key: cord-0712585-xzfxgsfw authors: Jung, Anne-Sophie; Haldane, Victoria; Neill, Rachel; Wu, Shishi; Jamieson, Margaret; Verma, Monica; Tan, Melisa; De Foo, Chuan; Abdalla, Salma M; Shrestha, Pami; Chua, Alvin Qijia; Bristol, Nellie; Singh, Sudhvir; Bartos, Michael; Mabuchi, Shunsuke; Bonk, Mathias; McNab, Christine; Werner, George K; Panjabi, Raj; Nordström, Anders; Legido-Quigley, Helena title: National responses to covid-19: drivers, complexities, and uncertainties in the first year of the pandemic date: 2021-11-29 journal: BMJ DOI: 10.1136/bmj-2021-068954 sha: 4bf441099a95d633fb96137e34512de4970c6e14 doc_id: 712585 cord_uid: xzfxgsfw Anne-Sophie Jung and colleagues argue that research and policy making must embrace complexity to build sustainable and long term approaches to pandemic preparedness The central government engages infrequently with regional health authorities. In the early stages (end of March), the president convened via teleconference between regional health governors together with the Minister of the Interior, the Minister of Health, and the Minister of Agriculture. They each presented the plans of their sectors and the measures that are adopted to guarantee security and food supply. The Ministry of Health initiated a national meeting of state governors and health authorities to coordinate efforts to respond to COVID-19. During the meeting, state authorities agreed to participate in working groups to learn first-hand the national situation, updates, and the decisions made to address each step of the pandemic. It was also agreed that local and municipal governments will be involved and will collaborate on communicating cases, incidents, and necessary actions. Germany: A whole-of-government approach was adopted. At the national level, the central government convenes weekly as the "Small Corona Cabinet". It consists of the Chancellor and various ministries. Additionally, the government convenes on a weekly basis in the "Large Corona Cabinet". Besides the members of the small cabinet, ministers from specific ministries depending on issues discussed are invited to join. The Ministry of Health and the Ministry of Home Affairs and Sports established a crisis committee, which helps with the operationalization and implementation of decisions made by the Corona Cabinets. The Ministry of Health also hosts a working group, which consists of experts from the Ministry of Finance and the Ministry for Foreign Affairs, as well as contact persons from the private sector. Japan: Set up the Coronavirus task force which consists of diverse medical experts (virologists, infectious disease, molecular genetics, genomic medicine, and computational science) and includes 36 high-ranking bureaucrats from several ministries. The headquarters acts as the site of the prime minister's decision-making process on the country's virus countermeasures. Countries with the least deaths per 100,0000, with a population of over 20 million Countries with the most deaths per 100,0000, with a population of over 20 million Countries in the middle category in terms of deaths per 100,000 population Waves & variants of concern China: First wave of the epidemic in Hubei province, with lockdowns introduced in parts of the province starting 23 January and lasting until March-April 2020. Vietnam: Resort city of Da Nang evauated 27 July after outbreak of COVID-19, requiring the movement of some 80,000 people. In 2020, Pakistan's GDP contacted by 1.5%, with 50% of the population seeing income or job impacts from the pandemic. The impacts are concentrated among informal and low-skilled workers, and poverty has increased from 4.4 to 5.4% in 2020. Thailand: In December 2020, an outbreak was reported in Samut Sakhon, which is home to many migrant workers. To contain the outbreak, which started at a market and its dormitories, mass testing was conducted and strict public health measures were enforced. Vietnam: In December 2020, over 100,000 students in Ho Chi Minh City were told to stay at home, and a dormitory was closed, after a teacher contracted COVID-19 from an imported case. United Kingdom: In September 2020 multiple outbreaks were reported in universities across the UK. Students were asked to selfisolate in dorms and refrain from socialising. In October 2020, students in a dormitory in Valencia were found to have a 20% test positivity rate, which prompted a switch to online learning. Singapore: In May 2020, 86% of the country's 17,548 COVID-19 cases were reported from foreign worker dormitory residents; multiple response measures were enacted in reaction to contain the outbreak and prevent future cases. Cases and deaths reported due to COVID-19 as of 06 Gross Domestic Product (GDP) as of ZS Hospital beds per 1,000 population as of most recent year data Mixture of public and private sectors. Hea primarily the responsibility of the prov government and is provided through a th tiered delivery system starting with Basic H Units. In early 2021, the province of Kh Pakhtunkhwa became the first to provide a care (up to 6497 USD/1 million Rs), however of the population of the population in Pak pays large amounts out-of-pocket for care. The National Healthcare Fund (FONASA) is financial entity responsible for collecting allocating resources to the health system. T are two main schemes, one for direct p healthcare for lower income groups and other is the National Health Insurance Sy that subsidises private health services fo employees and their families, pensioners, retirees. Sources: