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Soft law and individual responsibility: a review of the Swedish policy response to COVID-19.

ABSTRACT: Sweden's coronavirus disease 2019 (COVID-19) response, initially based largely on voluntary measures, has evoked strong reactions nationally and internationally. In this study, we describe Sweden's national policy response with regard to the general public, the community and the health care system, with a focus on how the response changed from March 2020 to June 2021. A number of factors contributed to Sweden's choice of policy response, including its existing legal framework, independent expert agencies and its decentralized, multi-level health care governance system. Challenges to the health- and elder care system during the pandemic, such as the need to increase intensive care- and testing capacity, and to ensure the safety of the elderly were addressed largely at the regional and local levels, with national authorities assuming a primarily coordinative role. Although the overall response based on voluntary compliance has persisted, the national government started to take a more prominent role in public messaging, and in enacting legally binding restrictions during subsequent waves of the pandemic. This study illustrates that not only policy responses, but also the fundamental structure of the health- and elder care system and its governance should be considered when evaluating the impact of the COVID-19 pandemic.

SUBMITTER: Winblad U

PROVIDER: S-EPMC8387683 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Swedish policy analysis for Covid-19.

Project description:IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has challenged health care systems and put societies to the test in the world beyond expectations.ObjectiveOur aim is to describe and analyze the Swedish approach in combating the pandemic.MethodsWe present and discuss data collated from various sources - published scientific studies, pre-print material, agency reports, media communication, public surveys, etc. - with specific focus on the approach itself, Covid-19 trends, healthcare system response, policy and measures overview, and implications.ResultsThe main intervention to manage the curve has been the general recommendations to adhere to good hand hygiene, beware of physical distance to others, to refrain from large gatherings and restrain from non-essential travel. Persons with suspected Covid-19 infection were recommended to stay at home and avoid social contacts. Additionally, visits to the elderly care homes and meetings with more than 50 people were forbidden. As a result, the healthcare system in the country has so far, never been overwhelmed. However, the relatively high mortality among the elderly, together with the vulnerability of some migrants, points out the drawbacks.ConclusionsMany countries have both marvelled and criticized the Swedish strategy that is formed in a close partnership between the government and the society based on a mutual trust giving the responsibility to individuals. It already highlights how much can be achieved with voluntary measures (recommendations) - something that was noticed and proposed as a future model by the World Health Organization.

| S-EPMC7455549 | biostudies-literature

COVID-19 economic policy response, resilience and tourism recovery

Project description:This study investigates whether tourism sector recovery from the COVID-19 pandemic is influenced by only the size of the economic stimulus packages or whether a country's resilience plays a moderating influence in the underlying relationship. The results show that while economic stimulus packages help to enhance tourism recovery from the COVID-19 pandemic, it is contingent on the level of a country's resilience. For instance, amongst the less resilient countries, the impact of economic policy response on the tourism recovery is more pronounced, but the effect dissipates as countries become more resilient. These findings have important implications for policymakers, management teams, and relevant stakeholders in their effort to revive the tourism sector from the impact of the COVID-19 pandemic.

| S-EPMC9515351 | biostudies-literature

Cost-Effectiveness of COVID-19 Policy Measures: A Systematic Review.

Project description:ObjectivesThe COVID-19 pandemic has had a major impact on our society, with drastic policy restrictions being implemented to contain the spread of the severe acute respiratory syndrome coronavirus 2. This study aimed to provide an overview of the available evidence on the cost-effectiveness of various coronavirus disease 2019 policy measures.MethodsA systematic literature search was conducted in PubMed, Embase, and Web of Science. Health economic evaluations considering both costs and outcomes were included. Their quality was comprehensively assessed using the Consensus Health Economic Criteria checklist. Next, the quality of the epidemiological models was evaluated.ResultsA total of 3688 articles were identified (March 2021), of which 23 were included. The studies were heterogeneous with regard to methodological quality, contextual factors, strategies' content, adopted perspective, applied models, and outcomes used. Overall, testing/screening, social distancing, personal protective equipment, quarantine/isolation, and hygienic measures were found to be cost-effective. Furthermore, the most optimal choice and combination of strategies depended on the reproduction number and context. With a rising reproduction number, extending the testing strategy and early implementation of combined multiple restriction measures are most efficient.ConclusionsThe quality assessment highlighted numerous flaws and limitations in the study approaches; hence, their results should be interpreted with caution because the specific context (country, target group, etc) is a key driver for cost-effectiveness. Finally, including a societal perspective in future evaluations is key because this pandemic has an indirect impact on the onset and treatment of other conditions and on our global economy.

| S-EPMC8481648 | biostudies-literature

Did the UK policy response to Covid-19 protect household incomes?

