When Covid-19 first struck: Analysis of the influence of structural characteristics of countries - technocracy is strengthened by open democracy.

<h4>Context</h4>The Covid-19 pandemic hit the developed world differentially due to accidental factors, and countries had to respond rapidly within existing resources, structures, and processes to manage totally new health challenges. This study aimed to identify which pre-existing struc...

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Main Authors: Michael J Rigby, Kinga Zdunek, Fabrizio Pecoraro, Marco Cellini, Daniela Luzi
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0257757
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author Michael J Rigby
Kinga Zdunek
Fabrizio Pecoraro
Marco Cellini
Daniela Luzi
author_facet Michael J Rigby
Kinga Zdunek
Fabrizio Pecoraro
Marco Cellini
Daniela Luzi
author_sort Michael J Rigby
collection DOAJ
description <h4>Context</h4>The Covid-19 pandemic hit the developed world differentially due to accidental factors, and countries had to respond rapidly within existing resources, structures, and processes to manage totally new health challenges. This study aimed to identify which pre-existing structural factors facilitated better outcomes despite different starting points, as understanding of the relative impact of structural aspects should facilitate achieving optimal forward progress.<h4>Methods</h4>Desk study, based on selecting and collecting a range of measures for 48 representative characteristics of 42 countries' demography, society, health system, and policy-making profiles, matched to three pandemic time points. Different analytic approaches were employed including correlation, multiple regression, and cluster analysis in order to seek triangulation.<h4>Findings</h4>Population structure (except country size), and volume and nature of health resources, had only minor links to Covid impact. Depth of social inequality, poverty, population age structure, and strength of preventive health measures unexpectedly had no moderating effect. Strongest measured influences were population current enrolment in tertiary education, and country leaders' strength of seeking scientific evidence. The representativeness, and by interpretation the empathy, of government leadership also had positive effects.<h4>Conclusion</h4>Strength of therapeutic health system, and indeed of preventive health services, surprisingly had little correlation with impact of the pandemic in the first nine months measured in death- or case-rates. However, specific political system features, including proportional representation electoral systems, and absence of a strong single party majority, were consistent features of the most successful national responses, as was being of a small or moderate population size, and with tertiary education facilitated. It can be interpreted that the way a country was lead, and whether leadership sought evidence and shared the reasoning behind resultant policies, had notable effects. This has significant implications within health system development and in promoting the population's health.
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spelling doaj.art-32959de4e6654d8f86fa0fb1c80eba682022-12-21T21:32:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-011610e025775710.1371/journal.pone.0257757When Covid-19 first struck: Analysis of the influence of structural characteristics of countries - technocracy is strengthened by open democracy.Michael J RigbyKinga ZdunekFabrizio PecoraroMarco CelliniDaniela Luzi<h4>Context</h4>The Covid-19 pandemic hit the developed world differentially due to accidental factors, and countries had to respond rapidly within existing resources, structures, and processes to manage totally new health challenges. This study aimed to identify which pre-existing structural factors facilitated better outcomes despite different starting points, as understanding of the relative impact of structural aspects should facilitate achieving optimal forward progress.<h4>Methods</h4>Desk study, based on selecting and collecting a range of measures for 48 representative characteristics of 42 countries' demography, society, health system, and policy-making profiles, matched to three pandemic time points. Different analytic approaches were employed including correlation, multiple regression, and cluster analysis in order to seek triangulation.<h4>Findings</h4>Population structure (except country size), and volume and nature of health resources, had only minor links to Covid impact. Depth of social inequality, poverty, population age structure, and strength of preventive health measures unexpectedly had no moderating effect. Strongest measured influences were population current enrolment in tertiary education, and country leaders' strength of seeking scientific evidence. The representativeness, and by interpretation the empathy, of government leadership also had positive effects.<h4>Conclusion</h4>Strength of therapeutic health system, and indeed of preventive health services, surprisingly had little correlation with impact of the pandemic in the first nine months measured in death- or case-rates. However, specific political system features, including proportional representation electoral systems, and absence of a strong single party majority, were consistent features of the most successful national responses, as was being of a small or moderate population size, and with tertiary education facilitated. It can be interpreted that the way a country was lead, and whether leadership sought evidence and shared the reasoning behind resultant policies, had notable effects. This has significant implications within health system development and in promoting the population's health.https://doi.org/10.1371/journal.pone.0257757
spellingShingle Michael J Rigby
Kinga Zdunek
Fabrizio Pecoraro
Marco Cellini
Daniela Luzi
When Covid-19 first struck: Analysis of the influence of structural characteristics of countries - technocracy is strengthened by open democracy.
PLoS ONE
title When Covid-19 first struck: Analysis of the influence of structural characteristics of countries - technocracy is strengthened by open democracy.
title_full When Covid-19 first struck: Analysis of the influence of structural characteristics of countries - technocracy is strengthened by open democracy.
title_fullStr When Covid-19 first struck: Analysis of the influence of structural characteristics of countries - technocracy is strengthened by open democracy.
title_full_unstemmed When Covid-19 first struck: Analysis of the influence of structural characteristics of countries - technocracy is strengthened by open democracy.
title_short When Covid-19 first struck: Analysis of the influence of structural characteristics of countries - technocracy is strengthened by open democracy.
title_sort when covid 19 first struck analysis of the influence of structural characteristics of countries technocracy is strengthened by open democracy
url https://doi.org/10.1371/journal.pone.0257757
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