Community, Economy and COVID-19: Lessons from Multi-Country Analyses of a Global Pandemic (Community Quality-of-Life and Well-Being) 3030981517, 9783030981518

Table of contents :
Acknowledgments
Contents
Chapter 1: Community, Economy and COVID-19: A Primer for Lessons from Multi-Country Analyses of a Global Pandemic
1.1 Introduction
1.2 The Unique Contribution of This Book
1.3 The Framework: Goals, Factors, and Relationships
1.3.1 Community Well-Being/QOL
1.3.2 Macro Factors
1.3.3 Catalytic Institutions and Marketing Systems
1.3.4 Goods and Services
1.3.5 Citizen-Consumers
1.4 Country Analyses
1.4.1 Argentina
1.4.2 Australia
1.4.3 Brazil
1.4.4 Canada
1.4.5 China
1.4.6 Colombia
1.4.7 Croatia
1.4.8 Finland
1.4.9 Germany
1.4.10 Ghana
1.4.11 India
1.4.12 Indonesia
1.4.13 Lebanon
1.4.14 Mexico
1.4.15 New Zealand
1.4.16 Russia
1.4.17 Rwanda
1.4.18 Singapore
1.4.19 South Africa
1.4.20 South Korea
1.4.21 Spain
1.4.22 Sweden
1.4.23 Thailand
1.4.24 Turkey
1.4.25 United Kingdom
1.4.26 United States
1.4.27 Vatican
1.4.28 Vietnam
1.5 Prologue
References
Chapter 2: Antifragility Strategies: The Arbusta Case in COVID-19 Argentina
2.1 Introduction
2.2 Argentina, an Uncertain Context
2.2.1 Argentina and COVID-19
2.3 The Arbusta Case
2.3.1 Brief Background to the Argentine Technological Context
2.3.2 Brief History of Arbusta
2.3.3 Arbusta and COVID-19 Impact
2.4 Discussion
2.4.1 Antifragility
2.4.2 Unbiased Attitude and Reflexivity
2.4.3 Tacit Talent
2.4.4 Redundancy and Plurality of Perspectives
2.5 Limitations and Future Research
2.6 Conclusions
References
Chapter 3: COVID-19 Response in Australia: An Examination of State Responses and System Vulnerabilities
3.1 Australia in COVID-19
3.2 Community Vulnerability and Flourishing
3.2.1 Determinants of Vulnerability and Resilience
3.2.2 Community Outcomes in Response to External Shocks
3.3 Australian Outcomes
3.3.1 Australia and the Australian Government´s Responses
3.3.2 Healthcare
3.3.3 Movement of People: International
3.3.4 Movement of People: Domestic
3.3.5 Employment
3.3.6 Industry: Individual Sectors
3.3.7 Summary
3.4 Case Study: The Single Lie That Shutdown a State
3.4.1 Background and Evolution of Events
3.4.2 Implications and Vulnerabilities
3.5 Lessons from the Australian COVID-19 Response
3.5.1 Role of Marketing
3.5.2 Conclusion
References
Chapter 4: Disdain, Generosity, and Solidarity as Institutional Responses to COVID-19 in Brazil
4.1 Introduction
4.2 COVID-19 Pandemic in Brazil: Effects over QOL
4.3 Macromarketing and the Role of Catalytic Institutions in Marketing Systems
4.3.1 Government: Disdain Against COVID-19-Case of the Bolsonaro Government
4.3.2 Business: Generosity Against COVID-19-Case of Itaú Unibanco
4.3.3 Social Movement: Solidarity Against COVID-19-Case of the Movimento dos Trabalhadores Rurais Sem Terra (MST)
4.4 Lessons and Final Thoughts
References
Chapter 5: Canada After COVID-19: A Flourishing Community for Everyone?
5.1 Introduction
5.2 The Canadian Context
5.3 Healthcare System
5.3.1 Healthcare in Canada: Before Covid
5.3.2 Healthcare in Canada: During Covid
5.4 Economic Equity
5.4.1 Poverty and Income Inequality in Canada
5.4.2 Childcare
5.4.3 Paid Sick Leave
5.5 Environmental (``Green´´) Factors
5.6 Putting It All Together
5.6.1 Paying the Bills
5.6.2 A Mandate for Change
5.7 Lessons Learned
5.7.1 Macro Factors
5.7.2 Catalytic Institutions
5.7.3 Towards a Canada Where Every One Flourishes
References
Chapter 6: Catalytic Institutions and Community Resilience: COVID-19, Obstacles, and Adaptive Mechanisms in Wuhan, China
6.1 Introduction
6.2 Inside Wuhan During the Pandemic
6.3 Political Sphere
6.4 Adverse Effect: Economic Loss and the Rise of Nationalism
6.5 Resilience as Metaphor and Adaptive Mechanism
6.5.1 ``Grid´´ Governance as an Institution
6.5.2 Collectivism as an Institution
6.5.3 The Interface of Policies and Economic Capital as an Institution
6.6 Application of the Community Well-Being Framework
6.7 Policy Implications and Lessons Learned
References
Chapter 7: Colombia: Resilience and Well-Being in Response to COVID-19
7.1 Introduction
7.2 Community Well-Being, a Systemic Framework
7.3 Colombian Vulnerability and Resilience Factors
7.3.1 Vulnerability Factors
7.3.1.1 Subsistence Marketplace Dynamics
7.3.1.2 Venezuelan Migration Crisis
7.3.2 Resilience Factors: Universal Health System
7.4 COVID-19 as a Disastrous Exogenous Force
7.5 Colombian Catalytic Institutions: Good Practices
7.5.1 Maintaining Citizen Subsistence Means
7.5.2 Broadening the Health Care System
7.6 Lessons Learned
References
Chapter 8: Croatia: Assessing Resilience and Responses of Firms and Consumers During COVID-19 Pandemic
8.1 Introduction
8.2 Literature Overview and Conceptual Development
8.2.1 Consumer Resilience During Crises
8.2.2 Firm Resilience During Crises
8.3 COVID-19 Pandemic in Croatia: Origins and Developments
8.3.1 Health Situation and Policy Reactions
8.3.2 Consumer Behavior During COVID-19
8.3.3 Firm Behavior During COVID-19
8.4 Primary Research
8.4.1 Consumer Resilience and Behavior During COVID-19 Pandemic
8.4.2 SMEs´ Resilience and Responses to Crisis
8.5 Discussion, Lessons, and Conclusions
References
Chapter 9: Finnish Response to the First Wave of COVID-19 Accentuated Persuasion
9.1 Introduction
9.2 The QOL Framework and the Finnish Response
9.3 A Finnish Perspective on COVID-19
9.3.1 Deaths and the Economy: It Could Have Been Even Worse
9.3.2 From Disease Control to Macro-Societal Persuasion
9.3.3 Dynamically Evolving Response
9.3.4 Key Macro-societal Responses in Finland
9.4 Discussion and Conclusions
Appendix 1: Selection of Government Communications on the Pandemic in Finland
Provision of Services and Utilities
Arrangements on Labor Market
Education in Welfare State
Flexibility of Finance
Recreation and Cultural Life
References
Chapter 10: The COVID-19 Outbreaks in the German Meat Industry: A Culturalistic Explanation
10.1 Introduction
10.2 Theoretical Foundations: Polanyi and Tönnies
10.2.1 Markets, Society, and Community
10.2.2 Embeddedness/Disembeddedness
10.2.3 Movements and Countermovements
10.2.4 Fictitious Commodities and the Liberal Market
10.3 Methodology and Case Study
10.3.1 Epistemological Background and Methodology
10.3.2 Posted Work in the German Meat Industry
10.3.2.1 The Event
10.3.2.2 Verl, Zollhausweg
10.3.2.3 Contracts for Work and Labor
10.3.2.4 The Rules of the Game
10.4 Case Analysis
10.4.1 The Rationalization of the HDE
10.4.1.1 Movement/Local (Cell 1, 1)
10.4.1.2 Movement/Trans-local (Cell 1, 2)
10.4.1.3 Countermovement/Local (Cell 2, 1)
10.4.1.4 Countermovement/Trans-local (Cell 2, 2)
10.4.1.5 Distinctions, but No ``False Dichotomies´´
10.4.2 Three Forms of Disembeddedness
10.4.3 Explanation of the Event
10.5 Conclusions, Outlook, and Limitations
References
Chapter 11: Ghana´s Response to the COVID-19 Pandemic
11.1 Background on Ghana, West Africa
11.2 Marketing Systems in Africa
11.2.1 Shortcomings of the African Marketing System
11.2.2 Essential Goods Distribution Network
11.2.3 Commodity Supply Chains
11.2.4 Informal Cross-Border Trade in African Marketing Systems
11.2.5 Vulnerabilities in Ghana´s Marketing System
11.2.6 Ghana´s Healthcare System
11.3 Ghana´s COVID-19 Containment Measures
11.3.1 Activity and Innovation Among Healthcare Catalytic Organizations
11.3.2 Expansion of Infrastructure for COVID-19 Testing, Treatment, and Management
11.3.3 Other Funding Interventions and Stimulus Packages
11.3.4 Social Safety Net Interventions Used During the Pandemic
11.4 Implications for Individual and Community Quality of Life and Best Practices
11.5 Conclusion
References
Chapter 12: Community and Market Development in India During Coronavirus: A Focus on the Migrant Worker (MW) Population
12.1 Introduction
12.2 The Great Indian Lockdown
12.2.1 Phase I (March 25 to April 14)
12.2.2 Phase 2 (April 15 to May 3)
12.2.3 Phase 3 (May 4 to May 17)
12.2.4 Phase 4 (May 18 to May 31)
12.3 MWs and Consumer Vulnerability
12.4 Evaluating Quality of Life (QOL) in the MW Community During the Coronavirus
12.4.1 Macro Factors
12.4.2 Role of Catalytic Institutions
12.5 Implications and Discussion
12.6 Conclusion
References
Chapter 13: The Pillars of Survival in the COVID-19 Pandemic: The Case of Indonesia
13.1 Background: The Virus Arrives and a Nation Reacts
13.1.1 Overview of Indonesia: Geography, Political Structure, and Its People
13.1.2 COVID-Related Key Events and Timeline
13.2 Changes in Indonesian Consumer Behavior
13.2.1 Digitally Transformed Consumers
13.2.2 Shifts in Consumer Preferences and Consumption Behavior
13.3 The Unique Phenomenon of Diminishing Risk Perception in Indonesia
13.4 Pillars of Survival in Fighting COVID-19 in Indonesia
13.4.1 Government
13.4.2 Society and Community
13.4.3 Digital Transformation and Technology
13.4.4 National Value and Principle
13.5 Unity in Diversity and Mutual Cooperation as Foundation for Community´s Responses to the Pandemic
13.5.1 The Mutual Cooperation Vaccine Program (Vaksin Gotong Royong)
13.5.2 Fabric Masks Production and Distribution by Volunteers and Industries
13.5.3 The Social Collaboration Platform
13.5.4 Practicing Self-restrain from ``Mudik´´
13.5.5 Convalescent Plasma Donor Community
13.5.6 The Rise of the Civil Society Through Volunteerism
13.6 A Final Thought from a Diverse and Unified Indonesia
References
Chapter 14: Fighting COVID-19 in a Multicrisis Context: The Case of Lebanon
14.1 Introduction
14.2 A Trilogy of Political, Economic, and Health Troubles
14.2.1 The Sectarian Political System
14.2.2 A Weak Economy
14.2.3 A Declining Health-Care Sector
14.3 Amplifying the Crisis: Religious, Cultural, and Demographic Specificities
14.4 COVID-19 and Vulnerable Communities
14.5 The Role of the Media
14.6 Government Mistrust
14.7 Lessons and Conclusion
References
Chapter 15: Loss of Well-Being During COVID-19 Pandemic in Mexico: A Public Policy Analysis Using a Systemic Approach
15.1 Introduction
15.2 Initial Framing of the Macro Systemic Analysis
15.3 The Loss of Well-Being Related to Health Care Issues
15.4 The Loss of Well-Being Related to Economic Issues
15.5 Lessons and Policy Recommendations
15.6 Conclusions
References
Chapter 16: COVID and New Zealand: An Outlier Case
16.1 New Zealand
16.2 The History of COVID-Free New Zealand: Lucky and Good
16.2.1 Essential Retail Only: Creating a Monopoly for Supermarkets
16.2.2 The Labor Market and Wage Subsidies: The Good, the Bad, and the Ugly
16.2.2.1 Unemployed Through COVID: ``Unlucky´´/Lucky Job Losses
16.2.3 Tourism in New Zealand
16.2.3.1 America´s Cup 2021
16.2.4 International Education in New Zealand
16.2.5 COVID and the New Zealand Housing Market
16.2.6 Primary Industries and COVID
16.2.7 Medical Supply Chains
16.3 The Impact of COVID on the NZ Economy and Markets: Into the Great Unknown
References
Chapter 17: Rwanda Galvanizes Healthcare Readiness, Citizen Support, and Technology to Flatten the Coronavirus Curve in the La...
17.1 Introduction
17.2 Conceptual Framework
17.3 Rwanda: Macro-factors
17.3.1 History Matters
17.3.2 Economics Matters
17.3.3 Social Context Matters
17.3.4 Democratic Institutions
17.3.5 Trust in Public Communications
17.4 Catalytic Institutions and the COVID-19 Response
17.4.1 Building an Effective, Decentralized Healthcare System
17.4.2 Community Support
17.5 Implementing a Cross-Sectoral Collaborative Approach
17.5.1 Border Screening and Controls
17.5.2 Contact Trancing
17.5.3 Pool Testing
17.5.4 Mass Mobilization
17.6 Technology and Innovation
17.6.1 Internet and Mobile Connectivity
17.6.2 Drones
17.6.3 Robots
17.7 Lessons Learned: COVID-19 Strategy
17.8 Framing the Shultz et al. Framework in the Rwanda Setting
17.9 Decoloniality, Postcoloniality, and the Discourse Surrounding COVID-19
17.10 A Final Update
References
Chapter 18: COVID-19 Pandemic, Catalytic Institutions, and Consumer Well-Being: Evidence from Russia
18.1 Introduction
18.2 Timeline of the COVID-19 Pandemic in Russia
18.3 Background
18.4 QOL Indicators at the Wake of the COVID-19 Pandemic in BRICS
18.5 Engagement of Russian Non-government and Non-profit Organizations During Pandemic
18.6 Role of Industry Associations in Fighting the COVID-19 Pandemic
18.7 Digital Transformation of Russian Consumers
18.8 Methods
18.9 Findings
18.10 Conclusion and Lessons Learned
References
Chapter 19: Battling COVID-19 Pandemic in a Densely Populated Island Nation: The Singapore Experience
19.1 Background
19.2 COVID-19 Sequence of Events in Singapore
19.2.1 Pre-outbreak: 2 January to 6 February 2020
19.2.2 Developing Outbreak: 7 February to 31 March 2020
19.2.3 Escalating Outbreak: 1 April 2020 to 1 June 2020
19.2.4 Maintaining Outbreak: 2 June 2020 to 31 January 2021
19.3 Governmental Directives and Initiatives
19.3.1 Mask Wearing
19.3.2 Technologically Aided Surveillance
19.4 Emergent Issues
19.4.1 Health and Scientific Literacy
19.4.2 Digital Literacy and the Vulnerable Populations
19.4.3 Rise of Misinformation
19.5 Changes in Public and Consumer Behaviors
19.5.1 Shopping Behavior Change: Waves of Panic Buys
19.5.2 Movement Changes: Staying at Home Instead of Going Outside
19.5.3 Meal Habit Changes: More Delivery and Home Dining Instead of Dining Out
19.6 Special Considerations and Early Lessons
19.6.1 The Elderly
19.6.2 People with Disability, Special Needs, and Pre-existing Health Conditions
19.6.3 Children in Low-Income Households
19.7 Conclusions
References
Chapter 20: ``History Repeats Itself´´: South Africa, An Epic Sighting-COVID-19
20.1 Introduction
20.2 Background
20.2.1 History of Pandemics in South Africa
20.2.1.1 Spanish Influenza (1918-1919)
20.2.1.2 Poliomyelitis (1918-1945)
20.2.1.3 Malaria (1837-Current)
20.2.1.4 Tuberculosis and HIV/AIDS (Ongoing)
20.2.1.5 COVID-19 (2020-Ongoing)
20.2.1.6 Lockdown Levels in South Africa (Disaster Management Act)
20.3 Community Well-Being
20.4 Quality-of-Life Indicators
20.5 Health and Safety Indicators
20.6 Economic Indicators
20.7 Lessons Learned and Practices
20.8 Conclusion
References
Chapter 21: COVID-19 Pandemic and Its Impact on Consumers in South Korea