Project description:We analyse the UK policy response to Covid-19 and its impact on household incomes in the UK in April and May 2020, using microsimulation methods. We estimate that households lost a substantial share of their net income of 6.9% on average. But policies protected household incomes to a substantial degree: compared to the drop in net income, GDP per capita fell by 18.9% between the first and second quarter of 2020. Earnings subsidies (the Coronavirus Job Retention Scheme) protected household finances and provided the main insurance mechanism during the crisis. Besides subsidies, Covid-related increases to state benefits, as well as the automatic stabilisers in the tax and benefit system, played an important role in mitigating the income losses. However, analysing the impact of a near-decade of austerity on the UK safety net, we find that, compared to 2011 policies, the 2020 pre-Covid tax-benefit policies would have been less effective in insuring incomes against the shocks. We also assess the potential distributional impact of introducing a Universal Basic Income (UBI) instead of the Covid emergency measures and find that a UBI would have supported the incomes of different vulnerable groups but would have provided less protection to those hit hardest by the labour market shocks.Supplementary informationThe online version contains supplementary material available at 10.1007/s10888-021-09491-w.

| S-EPMC8345904 | biostudies-literature

Response to COVID-19 in Cyprus: Policy changes and epidemic trends.

Project description:ObjectivesIn late July, Cyprus experienced the second epidemic wave of COVID-19. We present the steps taken by the government and evaluate their effect on epidemic trends.MaterialsCyprus Press and Information Office data were analysed. Using an R-based forecasting program, two models were created to predict cases up to 01/09/2020: Model 1, which utilised data up to 09/06/2020, when airports reopened to foreign travelers with COVID-19 screening; and Model 2, which utilised data until 24/06/2020, when screening for passengers from low-transmission countries was discontinued.ResultsPIO data revealed no significant policy changes between 24/06/2020 and 31/07/2020. Prediction models were robust and accurate (Model 1, R2 = 0.999, P < .001; Model 2, R2 = 0.998, P < .001). By August 30th, recorded cases exceeded those predicted by Model 1 by 24.47% and by Model 2 by 20.95%, with P values <.001 for both cases.ConclusionsThe significant difference between recorded cases and those projected by Models 1 and 2 suggests that changes in epidemic trends may have been associated with policy changes after their respective dates. Discontinuation of major restrictions such as airport reopening, can destabilise the control of the epidemic, and may concomitantly necessitate a reevaluation of the current epidemic status. In the face of an evolving situation such as the COVID-19 pandemic, states are forced to balance the imposing of restrictions against their impact on the economy.

| S-EPMC7883066 | biostudies-literature

Acknowledging individual responsibility while emphasizing social determinants in narratives to promote obesity-reducing public policy: a randomized experiment.

Project description:This study tests whether policy narratives designed to increase support for obesity-reducing public policies should explicitly acknowledge individual responsibility while emphasizing social, physical, and economic (social) determinants of obesity. We use a web-based, randomized experiment with a nationally representative sample of American adults (n = 718) to test hypotheses derived from theory and research on narrative persuasion. Respondents exposed to narratives that acknowledged individual responsibility while emphasizing obesity's social determinants were less likely to engage in counterargument and felt more empathy for the story's main character than those exposed to a message that did not acknowledge individual responsibility. Counterarguing and affective empathy fully mediated the relationship between message condition and support for policies to reduce rates of obesity. Failure to acknowledge individual responsibility in narratives emphasizing social determinants of obesity may undermine the persuasiveness of policy narratives. Omitting information about individual responsibility, a strongly-held American value, invites the public to engage in counterargument about the narratives and reduces feelings of empathy for a character that experiences the challenges and benefits of social determinants of obesity.

| S-EPMC4338108 | biostudies-literature

Outcomes of Elective Colorectal Cancer Surgery During COVID 19 Pandemic: Implications for Cancer Care Policy

