pandemic preparedness and response. These findings suggest the need for reevaluating current approaches and exploring alternative strategies for managing future health emergencies. [ABSTRACT FROM AUTHOR]

The global COVID-19 pandemic had an unprecedented impact on transportation worldwide. Significant decreases in transportation across all modes were evident and sustained as governments worldwide implemented various countrywide closures and quarantine restrictions to slow the spread of the virus. This paper quantifies and assesses daily vehicle counts by Federal Highway Administration (FHWA) vehicle classifications during the COVID-19 pandemic in New York and Florida throughout 2020. The study found that duringMarch and April of 2020, traffic among all investigated FHWA categories was significantly reduced in both Florida and New York. However, commodity carriers in both states were able to recover faster and remained more consistent than passenger vehicles. This pattern was also observed in both urban and rural communities in Florida. The findings of this work demonstrate how commodity carrier movements, assessed through FHWA vehicle category counts, were less impacted by the governmental restrictions during the pandemic than passenger transportation. While overall traffic volume dropped by more than half in most places at the height of the pandemic, larger commodity-carrying vehicles remained nearly unchanged from the prior year by June of 2020. This was likely because of the critical need to maintain trucking movements to sustain populations. Understanding how truck traffic and freight movements more broadly were impacted during the COVID-19 pandemic is critical in preserving the continuity of service and preventing supply shortages in the event of future outbreaks. [ABSTRACT FROM AUTHOR]

Background and Objectives Adopting preventive behaviors is crucial to avoiding coronavirus disease 2019 (COVID-19) infection, and perceived anxiousness may influence such behaviors among older adults and their caregivers. This study investigated the relationships between perceived anxiousness about COVID-19 and preventive behaviors in older adult–caregiver dyads. Research Design and Methods A cross-sectional study was conducted using 1,565 older adult–caregiver dyads from the 2020 National Health and Aging Trend Study (NHATS)/National Study of Caregiving (NSOC) COVID-19 Supplements data. Actor–partner interdependence models were estimated to examine the associations between older adults' and family caregivers' perceived anxiousness about COVID-19 and their engagement in personal (e.g. wearing masks, washing hands) and social (e.g. avoiding contact with friends, limiting grocery shopping) preventive behaviors. Separate models were estimated based on older adults' dementia status. Results We found significant actor effects of anxiousness about COVID-19 on preventive behaviors of both older adults and caregivers in nondementia dyads. The anxiousness about COVID-19 of older adults had significant partner effects on both personal and social preventive behaviors of caregivers, whereas caregivers' anxiousness about COVID-19 only had a significant partner effect on social preventive behaviors of older adults. No significant partner effect was found in dementia dyads. Discussion and Implications Our findings highlight the critical role of caregivers in promoting older adults' health behaviors during the COVID-19 pandemic and maintaining mental well-being of older adults. The study also implies future efforts to explore the dyadic relationship of dementia care dyads in promoting health behaviors and mental health. [ABSTRACT FROM AUTHOR]

Background: Over the past two decades, Canadian provinces and territories have introduced a series of primary care reforms in an attempt to improve access to and quality of primary care services, resulting in diverse organizational structures and practice models. We examine the impact of these reforms on family physicians' (FPs) ability to adapt their roles during the COVID-19 pandemic, including the provision of routine primary care. Methods: As part of a larger case study, we conducted semi-structured qualitative interviews with FPs in four Canadian regions: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario. During the interviews, participants were asked about their personal and practice characteristics, the pandemic-related roles they performed over different stages of the pandemic, the facilitators and barriers they experienced in performing these roles, and potential roles FPs could have filled. Interviews were transcribed and a thematic analysis approach was applied to identify recurring themes in the data. Results: Sixty-eight FPs completed an interview across the four regions. Participants described five areas of primary care reform that impacted their ability to operate and provide care during the pandemic: funding models, electronic medical records (EMRs), integration with regional entities, interdisciplinary teams, and practice size. FPs in alternate funding models experienced fewer financial constraints than those in fee-for-service practices. EMR access enhanced FPs' ability to deliver virtual care, integration with regional entities improved access to personal protective equipment and technological support, and team-based models facilitated the implementation of infection prevention and control protocols. Lastly, larger group practices had capacity to ensure adequate staffing and cover additional costs, allowing FPs more time to devote to patient care. Conclusions: Recent primary care system reforms implemented in Canada enhanced FPs' ability to adapt to the uncertain and evolving environment of providing primary care during the pandemic. Our study highlights the importance of ongoing primary care reforms to enhance pandemic preparedness and advocates for further expansion of these reforms. [ABSTRACT FROM AUTHOR]