21.1 Introduction
21.2 Background
21.2.1 South Korea Before the COVID-19
21.2.2 Current State of the COVID-19 Pandemic in South Korea
21.2.3 The Role of the Korean Government (a Catalytic Institution)
21.3 Impacts of COVID-19 on Korean Consumption
21.3.1 Economic Impact
21.3.2 Consumption-Related Impact
21.3.3 Korean Consumers´ Response in the Midst of the Pandemic (Trend Overview)
21.3.3.1 Trend 1: Contactless Consumption
21.3.3.2 Trend 2: Anxiety-Proof Consumption
21.3.3.3 Trend 3: Egocentric Consumption
21.4 Macro Factors Protecting Korean Consumers from Negative Externalities Associated with COVID-19
21.4.1 Government Policy: Policies that Ensure Regular Economic Activities
21.4.2 IT Infrastructure
21.4.3 Retailing Infrastructure: Fast Delivery of Goods and Services
21.4.4 Education: Digital Literacy (e.g., Smartphone Use)
21.4.5 Macro Factors, Consumption, and Quality of Life
21.5 Lessons Learned
21.5.1 The Possible Mechanisms for Why the Pandemic Decreases Consumers´ Quality of Life
21.5.2 Enabling Macro Factors Under the Pandemic
21.5.2.1 Administrative Roles to Keep the Balance Between Economic Stability and Public Health
21.5.2.2 Reliable IT and Retailing Infrastructure as the Backbone of Communities Under the Pandemic
21.5.2.3 Digitally Educated Individuals Well-Suited for Low Contact Way of Life
21.6 Suggestions for Ways to Enhance Quality of Life Given the Pandemic
21.6.1 Suggestions to Public Policy Makers
21.6.1.1 Trust Management Among Citizens
21.6.1.2 Compensation Plans for Businesses at Risk
21.6.1.3 Systematic Public Mental Healthcare Program
21.6.1.4 Consumer Education for Online Transaction
21.6.2 Suggestions to Marketers
21.6.2.1 Enhancing Consumer In-store Experiences
21.6.2.2 Enhancing Consumer Online Experiences in Support of Technical Tools
21.6.2.3 Socially Responsible Actions that Match Societal Needs
21.7 Conclusion
References
Chapter 22: The Role of Spain´s Catalytic Institutions to Facilitate Community Well-Being During the COVID-19 Pandemic
22.1 Introduction
22.2 Pre-pandemic Spain and the Arrival of SARS-CoV-2
22.2.1 Population
22.2.2 Housing
22.2.3 Education and the Digital Divide
22.2.4 Health
22.2.5 Politics
22.2.6 Economics
22.2.7 Business Landscape
22.2.8 Social Exclusion
22.2.9 Third Sector of Social Action
22.3 Methods
22.4 Response to First Wave: From Shock to Institutional Dynamism
22.4.1 Affected Groups and QOL
22.4.2 Nature of the Actions Administered
22.5 The Role of Catalytic Institutions
22.5.1 Government
22.5.2 Business Corporations
22.5.3 Third Sector of Social Action
22.5.4 Civil Society
22.6 The Impact of COVID-19: Vulnerability as a Challenge
22.7 Lessons Learned
22.7.1 Disaster Response
22.7.2 Response Effectiveness
22.7.3 Constructive Engagement Among Catalytic Institutions and Their Stakeholders
22.7.3.1 Establish a Solid Institutional Landscape
22.7.3.2 Recognize Other Catalytic Institutions as Valid Partners
22.7.3.3 Recognize Other Key Social Institutions in the Community
22.7.3.4 Understand Common Self-interests
22.7.3.5 Establish Coordination Mechanisms
22.7.3.6 Know When: And When Not: To Take Credit
22.7.3.7 Evaluate the Impact of Actions
22.8 Conclusion
References
Chapter 23: Case Study: Swedish COVID-19 First Wave Response in European Context
23.1 Sweden in COVID-19
23.1.1 COVID-19 Outbreak in Sweden
23.2 The COVID-19 Response in General
23.3 The Swedish Response
23.3.1 The ``Swedish Lockdown´´
23.3.2 To Test or Not to Test?
23.4 Impact of COVID-19 First Wave in Sweden
23.4.1 Impact on the Healthcare System
23.4.2 COVID-19 Immediate Economic Impact
23.5 Discussion
References
Chapter 24: Thailand and COVID-19 Pandemic: Lessons Learned, Challenges, and the Silver Linings
24.1 Introduction
24.2 Timeline of COVID-19 Pandemic in Thailand
24.3 Key Measures Implemented for Controlling COVID-19 Outbreak in Thailand
24.3.1 Managing Emergency Crises in Public Health
24.3.2 Preventing and Controlling Local Spread of the Disease
24.3.3 Diagnosing, Treating, and Developing Vaccines
24.3.4 Promoting Health Policies for Disease Prevention
24.3.5 Restoring Wellbeing of Pandemic-Affected People and Citizen Participation
24.4 Factors Contributing to Thailand´s Success in Controlling COVID-19 Pandemic
24.5 Lessons Learned, Challenges, and Silver Linings of COVID-19 Pandemic
24.5.1 Global Challenges and SDGs
24.5.2 ``New Normal´´
24.5.3 Supplies of Basic Needs
24.5.4 Global Leaders and Multilateral Collaboration
24.5.5 Community´s Three Pillars
24.5.6 Environmental Gains
24.6 Conclusions
Appendices
Appendix 1
Appendix 2
Highlights of Interview with Key Informant 1-September 14, 2020
Appendix 3
Highlights of Interview with Key Informant 2-September 25, 2020