Project description:Due to COVID 19 (Corona virus disease)pandemic, majority of surgeries, including surgery for cancer patients got delayed across the globe. Surgeries were limited to emergency set up only. At our institute we tried to perform colorectal cancer surgeries through out the pandemic, albeit in less numbers, as we thought cancer in itself is an emergency setting. we are planning to analyse the prospectively managed database of this particular group of patients over a period of last six 6 months and look out at 30 day post operative morbidity and mortality. Besides we will try to analyse the implications of our decision to carry on with cancer surgeries in terms of number of health care workers who got infected while being involved in primary care of these patients.

| 2354636 | ecrin-mdr-crc

Metabolomic/lipidomic profiling of COVID-19 and individual response to tocilizumab

Project description:The current pandemic emergence of novel coronavirus disease (COVID-19) poses a relevant threat to global health. SARS-CoV-2 infection is characterized by a wide range of clinical manifestations, ranging from absence of symptoms to severe forms that need intensive care treatment. Here, plasma-EDTA samples of 30 patients compared with age- and sex-matched controls were analyzed via untargeted nuclear magnetic resonance (NMR)-based metabolomics and lipidomics. With the same approach, the effect of tocilizumab administration was evaluated in a subset of patients. Despite the heterogeneity of the clinical symptoms, COVID-19 patients are characterized by common plasma metabolomic and lipidomic signatures (91.7% and 87.5% accuracy, respectively, when compared to controls). Tocilizumab treatment resulted in at least partial reversion of the metabolic alterations due to SARS-CoV-2 infection. In conclusion, NMR-based metabolomic and lipidomic profiling provides novel insights into the pathophysiological mechanism of human response to SARS-CoV-2 infection and to monitor treatment outcomes.

2022-02-21 | MTBLS2336 | MetaboLights

Effectiveness of controlling COVID-19 epidemic by implementing soft lockdown policy and extensive community screening in Taiwan.

Project description:Strict and repeated lockdowns have caused public fatigue regarding policy compliance and had a large impact on several countries' economies. We aimed to evaluate the effectiveness of a soft lockdown policy and the strategy of active community screening for controlling COVID-19 in Taiwan. We used village-based daily confirmed COVID-19 statistics in Taipei City and New Taipei City, between May 2, 2021, and July 17, 2021. The temporal Gi* statistic was used to compute the spatiotemporal hotspots. Simple linear regression was used to evaluate the trend of the epidemic, positivity rate from community screening, and mobility changes in COVID-19 cases and incidence before and after a level three alert in both cities. We used a Bayesian hierarchical zero-inflated Poisson model to estimate the daily infection risk. The cities accounted for 11,403 (81.17%) of 14,048 locally confirmed cases. The mean effective reproduction number (Re) surged before the level three alert and peaked on May 16, 2021, the day after the level three alert in Taipei City (Re = 3.66) and New Taipei City (Re = 3.37). Mobility reduction and a lower positive rate were positively associated with a lower number of cases and incidence. In the spatiotemporal view, seven major districts were identified with a radial spreading pattern from one hard-hit district. Villages with a higher inflow degree centrality among people aged ≥ 60 years, having confirmed cases, specific land-use types, and with a higher aging index had higher infection risks than other villages. Early soft lockdown policy and detection of infected patients showed an effective strategy to control COVID-19 in Taiwan.

| S-EPMC9282154 | biostudies-literature

Power law in COVID-19 cases in China.

Project description:The novel coronavirus (COVID-19) was first identified in China in December 2019. Within a short period of time, the infectious disease has spread far and wide. This study focuses on the distribution of COVID-19 confirmed cases in China-the original epicentre of the outbreak. We show that the upper tail of COVID-19 cases in Chinese cities is well described by a power law distribution, with exponent around one in the early phases of the outbreak (when the number of cases was growing rapidly) and less than one thereafter. This finding is significant because it implies that (i) COVID-19 cases in China is heavy tailed and disperse; (ii) a few cities account for a disproportionate share of COVID-19 cases; and (iii) the distribution generally has no finite mean or variance. We find that a proportionate random growth model predicated by Gibrat's law offers a plausible explanation for the emergence of a power law in the distribution of COVID-19 cases in Chinese cities in the early phases of the outbreak.

| S-EPMC9115516 | biostudies-literature

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