The novel coronavirus (COVID-19) pandemic has been a major global event. Countless restrictions and recommendations have revealed novel insights into the everyday lives of people, which are far from uniform across cultures. In this explorative study, the mood perception of people from "individualistic" (Finland) and "collectivistic" (Japan and South Korea) cultures were studied via self-administered questionnaires at the time of major social restrictions (spring–summer of 2020) when the sociocultural effect of the pandemic was at its strongest. A simple measure of "recent mood perception" forms the core of the analysis, against which various factors were analyzed. Such coarse measures fit well with cross-cultural research, for more specific experiences typically do not translate very well between cultures. Somewhat surprisingly, almost no "constant" measures (e.g., occupation, household structure) proved to be significantly correlated with recent mood, whereas the degree of "changes" in personal situation (time spent home, number of people met, and so on, before and after the outbreak) proved to be significant factors, highlighting contextuality and mindset. Further, difference between "individualistic" and "collectivistic" cultures was also observed. These results highlight the vital importance of not only observing consistent phenomena but also recognizing changes and understanding the unique perspectives and experiences individuals have of them. Depending on the context, an objectively same thing can evoke vastly different perceptions. [ABSTRACT FROM AUTHOR]

In the face of the unprecedented challenges posed by the COVID-19 pandemic, this article thoroughly explores the intricate landscape of COVID-related trauma and psychological distress experienced during lockdown enforcement, analyzing its origins and repercussions. By delving into individuals' experiences throughout the lockdown period, the study investigates how lockdown measures contributed to heightened trauma and psychological distress, particularly focusing on triggers such as illness fear, disrupted routines, and social isolation. The profound impact of isolation and restrictions on mental health and well-being is scrutinized, revealing disparities among various demographic groups in enduring COVID-related trauma. The article underscores adaptive coping mechanisms, like virtual connections and creative outlets, while emphasizing the crucial role of mental health support in mitigating trauma effects. It also elucidates the amplified trauma resulting from pandemic uncertainty and lockdowns, highlighting technology's role in alleviating distress. Cultural factors are examined, and the article concludes by offering recommendations for policymakers to integrate mental health services into crisis response plans, foster community resilience, and enhance public education on coping strategies to promote overall well-being during crises. [ABSTRACT FROM AUTHOR]

This study explores the impact of government subsidies on the production dynamics within the medical product supply chain, particularly focusing on the remanufacturing of medical goods. Amidst the backdrop of the COVID-19 pandemic, which has underscored the critical shortages in medical supplies, our research delves into the adoption of remanufacturing practices by medical product manufacturers as a strategic response to these shortages and environmental concerns. We investigate how government subsidies influence the production volumes of original manufacturers and remanufacturers and examine the competitive interplay between newly manufactured and remanufactured medical products. Through the development of three production game models—Scenario B (manufacturers produce both new and refurbished products), Scenario N (separate production of new and refurbished products by manufacturers and remanufacturers, respectively), and Scenario C (similar to Scenario N but includes a certification fee paid by remanufacturers to original manufacturers)—we analyze the strategies that could mitigate supply deficiencies during medical crises. Our findings indicate that the certification strategy (Scenario C) not only yields the highest total production of medical products but also offers a viable solution to enhance the sustainability of the entire medical production system by alleviating supply chain disruptions. Furthermore, we discuss the managerial implications of our results, emphasizing the potential of a joint remanufacturing strategy to stabilize the supply chain and foster environmental conservation. Lastly, we highlight our study's limitations and suggest future research directions, particularly concerning the variability in product quality and the reliance on government subsidies. This research contributes to a nuanced understanding of green remanufacturing within the pharmaceutical supply chain, offering insights for manufacturers, remanufacturers, and policymakers aiming for sustainable industry practices.

Monoclonal antibody therapeutics to treat coronavirus disease (COVID-19) have been authorized by the US Food and Drug Administration under Emergency Use Authorization (EUA). Many barriers exist when deploying a novel therapeutic during an ongoing pandemic, and it is critical to assess the needs of incorporating monoclonal antibody infusions into pandemic response activities. We examined the monoclonal antibody infusion site process during the COVID-19 pandemic and conducted a descriptive analysis using data from 3 sites at medical centers in the United States supported by the National Disaster Medical System. Monoclonal antibody implementation success factors included engagement with local medical providers, therapy batch preparation, placing the infusion center in proximity to emergency services, and creating procedures resilient to EUA changes. Infusion process challenges included confirming patient severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity, strained staff, scheduling, and pharmacy coordination. Infusion sites are effective when integrated into pre-existing pandemic response ecosystems and can be implemented with limited staff and physical resources.

