The following article is intended to serve as a cribsheet for policymakers dealing with the COVID-19 pandemic. It does not pretend to have all the answers; but does not even pretend to have all the questions. However, we hope that it will help government officials and others responsible for responding to coronavirus in their country with important considerations to bear in mind when making policy.
General
* What is the spiritual and moral state of the nation?
Nations’ response to crises reveals something very deep about our spiritual state and moral fibre. Righteousness exalts a nation. Great leaders uphold and are upheld by their nation in prayer. Will you as Churchill in the Blitz did call the national to prayer?
* How will fundamental rights and liberties be protected?
The current pandemic is not the first major crisis to come along, and while countries may decide to impose coercive temporary restrictions on those suspected of or known to have the virus, respect for inherent human rights remains of great importance. John Whitehead described the danger in a recent article thus:
Emboldened by the citizenry’s inattention and willingness to tolerate its abuses, the government has weaponized one national crisis after another in order to expands its powers.
* Where will your Government’s focus be during the crisis? Can you maintain control of all critical elements?
The WHO’s message to governments on 11 March 2020 suggested the following foci, courtesy of Zerohedge:
I have said from the beginning that countries must take a whole-of-government, whole-of-society approach, built around a comprehensive strategy to prevent infections, save lives and minimize impact
Let me summarize it in 4 key areas.
- Prepare and be ready.
- Detect, protect and treat.
- Reduce transmission.
- Innovate and learn”
I remind all countries that we are calling on you to (1):
- activate & scale up your emergency response mechanisms
- communicate with your people about the risks & how they can protect themselves
- find, isolate, test & treat every #COVID19 case & trace every contact”
I remind all countries that we are calling on you to (2):
- ready your hospitals
- protect and train your #healthworkers
- let’s all look out for each other”
* A pandemic makes enormous demands of policymakers. Are you up to it?
Government officials should remember this is a marathon, not a sprint. Stay sane! Stay sober! Keep healthy!
* Will government measures crush the upside benefits of the crisis?
When oil prices fall, this benefits haulage companies and commuters. When air travel collapses, this benefits air quality. If a pandemic causes house prices to plummet, young couples who were previously unable to buy their first home might be able to get a foot on the property ladder. If companies lose staff to the virus, as tragic as this would be, it will also give opportunities to the unemployed and unpromoted to assume greater responsibility.
While we would not necessary desire any of these ends, neither is it necessarily right to respond to dramatic changes in social and economic circumstances by seeking to revert to the previous states of affairs. Disruption in global supply chains may well give your manufacturers the opportunity to get a start on foreign competition. If your government attempts to solve immediate problems by paying a over the odds on international markets for scarce medical supplies which could have been produced domestically, it will crush the upside benefits of this otherwise sad crisis for the local economy.
Governance and Management
* How will the crisis be managed? What a crisis management mechanisms exist? Is there a crisis management team? Is there strong coordination across sectors and stakeholder authorities? What is the nature of its the crisis team’s authority?
* Is there a public health emergency operation centre (PHEOC) in place?
* What are the governing national laws? Is there a need for emergency legislation or are existing provisions sufficient? How will legislation be passed if lawmakers are ill? Will the emergency legislation rollback additional government powers following the outbreak?
* Which parties are responsible for the development of strategy and policy on a strategy level? Who will take a lead on developing relevant legislation?
* On the implementation side, do all parties know their relevant roles and responsibilities? Are chains of command fit for purpose?
Strategy
* What existing pandemic planning is in place?
* Is there an existing National Action Plan for Health Security (NAPHS)? Is there a Pandemic Influenza Preparedness Plan? Do these need adapted for COVID-19?
* What epidemiological estimates have been made for the possible spread of the disease in your country? Who has conducted these?
* Have the relevant capacity analysis been undertaken? What about risk assessments?
* What scenario planning has been conducted? Does foresighting cover the economic and social consequences of a pandemic?
* Are policymakers and decision-makers able to access relevant information, data and research from a wide variety of sources?
Non-managed information flows can be crucial to overcoming ‘executive blindness’. How would you balance social media reports of children suffering and dying from the coronavirus in Iran via Twitter, with academic reports from China saying that children are unaffected. Maintain a critical attitude; keep your scepticism!
Communications
* Who will take the lead with public engagement? Will the pandemic response have a “face”?
* What are the primary channels for communication with the public?
* How to make sure that communication is two-way? Are policymakers able to “hear” the public? Is communication surrounding the pandemic being appropriately balanced with other communications? Are communications proactive rather than reactive?