Appendix 4
Highlights of Interview with Key Informant 3-October 2, 2020
Appendix 5
Highlights of Interview with Key Informant 4-October 8, 2020
Appendix 6
Highlights of Interview with Key Informant 5-October 13, 2020
References
Chapter 25: Local-Level ``Best Practices´´ During COVID-19 and Their Impact on Community Well-Being: Cases from the Municipali...
25.1 Introduction
25.2 Brief History and the Impact of COVID-19 in Turkey
25.2.1 Economic Impact
25.2.2 Social Impact
25.2.2.1 Changing Lives and Intensified Vulnerabilities of Women
25.2.2.2 Changing Nature of Vulnerable Groups for Social Services
25.3 Social Aid Programs to Maintain the Well-Being of Kadköy Community
25.3.1 Challenges Faced During the Design and Implementation of Social Services
25.3.2 Catalytic Institutions that Facilitated the Delivery of Social Services
25.3.3 Positive Externalities Created
25.4 Putting It All Together
25.5 Concluding Remarks and Lessons for Future Crises
References
Chapter 26: A Solidarity-Care Ethics and Human Flourishing Approach to the COVID-19 Pandemic: A UK Perspective
26.1 Introduction
26.2 Introduction to SRS and SHK
26.2.1 Overview of the SRS Model
26.2.2 Overview of the SHK Framework
26.2.3 How SRS and SHK Are Similar
26.2.4 How SRS and SHK Differ
26.2.5 The Fused SRS-SHK Framework
26.3 The UK Context
26.4 The United Kingdom´s COVID Response
26.4.1 Solidarity-Care Ethics Level 1: Solidarity for and Caring About the ``Other´´
26.4.2 Solidarity-Care Level 2: Solidarity with and Caring for ``the Other´´
26.4.3 Solidarity-Care Level 3: Solidarity as and Caring as Giving for the ``Other´´
26.5 Discussion
26.6 Conclusion
References
Chapter 27: A Matter of Trust: The COVID-19 Pandemic in the United States amidst Political and Media Polarization, and a Narci...
27.1 Introduction
27.2 Catalytic Institutions and Greater Community Responses to the Pandemic
27.3 Macro Factors System Impact: Federalism and Political Polarization
27.4 Infodemic: Systemic Misinformation and Disinformation by a Complicit Media and the Executive Branch
27.5 Evolution and Structure of the US Health System
27.5.1 The Public Health System in Flux
27.5.1.1 Health-Care Deserts: Underserved Urban and Rural Communities
27.5.1.2 The Public Health Imperative
27.6 When the Needs of the Few Outweigh the Needs of the Many
27.6.1 US Political Leadership During the COVID-19 Pandemic
27.6.2 National Mitigation Efforts
27.6.3 The Vaccine: Operation Warp Speed
27.6.4 The New Leadership Effect
27.7 The Damage Done: Vaccine Miracle-cum-Nightmare of Doubt and Resurgence
27.8 Lessons, the Future, and Policy Implications
References
Chapter 28: The Vatican´s Response to the Coronavirus Pandemic: The COVID-19 Commission and Preparing the Future
28.1 Introduction
28.2 The Vatican COVID-19 Commission
28.2.1 Working Group 1: Acting Now for the Future
28.2.2 Working Group 2: Looking to the Future with Creativity
28.2.3 Working Group 3: Communicating Hope
28.2.4 Working Group 4: Seeking Common Dialogue and Reflection
28.2.5 Working Group 5: Supporting to Care
28.3 Quality of Life (QOL): The COVID-19 Commission as a Catalytic Institution Facilitator
28.4 Conclusion
References
Chapter 29: Vietnam in the Combat Against COVID-19: Responses of the Government and Cooperation Among Stakeholders
29.1 Introduction
29.2 Overview of the COVID-19 Pandemic Situation in Vietnam
29.3 Impacts of the COVID-19 Pandemic on Vietnamese Citizens and Businesses
29.3.1 Impact on Citizen QOL
29.3.2 Impact on Businesses
29.4 Responses of the Government and Cooperation Among Stakeholders During the Pandemic
29.4.1 Responses of the Government
29.4.2 Responses of Businesses
29.4.3 Responses of NGOs
29.4.3.1 Case 1: Plan International Vietnam During the COVID-19 Pandemic
29.4.3.2 Case 2: Seed to Table
29.4.4 Responses of Citizens
29.4.5 Cooperation Among Stakeholders
29.5 Challenges, Lessons, and Implications for Policymakers
29.6 Conclusion
Appendix
References
Chapter 30: Effective Interventions to Mitigate the Ill-Being Effects of COVID-19: Lessons Learned from Countries Around the W...
30.1 Introduction
30.2 Interventions Deemed Effective in Mitigating the Spread of COVID-19
30.2.1 Interventions by the Public Health System
30.2.2 Interventions by Government
30.2.3 Interventions by Non-governmental Organizations
30.3 Moderating Factors Related to Public Health Interventions
30.3.1 Demographic, Geographic, and Socio-cultural Moderators
30.3.2 Institutional and Other Macro Moderators
30.4 Interventions Deemed Effective in Mitigating the Adverse Economic and Social Effects
30.4.1 Interventions by Government Institutions
30.4.2 Interventions by Non-government Institutions
30.5 Epilogue
References

