Since 2020, Thailand has experienced four waves of COVID-19. By 31 January 2022, there were 2.4 million cumulative cases and 22,176 deaths nationwide. This study assessed the governance and policy responses adapted to different sizes of the pandemic outbreaks and other challenges.
A qualitative study was applied, including literature reviews and in-depth interviews with 17 multi-sectoral actors purposively identified from those who were responsible for pandemic control and vaccine rollout. We applied deductive approaches using health systems building blocks, and inductive approaches using analysis of in-depth interview content, where key content formed sub-themes, and different sub-themes formed the themes of the study.
Three themes emerged from this study. First, the large scale of COVID-19 infections, especially the Delta strain in 2021, challenged the functioning of the health system\'s capacity to respond to cases and maintain essential health services. The Bangkok local government insufficiently performed due to its limited capacity, ineffective multi-sectoral collaboration, and high levels of vulnerability in the population. However, adequate financing, universal health coverage, and health workforce professionalism and commitment were key enabling factors that supported the health system. Second, the population\'s vulnerability exacerbated infection spread, and protracted political conflicts and political interference resulted in the politicization of pandemic control measures and vaccine roll-out; all were key barriers to effective pandemic control. Third, various innovations and adaptive capacities minimized the supply-side gaps, while social capital and civil society engagement boosted community resilience.
This study identifies key governance gaps including in public communication, managing infodemics, and inadequate coordination with Bangkok local government, and between public and private sectors on pandemic control and health service provisions. The Bangkok government had limited capacity in light of high levels of population vulnerability. These gaps were widened by political conflicts and interference. Key strengths are universal health coverage with full funding support, and health workforce commitment, innovations, and capacity to adapt interventions to the unfolding emergency. Existing social capital and civil society action increases community resilience and minimizes negative impacts on the population.

We employ unique panel data on the universe of COVID-19 vaccination and infection cases in Israel to examine the role of political belief in COVID-19 vaccine uptake, virus transmission, and closure policy response. The paper identifies political beliefs based on statistical area votes in national elections held in Israel on the eve of the COVID-19 outbreak in March 2020. Unlike the U.S. and elsewhere, pandemic policy intervention in Israel was broadly supported by politicians across the belief spectrum. As such, household response to virus risk was not biased by contemporaneous partisan disagreement and debate among political leaders. Findings show, all things equal, that in the wake of emergent and localized virus risk, voters in politically right-of-center and religious areas displayed substantially higher odds of both vaccine resistance and virus transmission as compared to their left-center counterparts. Moreover, political belief is highly salient to aggregate pandemic outcomes. Model simulation shows that had all areas responded to virus risk with the more risk-averse behaviors of left-of-center areas, the number of vaccinations nationwide would have increased by 15 percent. That same scenario results in a full 30 percent reduction in total infection cases. Results also show that coercive policy measures such as economic closure were more effective in reducing virus transmission among less risk-averse right-wing and religious areas. Findings provide new evidence of the role of political belief in household response to health risks. Results further underscore the importance of timely, targeted messaging and intervention among divergent political belief groups to reduce vaccine hesitancy and enhance disease control. Future studies should explore the external validity of findings, including the use of individual voter data, if available, to evaluate political belief effects.

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Against the unprecedented outbreaks of the COVID-19 variants, countries have introduced restrictive measures with discretion, ranging from lifting the closure thoroughly to implementing stringent policies, but all together guarding the global public health. Under the changing circumstances, we firstly apply the panel data vector autoregression (PVAR) model, using a sample of 176 countries/territories from 15 June 2021 to 15 April 2022, to estimate the potential associations among the policy responses, the progression of COVID-19 in deaths and vaccination, and medical resources possessed. Furthermore, we use the random effect method and the fixed effect speculation, to examine the determinants of policy variances across regions and over time. Our work has four main findings. Firstly, it showed the existence of a bidirectional relationship between the policy stringency and variables of interest including new daily deaths, the fully vaccinated percentage and health capacity. Secondly, conditional on the availability of vaccines, the sensitivity of policy responses to the death numbers tends to decline. Thirdly, the role of health capacity matters in coexisting with the virus mutation. Fourthly, regarding the variance in policy responses over time, the impact of new deaths tends to be seasonal. As to geographical differences in policy responses, we present the analysis for Asia, Europe, and Africa, and they show different levels of dependencies on the determinants. These findings suggest that bidirectional correlations exist in the complex context of wrestling with the COVID-19, as government interventions exert influence on the virus spread, the policy responses also progress alongside multiple factors evolving in the pandemic. This study will help policymakers, practitioners, and academia to formulate a comprehensive understanding of the interactions between policy responses and the contextualized implementation factors.