Abstract The COVID-19 pandemic has revealed the contested politics of global health governance, though we still don’t know enough about the dynamics of domestic pandemic responses, or about the relationship between the politics of those responses and the politics of global health governance, both of which have changed significantly in recent decades. Focusing on three cases (HIV/AIDS, SARS, and COVID-19) of cross-border infectious diseases, this article explores the trajectory of China’s pandemic responses in the context of globalization. Attending to changing politics at domestic, international, and global levels, I argue that those responses have been a complex combination of China’s domestic politics (e.g., priorities, institutions, leadership, and timing), its international relations (especially with the US), and its engagements with global health governance. It is concluded that the increasing divergence of pandemic responses in a time of ubiquitous global health crisis demands urgent attention to the connections (including contestations) between domestic pandemic responses and the evolvement of global health governance from a broader perspective that considers changes in geopolitics.

This short commentary draws on academic and grey literature to critically evaluate the UK response to the COVID-19 pandemic, highlighting aspects in which the response fell short and their ramifications on public trust and compliance with preventive measures. Such aspects include the initial delay in response to the outbreak, the controversial “herd immunity approach,” the mismanagement of care home patients, the inadequacy of the contact tracing system, the scandals around the procurement of personal protective equipment, and the breach of lockdown/social distancing regulations by government officials. Based on the lessons learned from these shortcomings, this commentary seeks to provide suggestions for effective public governance in the face of future health emergencies.

bstract Crisis narratives have long been a prominent feature of the climate movement to spur system change. The COVID‐19 pandemic brought to the fore the complexities of navigating climate action through the overlapping crises of the Anthropocene. While crisis is seen to offer possibilities for transformational change, it also threatens to prioritise urgency over justice. It is therefore important to understand how climate activists, in practice, are mobilising different narratives of crisis. To this end, we empirically examine climate activists' reflections on crisis in Aotearoa New Zealand through their experiences of the COVID‐19 pandemic. We identify a narrative of ‘panic‐activism’ that uses crisis to demonstrate the severity of the climate threat to enable drastic action. Such narratives are often underpinned by a ‘hierarchy of crisis’ that positions climate change as the most imminent existential crisis. We caution that this crisis narrative is troubling for climate justice, particularly as it positions one crisis as more urgent than others. However, in contrast to panic‐activism, our study suggests climate activists in Aotearoa tended to approach crisis cautiously and with reluctant necessity, rather than as something to be actively catalysed or capitalised on. Instead, activists cultivated a narrative of ‘crisis solidarity’ that highlights the networks of reciprocity and vulnerability across and within communities for more intersectional social movement organising. [ABSTRACT FROM AUTHOR]

AbstractObjectiveParticipantsMethodsResultsConclusionsThis study at a US Native American-serving Nontribal Institution (NASNTI) deeply analyzed collegiate leadership’s responses and experiences during the first year of the COVID-19 pandemic.Elite interviews were conducted between April and June 2021 with the college president, provost, dean of student engagement, human resources director, and chief of police. Interviewees were purposively selected due to their positions of authority.Each one-hour interview used a semi-structured guide for standardization and was conducted either virtually or in-person while following COVID-19 protocols. The general inductive method was used to identify nodes and categories within the transcripts.Six nodes (conceptual domains) and 18 categories were identified. Though there was variability in interviewee emphasis, the respondents described the motivations, drivers, and sentiment behind their decision-making in a transparent way.NASNTI leadership reported being able to navigate the pandemic by emphasizing transparency and engaging students, while working alongside the community. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic was uniquely challenging for public health workers charged with enforcing recommendations. In the United States, media reports highlight frequent outbursts and threats from community members and elected officials regarding masking protocols, vaccine mandates, and other public health measures such as isolation/quarantining recommendations. Given this backdrop, the purpose of this study was to better understand the lived experiences of this critical workforce in the context of COVID-19. We conducted in-depth phone interviews with public health workers in Ohio (N = 11). Questions were designed to illicit workers' experiences and sense-making of the pandemic experience. We analyzed results using the techniques of interpretive phenomenological analysis. Five major themes focused on how workers experienced public perceptions of COVID-19 and the public health response. Three themes highlight the role of media and social media in polarizing public perceptions. These we note as: Dealing with Deadlock, Feeling Misunderstood and Misrepresented, and The Rollercoaster of Public Opinion. Getting on With the Work reveals strategies used to navigate public perceptions and misperceptions. This ranged from aggressive education and information sharing, to setting boundaries around the controversial or disputed aspects of the pandemic. Finally, After the Dust Settles comments on hopes for postpandemic transformations of public health and public perceptions thereof. These results can inform new pathways for public health. Paramount among these are effective strategies that address public knowledge, values, and worldviews. Such messaging must promote nuanced understanding and customized approaches for local realities, rather than relying on rigid dichotomies that further polarization and distrust. [ABSTRACT FROM AUTHOR]