Citation preview

Community Quality-of-Life and Well-Being

Clifford J. Shultz, II Don R. Rahtz M. Joseph Sirgy   Editors

Community, Economy and COVID-19 Lessons from Multi-Country Analyses of a Global Pandemic

Community Quality-of-Life and Well-Being Series Editor Rhonda Phillips, Purdue University, West Lafayette, IN, USA Editorial Board Members Meg Holden, Urban Studies Program, 2nd Floor, Simon Fraser University, Vancouver, BC, Canada Charlotte Kahn, Boston Foundation, Boston, USA Youngwha Kee, Soongsil University, Dongjak-Gu, Korea (Republic of) Alex C Michalos, Faculty of Arts, Brandon University, Brandon, MB, Canada Don R. Rahtz, Sadler Center, College of William & Mary, Williamsburg, USA Joseph Sirgy, Virginia Polytechnic Institute, Blacksburg, VA, USA

The Community Quality of Life and Well-being book series is a collection of volumes related to community level research, providing community planners and quality of life researchers involved in community and regional well-being innovative research and application. Formerly entitled, Community Quality of Life Indicators: Best Practices, the series reflects a broad scope of well-being. Next to best practices of community quality-of-life indicators projects the series welcomes a variety of research and practice topics as related to overall community well-being and quality of life dimensions, whether relating to policy, application, research, and/or practice. Research on issues such as societal happiness, quality of life domains in the policy construct, measuring and gauging progress, dimensions of planning and community development, and related topics are anticipated. This series is published by Springer in partnership with the International Society for Quality-of-Life Studies, a global society with the purpose of promoting and encouraging research and collaboration in quality of life and well-being theory and applications.

Clifford J. Shultz, II • Don R. Rahtz • M. Joseph Sirgy Editors

Community, Economy and COVID-19 Lessons from Multi-Country Analyses of a Global Pandemic

Editors Clifford J. Shultz, II Loyola University Chicago Chicago, IL, USA

Don R. Rahtz William & Mary Williamsburg, VA, USA

M. Joseph Sirgy Pamplin College of Business Virginia Tech Blacksburg, VA, USA WorkWell Research Unit, Faculty of Economic and Management Sciences North West University Potchefstroom Campus, South Africa

ISSN 2520-1093 ISSN 2520-1107 (electronic) Community Quality-of-Life and Well-Being ISBN 978-3-030-98151-8 ISBN 978-3-030-98152-5 (eBook) https://doi.org/10.1007/978-3-030-98152-5 © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Dedicated to the memory of the millions of people who lost their lives during the COVID19 pandemic and to the survivors working earnestly to ensure a similar, preventable public-health crisis never again occurs.

Acknowledgments

We wish to thank our contributors to this book, who shared their time, energy, and keen insights in service to the academy and to the well-being of their communities, countries, and humanity. We thank Rhonda Phillips and the staff at Springer for being early champions of this project, and we thank our families for their patience, understanding, and tireless support as we wrote, reviewed, edited, discussed, and assembled chapters on the scholarly journey that culminated in this tome. We also would like to acknowledge the millions of people who suffered and perished during the COVID-19 pandemic. You are not forgotten. Lastly, we salute the billions of others who have endured this global crisis—and perhaps have discovered or implemented best practices, appropriate behaviors, and lessons to end it—so that the next pandemic and its devastating effects will be averted, mitigated, or expeditiously ended.

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Contents

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Community, Economy and COVID-19: A Primer for Lessons from Multi-Country Analyses of a Global Pandemic . . . . . . . . . . . . Clifford J. Shultz II, M. Joseph Sirgy, and Don R. Rahtz

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Antifragility Strategies: The Arbusta Case in COVID-19 Argentina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Liza Kharoubi Echenique and Jaqueline Pels

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COVID-19 Response in Australia: An Examination of State Responses and System Vulnerabilities . . . . . . . . . . . . . . . . . . . . . . . Michael Polonsky and Virginia Weber

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Disdain, Generosity, and Solidarity as Institutional Responses to COVID-19 in Brazil . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Marcus Wilcox Hemais, João Felipe R. Sauerbronn, Ronan Torres Quintão, and Eduardo Teixeira Ayrosa

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Canada After COVID-19: A Flourishing Community for Everyone? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Stanley J. Shapiro and Julie Stanton

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Catalytic Institutions and Community Resilience: COVID-19, Obstacles, and Adaptive Mechanisms in Wuhan, China . . . . . . . . . 119 Jie G. Fowler, James Gentry, and Rongwei Chu

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Colombia: Resilience and Well-Being in Response to COVID-19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Andrés Barrios, Marcos Ferreira Santos, and Héctor Erlendi Godoy Hernández