OBJECTIVE: During the early stages of the COVID-19 pandemic, the full reopening of the economy typically accelerated viral transmission. This study aims to determine whether policy response could contribute to the dual objective of both reducing the spread of the epidemic and revitalising economic activities.
METHODS: This is a longitudinal study of Organization for Economic Cooperation and Development (OECD) and Brazil, Russia, India, Indonesia, China, and South Africa (BRIICS) from the first quarter (Q1) of 2020 to the same period of 2021.
METHODS: From a health-economic perspective, this study established a framework to illustrate the following outcomes: suppression-prosperity, outbreak-stagnancy, outbreak-prosperity and suppression-stagnancy scenarios. Multinomial logistic models were used to analyse the associations between policy response with both the pandemic and the economy. The study further examined two subtypes of policy response, stringency/health measures and economic support measures, separately. The probabilities of the different scenarios were estimated.
RESULTS: Economic prosperity and epidemic suppression were significantly associated with policy response. The effects of policy response on health-economic scenarios took the form of inverse U-shapes with the increase in intensity. \'Leptokurtic\', \'bimodal\' and \'long-tailed\' curves demonstrated the estimated possibilities of suppression-prosperity, outbreak-prosperity and suppression-stagnancy scenarios, respectively. In addition, stringency/health policies followed the inverted U-shaped pattern, whereas economic support policies showed a linear pattern.
CONCLUSIONS: It was possible to achieve the dual objective of economic growth and epidemic control simultaneously, and the effects of policy response were shaped like an inverse U. These findings provide a new perspective for balancing the economy with public health during the early stages of the pandemic.

Quick-response research during a time of crisis is important because time-sensitive findings can inform urgent decision-making, even with limited research budgets. This research, a National Science Foundation-funded Rapid Response Research (RAPID), explores the United States (U.S.) government\'s messaging on science in response to the COVID-19 pandemic, and how this messaging informed policy. Using rapidly emerging secondary data (e.g., policy documents taken from government websites and others), much of which has since been removed or changed, we examined the interactions between governing bodies, non-governmental organizations, and civilian populations in the Southeastern U.S. during the first 2 years of the pandemic. This research helps to better understand how decision-makers at the federal, state, and local levels responded to the pandemic in three states with the lowest vaccine rates and highest levels of poverty, income inequality, and disproportionate impacts borne by people of color in the nation: Alabama, Louisiana, and Mississippi. This study incorporates the Policy Regime Framework to discuss how two foundational concepts (ideas and institutions) helped govern policy implementation during the COVID-19 pandemic. This research fills a significant information gap by providing a better understanding of how policy regimes emerge across multiple levels of government and impact vulnerable populations during times of a public health crisis. We use automated text analysis to make sense of a large quantity of textual data from policy-making agencies. Our case study is the first to use the Policy Regime Framework in conjunction with empirical data, as it emerged, from federal, state, and local governments to analyze the U.S. policy response to COVID-19. We found the U.S. policy response included two distinct messaging periods in the U.S. during the COVID-19 pandemic: pre and post-vaccine. Many messaging data sources (agency websites, public service announcements, etc). have since been changed since we collected them, thus our real-time RAPID research enabled an accurate snapshot of a policy response in a crisis. We also found that there were significant differences in the ways that federal, state, and local governments approached communicating complex ideas to the public in each period. Thus, our RAPID research demonstrates how significant policy regimes are enacted and how messaging from these regimes can impact vulnerable populations.