To reduce transmission risk during the COVID-19 pandemic, 'telehealth' (health care delivered via telephone/video-conferencing) was implemented into Australian maternity services. Whilst some reports on telehealth implementation ensued, there was scant evidence on women and midwives' perspectives regarding telehealth use. A qualitative study was conducted in Australia during 2020–2021 using two data sources from the Birth in the Time of COVID-19 (BITTOC) study: i) interviews and ii) surveys (open-text responses). Content analysis was utilised to analyse the data and explore telehealth from the perspective of midwives and women accessing maternity care services. In-depth interviews were conducted with 20 women and 16 midwives. Survey responses were provided from 687 midwives and 2525 women who were pregnant or gave birth in 2021, generating 212 and 812 comments respectively. Telehealth delivery was variable nationally and undertaken primarily by telephone/videoconferencing. Perceived benefits included: reduced COVID-19 transmission risk, increased flexibility, convenience and cost efficiency. However, women described inadequate assessment, and negative impacts on communication and rapport development. Midwives had similar concerns and also reported technological challenges. During the COVID-19 pandemic, telehealth offered flexibility, convenience and cost efficiency whilst reducing COVID-19 transmission, yet benefits came at a cost. Telehealth may particularly suit women in rural and remote areas, however, it also has the potential to further reduce equitable, and appropriate care delivery for those at greatest risk of poor outcomes. Telehealth may play an adjunct role in post-pandemic maternity services, but is not a suitable replacement to traditional face-to-face maternity care. [ABSTRACT FROM AUTHOR]

Purpose: The COVID‐19 pandemic highlighted the importance of having emergency and acute care services close to home and emerged as an opportunity for hospital‐community engagement. This study examined whether rural residents' satisfaction with their local hospital's pandemic response was associated with improved community perception of the hospital and an intention to use it in the future. Methods: Data for the study were obtained from a survey of rural residents of 6 Georgia rural communities and analyzed using multivariable logistic regression and mediation analyses. Results: Rural residents' satisfaction with their local hospital's pandemic response was associated with an improved perception of the hospital. Improvement in the perception of rural hospitals following the pandemic was found to partially mediate a positive association between community residents' satisfaction with hospital pandemic response and the intention to use the hospital when needed. Conclusion: The COVID‐response efforts may have given rural hospitals an opportunity to influence public perception. [ABSTRACT FROM AUTHOR]

Munster Technological University (MTU) responded to the COVID-19 pandemic's educational challenges with the creation of the Reach Initiative. This initiative, a comprehensive academic mentoring and coaching programme, was developed at MTU in response to the unique challenges of the COVID-19 pandemic. Primarily targeting first and second year students, this initiative was designed to support their academic and non-academic needs during the transition to online Emergency Remote Teaching (ERT). The programme involved the recruitment and training of Academic Mentors (members of academic staff) from various disciplines who provided tailored individual support to the students. A key component of this study is a survey conducted to evaluate the initiative's impact. The survey aimed to understand students' challenges during the pandemic and assess the effectiveness of the Reach Initiative as a support mechanism. The findings revealed significant engagement with the programme, indicating its importance in providing both academic guidance and emotional support. Students reported benefiting from the initiative in various ways, including improved understanding of academic content, better access to university resources, and enhanced emotional well-being. The conclusion highlights the critical role of academic mentoring in supporting students during unprecedented times. It underscores the need for such initiatives in higher education, particularly during crises that disrupt traditional learning environments. The Reach Initiative not only facilitated academic success but also contributed positively to the students' overall university experience during the pandemic. [ABSTRACT FROM AUTHOR]

As the phenomenon of populism is in the preliminary stages of exploratory research, the present study involves an empirical investigation involving a case study of the United States, India, and Brazil to examine whether a correlation exists between populism and management of COVID‐19. The study adopts the ideational approach of populism as a set of ideas or discourse to review how core conceptual features of populism have impacted on management of COVID‐19. The study has two main objectives: (1) to examine whether populism in the United States, India, and Brazil has determined "a populist response" to the pandemic in dealing with the health crises and (2) to explore the management of COVID‐19 in the states led by right‐wing populism and the commonality of populist approaches adopted in handling the health crisis. Comparing the three states' statistical data of management models, the study has argued that common populist mechanisms such as distrust for experts, contempt for institutions, and suspicion of "others" have guided the US, India, and Brazilian leadership response to COVID‐19. It further argues that leadership in the United States, India, and Brazil has prevented effective management by politicizing the crisis, aggravating social polarization, and contradicting expert advice. Moreover, populist and nationalist orientation of the leadership has evaded responsibility in these states with the leadership blaming ethnicities for spreading the virus and by weakening societal solidarity. [ABSTRACT FROM AUTHOR]