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Croatia: Assessing Resilience and Responses of Firms and Consumers During COVID-19 Pandemic . . . . . . . . . . . . . . . . . . . . 155 Dario Miočević, Ivana Kursan Milaković, Biljana Crnjak-Karanović, Mirela Mihić, and Antonija Kvasina

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Finnish Response to the First Wave of COVID-19 Accentuated Persuasion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Petteri Repo, Pia Polsa, and Päivi Timonen

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The COVID-19 Outbreaks in the German Meat Industry: A Culturalistic Explanation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 Michaela Haase and Anne Schade

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Ghana’s Response to the COVID-19 Pandemic . . . . . . . . . . . . . . . . 233 Charlene Ama Dadzie

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Community and Market Development in India During Coronavirus: A Focus on the Migrant Worker (MW) Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251 Nicholas J. C. Santos and Subhasis Ray

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The Pillars of Survival in the COVID-19 Pandemic: The Case of Indonesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267 Primidya K. M. Soesilo and Fathony Rahman

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Fighting COVID-19 in a Multicrisis Context: The Case of Lebanon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 Georges Aoun and Karine Aoun Barakat

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Loss of Well-Being During COVID-19 Pandemic in Mexico: A Public Policy Analysis Using a Systemic Approach . . . . . . . . . . . 305 Luis Raúl Rodríguez-Reyes, Mireya Pasillas, and Keren Camberos

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COVID and New Zealand: An Outlier Case . . . . . . . . . . . . . . . . . . 325 Ben Wooliscroft, Sabeehuddin Hasan, and Alexandra GanglmairWooliscroft

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Rwanda Galvanizes Healthcare Readiness, Citizen Support, and Technology to Flatten the Coronavirus Curve in the Land of a Thousand Hills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341 June N. P. Francis and Lama Mugabo

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COVID-19 Pandemic, Catalytic Institutions, and Consumer Well-Being: Evidence from Russia . . . . . . . . . . . . . 367 Alexander Krasnikov, Vera Rebiazina, and Svetlana Berezka

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Battling COVID-19 Pandemic in a Densely Populated Island Nation: The Singapore Experience . . . . . . . . . . . . . . . . . . . . . . . . . 389 May O. Lwin, Chitra Panchapakesan, Anita Sheldenkar, Edson Tandoc Jr, Hye Kyung Kim, Shanshan Yang, Zoe Ong, Si Yu Lee, and Melissa Rachel Kwan

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“History Repeats Itself”: South Africa, An Epic Sighting—COVID-19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417 Stefan Kruger

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COVID-19 Pandemic and Its Impact on Consumers in South Korea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437 Grace B. Yu and Najung Kim

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The Role of Spain’s Catalytic Institutions to Facilitate Community Well-Being During the COVID-19 Pandemic . . . . . . . . 461 María José Montero-Simó, Rafael A. Araque-Padilla, Rosa Melero-Bolaños, and Clifford J. Shultz II

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Case Study: Swedish COVID-19 First Wave Response in European Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489 Ira Haavisto, Tommi Uimonen, Suvi Karvinen, Hlekiwe Kachali, and Riikka-Leena Leskelä

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Thailand and COVID-19 Pandemic: Lessons Learned, Challenges, and the Silver Linings . . . . . . . . . . . . . . . . . . . . . . . . . . 505 Busaya Virakul, Chartchai Na Chiangmai, and Kalayanee Senasu

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Local-Level “Best Practices” During COVID-19 and Their Impact on Community Well-Being: Cases from the Municipality of Kadıköy, Istanbul . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 531 Ahmet Ekici

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A Solidarity–Care Ethics and Human Flourishing Approach to the COVID-19 Pandemic: A UK Perspective . . . . . . . . . . . . . . . . 549 Haseeb A. Shabbir, Michael R. Hyman, and Alena Kostyk

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A Matter of Trust: The COVID-19 Pandemic in the United States amidst Political and Media Polarization, and a Narcissistic Presidency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 575 Don R. Rahtz, Clifford J. Shultz II, and M. Joseph Sirgy

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The Vatican’s Response to the Coronavirus Pandemic: The COVID-19 Commission and Preparing the Future . . . . . . . . . . 603 Nicholas J. C. Santos and Dominic H. Chai

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Vietnam in the Combat Against COVID-19: Responses of the Government and Cooperation Among Stakeholders . . . . . . . 611 Nguyen Thi Tuyet Mai and Mai The Cuong

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Effective Interventions to Mitigate the Ill-Being Effects of COVID-19: Lessons Learned from Countries Around the World . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 633 M. Joseph Sirgy, Clifford J. Shultz II, and Don R. Rahtz

Chapter 1

Community, Economy and COVID-19: A Primer for Lessons from Multi-Country Analyses of a Global Pandemic Clifford J. Shultz II

, M. Joseph Sirgy

, and Don R. Rahtz

Abstract The COVID-19 pandemic has swept across the planet, killing millions of people, at a cost of trillions of dollars and untold human suffering, leaving a wake of distress, despair, and dysfunction in communities large and small. In response to this global crisis, the editors assembled a team of leading scholars from 28 countries, representing seven continents. These scholars analyzed the countries, guided by a systemic framework to assess and ultimately to facilitate individual quality of life (QOL) and the well-being of communities and countries. This chapter provides an overview of the origins and evolution of the pandemic and the framework of analysis; it introduces author-teams, their countries, and the various foci of their studies vis-à-vis the pandemic. In the final chapter, we synthesize and interpret key findings from the studies. Each country offers lessons for discerning effective interventions to mitigate the ill-being effects of COVID-19; they collectively reveal constructive engagement among catalytic institutions and their stakeholders is vital to ensure that well-being is enhanced and people, communities, and countries can flourish. Keywords COVID-19 · SARS-CoV-2 · Pandemic · Community well-being · Constructive engagement · Marketing systems · Public health · Quality of life