We investigate the impact of the COVID-19 pandemic and related policy responses on non-COVID-19 healthcare utilization (i.e., different types of outpatient care) up to October 2020 in China. Using an administrative database from a large prefecture-level city, we find that both direct exposure to the COVID-19 pandemic and the strict containment policy responses led to reductions in outpatient care utilization. The largest decline during the lockdown was observed in preventive care visits, which nevertheless recovered to pre-pandemic levels 2 months after the lockdown. The disruptions in prenatal care visits could not be offset by the recovery later on. Chronic care and emergency department visits had not returned to pre-pandemic levels as of October 2020, which may be driven by extended days\' supply of prescription medication, increased use of telemedicine, and improved health-protective behaviors. In the reopening period, there were increases in visits for mental and sleep disorders, especially among children, and for medical abortion. Among health facilities at all levels, primary care facilities saw the least reductions in total outpatient visits. Our results emphasize the need for strategies to ensure access to urgent or essential care services when managing the current epidemiologic transition and future crises.

In this paper, we discuss the lack of consideration given to children in the COVID-19 health systems policy response to the pandemic. We do this by focusing on the case of children with complex medical needs. We argue that, in broad terms, health systems policies that were implemented during the pandemic failed adequately to meet our obligations to both children generally and those with complex medical needs by failing to consider those needs and so to give them fair protection against harm and disadvantage. We argue that justice requires that the distinct needs and vulnerabilities of children with medical complexities are explicitly integrated and prioritised in decisions concerning healthcare and operational planning in the recovery phase and beyond.

The occurrence of major water contamination events across the world have been met with varying levels of policy responses. Arsenic-a priority water contaminant globally, occurring naturally in groundwater, causing adverse health effects-is widespread in Bangladesh. However, the policy response has been slow, and marked by ineffectiveness and a lack of accountability. We explore the delayed policy response to the arsenic crisis in Bangladesh through comparison with water contamination crises in other contexts, using the Multiple Streams Framework to compare policy processes. These included Escherichia coli O157:H7 and Campylobacter in Walkerton, Canada; lead and Legionella in Flint, Michigan, USA; and chromium-6 contamination in Hinkley, California, USA. We find that, while water contamination issues are solvable, a range of complex conditions have to be met in order to reach a successful solution. These include aspects of the temporal nature of the event and the outcomes, the social and political context, the extent of the public or media attention regarding the crisis, the politics of visibility, and accountability and blame. In particular, contaminants with chronic health outcomes, and longer periods of subclinical disease, lead to smaller policy windows with less effective policy changes. Emerging evidence on health threats from drinking water contamination raise the risk of new crises and the need for new approaches to deliver policy change.

OBJECTIVE: This review evaluated the knowledge, utilisation, prevention education, and policy response across the six geopolitical regions of Nigeria to inform national efforts for the prevention and control of cervical cancer.
METHODS: A keyword-based systematic search was conducted in PubMed/MEDLINE (NCBI), Google Scholar, and AJOL electronic databases, including a manual scan of papers, journals and websites to identify relevant peer-reviewed studies. Articles were screened and assessed for eligibility.
RESULTS: Many (158) articles were downloaded and after duplicates were removed, 110 articles were included in the final analysis. These were made up of qualitative, quantitative (cross-sectional), intervention and policy studies. Studies have generally reported poor knowledge and awareness of cervical cancer screening but those carried out in urban areas demonstrated a slightly higher level of awareness of Human Papilloma Virus (HPV) vaccine, HPV vaccination uptake and utilization of cervical cancer preventive services than the rural studies. The studies did not show strong government support or policies in relation to cervical cancer control.
CONCLUSIONS: Knowledge and uptake of cervical cancer preventive services across diverse groups in Nigeria remain poor. These could be linked to socio-cultural factors, the lack of an organised cervical cancer screening programme and low financial resource pool for cervical cancer prevention. Therefore, it is necessary to increase government, donor prioritisation and political support in order to ensure increased investment and commitment to cervical cancer elimination in Nigeria.