Patient-reported experience measures (PREMs) provide assessments of patients' subjective experiences and perceptions regarding their interactions with the healthcare system and its services. We present a cross-sectional study of the patient perception and evolution of COVID-19 cases performed at Ovidius Clinical Hospital in Romania during the COVID-19 pandemic. The study objective is to explore the utility and the utilization of PREMs in monitoring patient perceptions of the supplementary protective actions. During the pandemic, the hospital implemented early supplementary protective actions, like PCR and lung CT, to all surgically admitted patients in the hospital alongside government-recommended actions. At the same time, functional PREMs were used to evaluate patient perceptions regarding these supplementary actions. The research was carried out for 19 months between June 2020 and December 2021. The findings revealed that opinions about the severity of the COVID-19 pandemic, the personal risk of infection, and the perception of protective actions in the hospital were not correlated. Conclusions: The patients' appreciation of the COVID-19 protective actions taken by the hospital is related more to the general perceptions induced by the number of cases presented in the mass media and less by perceptions of the gravity of the problem or the risk of infection. In a hospital, the primary mission of patient safety is essential, and it must be fulfilled even if the patients are not sure or fully convinced that this is for their benefit. For management decisions and monitoring, using PREMs can be essential in a situation when general evidence is not conclusive. [ABSTRACT FROM AUTHOR]

Background: Data documenting period product insecurity, or an inability to access products, in the United States have recently emerged. With multiple years of data now available, we assessed trends in period product insecurity among two nationally representative samples of U.S. adults. Materials and Methods: Data from nationally representative, cross-sectional online surveys conducted in January 2018 and April 2021 were used to run weighted logistic regressions. Those aged 18–49 years and who had menstruated in the past year (n = 922 in 2018; n = 1037 in 2021) were included. Results: In 2021, 59% experienced period product insecurity compared with 53% in 2018. In 2018 (adjusted odds ratio [aOR] 1.91, confidence interval [95% CI]: 1.29–2.83) and 2021 (aOR 1.53, 95% CI: 1.06–2.21), Hispanic respondents were more likely to find products unaffordable. Some college attainment was associated with finding products unaffordable in 2018 (aOR 1.53, 95% CI: 1.00–2.34) and 2021 (aOR 1.97, 95% CI: 1.35–2.88). Participants struggling to purchase products had higher odds of experiencing period product insecurity in 2018 (aOR 11.78, 95% CI: 8.07–17.20) and 2021 (aOR 7.71, 95% CI: 5.44–10.93). Conclusions: Hispanic ethnicity, lower educational attainment, and struggling to purchase period products were strong predictors of finding products unaffordable and experiencing product insecurity in both 2018 and 2021. Policies that improve access to or affordability of period products in the United States are needed to help those most vulnerable. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has revealed the contested politics of global health governance, though we still don't know enough about the dynamics of domestic pandemic responses, or about the relationship between the politics of those responses and the politics of global health governance, both of which have changed significantly in recent decades. Focusing on three cases (HIV/AIDS, SARS, and COVID-19) of cross-border infectious diseases, this article explores the trajectory of China's pandemic responses in the context of globalization. Attending to changing politics at domestic, international, and global levels, I argue that those responses have been a complex combination of China's domestic politics (e.g., priorities, institutions, leadership, and timing), its international relations (especially with the US), and its engagements with global health governance. It is concluded that the increasing divergence of pandemic responses in a time of ubiquitous global health crisis demands urgent attention to the connections (including contestations) between domestic pandemic responses and the evolvement of global health governance from a broader perspective that considers changes in geopolitics. [ABSTRACT FROM AUTHOR]

This study sheds light on how political leaders engage in visual meaning-making on social media during a major crisis. In addition, it explores which kinds of visual messages by political leaders on social media drive high popular engagement in times of crisis. The study employs content analysis, including automatic facial expression analysis, to investigate visual communication on the Instagram accounts of three Nordic prime ministers (PMs) during the critical initial wave of the COVID-19 pandemic. The analysis covers visual personalization, depicted individuals, national symbols and facial expressions. Furthermore, the study explores the visual elements within the posts that garnered the highest public engagement, as measured by the number of likes and comments. The findings indicate that the PMs primarily projected an image of professional, capable and credible crisis leadership through their visual content. However, the potential for leaders to convey compassion, empathy and authenticity through visual imagery is also evident, particularly exemplified by the Danish PM. The visual content that generated the most significant public engagement predominantly consisted of videos featuring the PMs in formal professional settings, directly addressing the audience about serious matters. [ABSTRACT FROM AUTHOR]