* Do communications need to be translated? Are they accessible to the blind and deaf?
Surveillance and Monitoring
* What phase of the pandemic is your country in? Are your response appropriate?
* Are all necessary data monitoring mechanisms in place? What monitoring and reporting protocols are in place? Are you able to access “robust and timely” data analysis?
* Have case finding and surveillance systems being implemented?
* Do you have rapid response teams in place to investigate clusters and undertake contact tracing?
* Who will conduct the post-epidemic response review?
Flattening the Curve
* What measures can be taken to #flattenthecurve?
Movement Restrictions
* What measures will be put in place at points of entry?
* Will direct air or land travel from certain countries be suspended? What are the criteria for suspension? What are the criteria for reinstatement?
* Will a prospective entrant’s travel history be taken into consideration when determining whether to allow them admission?
* How will visa applications be affected?
* What about those currently in-country unable to travel internally or leave because of the outbreak? Will they be given automatic visa extensions?
* What about illegal aliens/those subject to deportation who would be subject to risk by being returned to their home country?
* How will the country respond to deportation orders received from overseas?
Lockdowns
* Should large events be cancelled?
* Should in-person preschool, primary, secondary, vocational and higher education be suspended? What provisions are in place for childcare for children whose parents are working? Family support etc.
Quarantines
* Will travellers from certain countries be quarantined?
* How long will suspected cases be asked to self-quarantine? Will home quarantines be enforced? If so, how? And by whom?
Sanitary Measures
* Will there be disinfection of public places? What disinfectants will be used? Are these safe? How will the process be controlled?
* What protocols should be adopted for public toilets or toilets in public areas?
Case Management
* What protocols are being followed for treating cases? Are these unified across the country? Are they being reviewed? How frequently are they being reviewed? Do those responsible for their review have the resources they require? How are updates to protocols being communicated? What is the feedback loop from hospitals like?
Protection of frontline medical staff should be an absolute priority. A report from IRNA news agency illustrates this:
Mehdi Hosseini-Nejad, head of the Industry and Mines Organization in the Province of Kerman (southern Iran), was cited by IRNA news agency saying that 41 percent of Coronavirus cases in that province were from among the medical staff and personnel, due to shortage of “face masks, alcohol and gloves.”
* How should cases that present at hospital be managed?
* How should cases encountered in public places be managed?
* How should cases calling from home or office be managed?
Resources, Capacities and Logistics
* In the most general sense, what resources will be required to meet the outbreak?
* What resources exist in the third sector, from philanthropy, to meet the crisis?
* What is the current state of relevant inventories?
* Which resources are produced domestically? Are there threats to national producers’ ability to continue supply? What contingency plans exist for supply interruption or suspension?
* Which resources are produced internationally? Are there any threats to supply from overseas? What contingency plans exist for supply interruption or suspension?
Public Finances
* How solvent is the state? What’s happening in the bond market?
* Has forecasting been done on the potential impact of the outbreak on public finances? What is the potential downside on the income side? What is the potential downside on the expenditures side? Where does this leave public finances over various time periods? How will this shortfall be addressed?
* What is the current and projected state of the finances of regional, state or sub-federal public bodies? What planning is being done for subnational government cost overruns or defaults?
* What is the current and projected state of the finances of any other public authority?
Economic Consequences
* How will public health and economic concerns be balanced?
* What impact will a stock market crash have on business activity?
* Will the crisis give a boost to domestic production? How can it be used to repatriate or seed production at home?
Labour Market Consequences
* What is the risk of mass unemployment?
* What benefits will be available to those out of work? What social protections?
* How will return to work be managed?
Social Consequences
* How is morale? What can be done to improve it? Does your nation respond well to a crisis?
* What is the risk of popular unrest? What plans are in place to maintain law and order?
* What persons are dependent on state care? What will be done to mitigate disruption?
Prisons
* What measures will be taken to stop the spread of the virus in prisons?
Cooperation with Foreign Governments
* What are your priorities with regards to intergovernmental relations?
Coordination with International Agencies
* How will coordination with WHO be handled?
* What other international organisations demand your attention?
Picture by Dipartimento Protezione Civile from Italia – Emergenza coronavirus, CC BY 2.0, Link. “Roma, 6 febbraio 2020 – Il Presidente del Consiglio dei Ministri, Giuseppe Conte, presiede il Comitato Operativo della Protezione Civile, riunito per coordinare gli interventi finalizzati a ridurre il rischio da coronavirus. Presente anche il Ministro della Salute Roberto Speranza.”