The Coalition for Epidemic Preparedness Innovations' "100‐day moonshot" aspires to launch a new vaccine within 100 days of pathogen identification, followed by large‐scale vaccine availability within the "second hundred days." Here, we describe work to optimize adenoviral vector manufacturing for rapid response, by minimizing time to clinical trial and first large‐scale supply, and maximizing output from the available manufacturing footprint. We describe a rapid virus seed expansion workflow that allows vaccine release to clinical trials within 60 days of antigen sequence identification, followed by vaccine release from globally distributed sites within a further 40 days. We also describe a perfusion‐based upstream production process, designed to maximize output while retaining simplicity and suitability for existing manufacturing facilities. This improves upstream volumetric productivity of ChAdOx1 nCoV‐19 by approximately fourfold and remains compatible with the existing downstream process, yielding drug substance sufficient for 10,000 doses from each liter of bioreactor capacity. This accelerated manufacturing process, along with other advantages such as thermal stability, supports the ongoing value of adenovirus‐vectored vaccines as a rapidly adaptable and deployable platform for emergency response. [ABSTRACT FROM AUTHOR]

Several months into this return to a Marcos rule that we thought we had foresworn and forestalled, we are yet to grapple with the slaughters and plunders of the past Duterte administration. But this present worrisome political regime is precisely enabled by the previous fatal Duterte government. To understand this Marcos regime, then, we must clarify the meaning of Duterte's rule with finality and demonstrate its place in the cycle of violence and corruption that is our politics. And so, we need to ask, what was/is the meaning of Duterte? To ask this question is to set aside the commonplace move of pointing to the obvious referent and thinking of the name "Duterte" as a sign. In this paper, we are particularly interested in the sign Duterte as indicating a coherent shared understanding and as a practical efficiency. As such, we examine two consistent meanings for Duterte: first, Duterte is the sign of the ideological deployment of middle-class fantasy, as both the bearer and the obscene means of our agency--borne of 1986 EDSA but subsequently lost. Second, Duterte is the name for the continuous experience of normalized emergency--specifically as state terror and militarized pandemic response. [ABSTRACT FROM AUTHOR]

Background Coronavirus disease 2019 (COVID-19) exposed weaknesses in the health systems of countries such as Nigeria, which affected the effectiveness of the health system response to the pandemic. This paper provides new knowledge on the level of the availability, effectiveness and equity of resources in response to COVID-19 in Nigeria. This is valuable information for improving the delivery of countermeasures against future pandemics. Methods The study was conducted at the federal level and in two states in Nigeria. The states were Lagos in the southwest and Enugu in the southeast. In-depth interviews were undertaken with 34 key informants. NVivo version 12 software was used for coding and thematic analysis. Results There were inadequate, inequitable and suboptimal resources (human, financial, equipment and materials) for the response. In some of the countermeasures, only people that were employed in the formal sector benefitted from the distribution of welfare materials and financial packages; the informal sector, which constitutes the majority of the poor population in Nigeria, was excluded. Conclusions Inequity and suboptimal availability of resources to control COVID-19 led to reduced effectiveness of the health system response to the disease in Nigeria. Such negative factors must be mitigated in future responses to pandemics in the country. [ABSTRACT FROM AUTHOR]

The onset of the COVID-19 pandemic drove a widespread, often uncoordinated effort by research groups to develop mathematical models of SARS-CoV-2 to study its spread and inform control efforts. The urgent demand for insight at the outset of the pandemic meant early models were typically either simple or repurposed from existing research agendas. Our group predominantly uses agent-based models (ABMs) to study fine-scale intervention scenarios. These high-resolution models are large, complex, require extensive empirical data, and are often more detailed than strictly necessary for answering qualitative questions like “Should we lockdown?” During the early stages of an extraordinary infectious disease crisis, particularly before clear empirical evidence is available, simpler models are more appropriate. As more detailed empirical evidence becomes available, however, and policy decisions become more nuanced and complex, fine-scale approaches like ours become more useful. In this manuscript, we discuss how our group navigated this transition as we modeled the pandemic. The role of modelers often included nearly real-time analysis, and the massive undertaking of adapting our tools quickly. We were often playing catch up with a firehose of evidence, while simultaneously struggling to do both academic research and real-time decision support, under conditions conducive to neither. By reflecting on our experiences of responding to the pandemic and what we learned from these challenges, we can better prepare for future demands.

This study focuses on how academic libraries face ongoing challenges in adapting to emerging technologies and external events like the COVID-19 pandemic. It explores the literature on the decline in reference transactions and the growing reliance on technology-mediated reference services. It presents [Institution] Library’s approach to remediate and reverse this decline. The library aimed to enhance student access to reference services and increase librarian visibility by piloting in 2022-23 a mobile ASK desk. Data analysis from the pilot program indicates an increase in reference queries compared to previous years, reversing the multiyear downward trend and suggesting the effectiveness of the ASK desk in meeting student needs. The article introduces the Holistic 360 Reference Services Model (H360 Ref), which provides a framework for delivering comprehensive reference services. Overall, it asserts that enhancing reference services can contribute to increased student engagement, solidifying the essential role of libraries in supporting learning and research endeavors.

The COVID-19 pandemic has profoundly impacted global public health systems and economic frameworks. Many researchers have delved into these effects and widely discussed the ramifications. Building upon existing literature, this paper comparatively analyses the strategies adopted by France and Sweden in responding to the COVID-19 outbreak, emphasising the effectiveness and implications of the approaches undertaken by countries with centralised versus decentralised political systems to overcome COVID-19. Through comprehensive review of literature, news reports, and other sources, this study reveals psychological resistance and disdain towards COVID-19 vaccination among the populace under France’s centralised government system, alongside significant issues of “Tyranny of Experts” within Sweden’s decentralised governance framework.

Leiqing Gao,1,2,* Shi Tang,1,* Weiyan Zheng1 1Department of Nursing, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of Nursing, Pu Jiang Hospital, Minhang District, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Weiyan Zheng, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Pudong District, Shanghai, 200127, People’s Republic of China, Fax +86-21-63730455, Email renji_zhengweiyan@163.comObjective: In the first half of 2022, Shanghai faced the challenge of an emerging wave of epidemics caused by the Omicron variant. In response, 48 hospitals, spanning municipal and district levels, were rapidly converted into designated hospitals. This case study focuses on the South Branch of Renji Hospital, School of Medicine, Shanghai Jiaotong University, as one such designated hospital.Methods: Facing unprecedented challenges without prior experience, we devised a strategic approach to deploy ICU nurses effectively. This approach involved crisis event gradation, establishing a human resources pool, and classifying nursing staff based on qualifications and proficiencies.Results: By May 11, 2022, all 48 designated hospitals were operational. The South Branch of Renji Hospital treated 3310 Omicron-infected patients between April 7 and June 21, 2022, including 115 critically ill patients in a 38-bed ICU. We meticulously assigned 136 nurses, distributed as follows: Grade A 12.5%, Grade B 12.5%, Grade C 40%, and Grade D 35%, with three specialized nursing managers. Nurses worked tirelessly in 4-hour shifts, wearing full protective gear. Remarkably, the hospital maintained a flawless record, with no nursing-related adverse events and zero patient mortality in the ICU.Conclusion: Effective management of ICU nursing personnel is associated with patient safety. Strategic rostering and placement of ICU nurses in designated hospitals optimize resource utilization, enhancing service effectiveness and working conditions. This technique is a crucial resource for hospitals facing unforeseen public health crises requiring rapid ICU nurse resource allocation and management.Keywords: Omicron variant, pandemic response, designated hospital, ICU, nurse, human resource management, resource allocation

Abstract Background Participant involvement in research studies is not a new concept, yet barriers to implementation remain and application varies. This is particularly true for pandemic response research studies, where timeframes are condensed, pressure is high and the value and inclusion of participant involvement can be overlooked. The SIREN Participant Involvement Panel (PIP) provides a case study for participant involvement in pandemic research, working in partnership with people who the research is for and about. Methods SIREN and the British Society for Immunology (BSI) recruited and ran two phases of the PIP, involving 15 members in total over a 16-month period. Phase 1 ran between January and August 2022 and Phase 2 between October 2022 and March 2023. Activity figures including recruitment interest and PIP meeting attendance were recorded. To evaluate how the PIP has influenced SIREN, feedback was collected from (a) researchers presenting at the PIP and (b) PIP members themselves. Evaluation at the end of Phase 1 informed our approach to Phase 2. Thematic grouping was planned to identify key lessons learned. Results Applications increased from n = 30 to n = 485 between Phase 1 and Phase 2 of the PIP, a more than 15-fold increase. The SIREN PIP positively impacted the design, implementation and evaluation phases of the study and sub-studies. Feedback from PIP members themselves was positive, with members highlighting that they found the role rewarding and felt valued. Learnings from the PIP have been condensed into five key themes for applying to future pandemic response research studies: the importance of dedicated resources; recruiting the right panel; understanding motivations for participant involvement; providing flexible options for involvement and enabling the early involvement of participants. Conclusions The SIREN PIP has demonstrated the value of actively involving people who research is for and about. The PIP has provided an active feedback mechanism for research and demonstrated a positive influence on both SIREN study researchers and PIP members themselves. This paper makes the case for participant involvement in future pandemic research studies. Future work should include improved training for researchers and we would support the development of a national PIP forum as part of future pandemic research preparedness.

Abstract Background During the COVID-19 pandemic, healthcare systems and healthcare workers (HCWs) faced significant demands and unique challenges. In this qualitative study, we explore the effects of the COVID-19 public health policies on British Columbia’s frontline HCWs, describe what worked in the management of the pandemic, and elucidate the lessons learned that could be applied to future pandemic preparedness, recovery and response. Methods This qualitative descriptive study is part of a larger, national multi-case study on pandemic policy communication and uptake. Semi-structured interviews were conducted from November 2020- June 2021 with fourteen HCWs working in long-term care (LTC), acute care and public health settings. Data were inductively coded, and analyzed following a resilience framework for public health emergency preparedness, which emphasizes the essential elements of a public health system, vital to all phases of health emergency management, readiness, response and recovery. Results HCWs experienced confusion, frustration, uncertainty, anxiety, fatigue and stress, during the pandemic and detailed challenges that affected policy implementation. This included communication and coordination inconsistencies between the province and regional health authorities; lack of involvement of frontline staff in pandemic planning; inadequate training and support; inadequate personal protective equipment resource capacity and mobilization; and staffing shortages. HCWs recommended increased collaboration between frontline staff and policy makers, investment in preparing and practicing pandemic plans, and the need for training in emergency management and infection prevention and control. Conclusions Pandemic planning, response and recovery should include inputs from actors/key stakeholders at the provincial, regional and local levels, to facilitate better coordination, communication and outcomes. Also, given the critical roles of frontline HCWs in policy implementation, they should be adequately supported and consideration must be given to how they interpret and act on policies. Bi-directional communication channels should be incorporated between policymakers and frontline HCWs to verify the appropriate adoption of policies, reflective learning, and to ensure policy limitations are being communicated and acted upon by policy makers.

Globally, countries have used diverse methods to report data during the COVID-19 pandemic. Using international guidelines and principles of emergency management, we compare national data reporting systems in African countries in order to determine lessons for future pandemics. We analyse COVID-19 reporting practices across 54 African countries through 2020. Reporting systems were diverse and included summaries, press releases, situation reports and online dashboards. These systems were communicated via social media accounts and websites belonging to ministries of health and public health. Data variables from the reports included event detection (cases/deaths/recoveries), risk assessment (demographics/co-morbidities) and response (total tests/hospitalisations). Of countries with reporting systems, 36/53 (67.9%) had recurrent situation reports and/or online dashboards which provided more extensive data. All of these systems reported cases, deaths and recoveries. However, few systems contained risk assessment and response data, with only 5/36 (13.9%) reporting patient co-morbidities and 9/36 (25%) including total hospitalisations. Further evaluation of reporting practices in Cameroon, Egypt, Kenya, Senegal and South Africa as examples from different sub-regions revealed differences in reporting healthcare capacity and preparedness data. Improving the standardisation and accessibility of national data reporting systems could augment research and decision-making, as well as increase public awareness and transparency for national governments.

Responses to the early (February-July 2020) COVID-19 pandemic varied widely, globally. Reasons for this are multiple but likely relate to the healthcare and financial resources then available, and the degree of trust in, and economic support provided by, national governments. Cultural factors also affected how different populations reacted to the various pandemic restrictions, like masking, social distancing and self-isolation or self-quarantine. The degree of compliance with these measures depended on how much individuals valued their needs and liberties over those of their society. Thus, several themes may be relevant when comparing pandemic responses across different regions. East and Southeast Asian populations tended to be more collectivist and self-sacrificing, responding quickly to early signs of the pandemic and readily complied with most restrictions to control its spread. Australasian, Eastern European, Scandinavian, some Middle Eastern, African and South American countries also responded promptly by imposing restrictions of varying severity, due to concerns for their wider society, including for some, the fragility of their healthcare systems. Western European and North American countries, with well-resourced healthcare systems, initially reacted more slowly, partly in an effort to maintain their economies but also to delay imposing pandemic restrictions that limited the personal freedoms of their citizens.