C. J. Shultz II (*) Quinlan School of Business, Loyola University Chicago, Chicago, IL, USA e-mail: [email protected] M. J. Sirgy Pamplin College of Business, Virginia Tech, Blacksburg, VA, USA WorkWell Research Unit, Faculty of Economic and Management Sciences, North West University, Potchefstroom Campus, South Africa e-mail: [email protected] D. R. Rahtz Mason School of Business, College of William & Mary, Williamsburg, VA, USA e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_1

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Introduction

The emergence of the novel coronavirus, SARS-CoV-2, and the subsequent COVID-19 disease and pandemic is a global crisis of historic proportions. Not since the 1918 H1N1 pandemic,1 which killed approximately 50 million people worldwide (Taubenberger & Morens, 2006; cf. Spreeuwenberg et al., 2018), has a viral contagion swept so swiftly across the globe with such system wide, devastating effects: more than 233 million confirmed cases of COVID-19, more than 4.7 million deaths,2 and more than 6.1 billion vaccinations3 (World Health Organization (WHO), 2021a). Estimations of economic costs vary, but all of them are staggering and add up to trillions of US dollars (e.g., The Economist, 2021), with losses in future earnings estimated to be more than 10 trillion US dollars (Global Preparedness Monitoring Board, 2020). These measures do not capture the depth and breadth of suffering and disruption, and their ripple effects over space and time, which seemingly impact all aspects of human life, including the ecosystems in which we live and the well-being of our communities (United Nations, 2021; World Bank, 2021). Nor do they capture positive responses to this crisis that have saved lives and enhanced well-being, many of which we reasonably expect will continue to benefit humanity for years to come—assuming the appropriate vision, leadership, and commitment necessary to prepare for the next global health crisis. Pandemics of course are not a new phenomenon. The spread of infectious disease across a large region and potentially worldwide has shaped the path of human civilization for millennia. Thucydides (1989) wrote of a scourge, most likely plague, that ravaged the classical Greek world 2500 years ago. “The Black Death” that swept through Asia and Europe from the fourteenth to eighteenth century is estimated to have killed 75–200 million people—perhaps a third of Europe and a fifth of the world’s population. Pandemics by their very nature are deadly, far-reaching, cataclysmic, society-altering events with the power to shape humanity (Kelly, 2005; Loomis, 2018). That SARS-CoV-2 could be so damaging, so quickly, on so many measures to so many people and institutions, is mind boggling and humbling. The virus is the simplest of organisms—a protein and lipid sheath with protruding spikes, surrounding a single strand of RNA (Fischetti et al., 2020; Kakodkar et al., 2020; Walls et al., 2020). Amoral and apolitical, it apparently exists for a single purpose: to hijack cells of its host, which then replicate more virus. It is an obligate, intracellular parasite. In

Also known as “Spanish flu.” “The actual death toll from COVID-19 is likely to be higher than the number of confirmed deaths . . . due to limited testing and problems in the attribution of the cause of death” (Our World in Data, 2021). 3 When this chapter went to press, “Globally, as of 5:54 pm CEST, 1 October 2021, there have been 233,503,524 confirmed cases of COVID-19, including 4,777,503 deaths, reported to WHO. As of 29 September 2021, a total of 6,143,369,655 vaccine doses have been administered”; the WHO has reported the data, daily, via this link: https://covid19.who.int/ 1 2

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other words, without access to a living host, SARS-CoV-2 dies in fairly short order. Human behavior is ironically and tragically the primary driver of transmission among humans. Indeed, that behavior is responsible for the first infection in Homo sapiens, subsequent infections, and the pandemic conditions in which we currently find ourselves. Moreover, each new transmission presents opportunity for mutation, hence the arrival of new and potentially more deadly variants of the virus (Centers for Disease Control and Prevention (CDC), 2021). Common among Chiroptera (i.e., bats), the first evidence of human infection appeared in late 2019; the location was in Wuhan, China (Zhou et al., 2020). By most accounts, the transmission to humans occurred zoonotically—directly from one species to another, specifically, bat to human—and/or perhaps via a market or some other part of a food supply chain in which bats or other animals were prepared for human consumption (WHO, 2021b, pp. 112–118). A rival hypothesis suggests that this novel coronavirus was transmitted to humans in a laboratory, possibly manufactured or altered in some way for purposes unknown, or from some other “laboratory incident” (WHO, 2021b, pp. 118–120; WHO, 2021c). Whether the initial human infection resulted from zoonotic transmission or laboratory manufacture/mistake, SARS-CoV-2 has not been previously discovered in our species. Our behavior and the forces that dictate it—e.g., physics, chemistry and geography; culture, institutions, systems, and policies; markets, marketing, commerce, and consumption; the most basic and higher-order needs that dictate it; and the multiple ways in which these forces interact—caused or affected the initial transmission and infection. Our behavior vis-à-vis those forces continues to dictate the extent to which COVID-19 injures or kills or is mitigated and how and whether the virus spreads or will be contained and ideally eliminated. Therefore, SARS-CoV-2 and its human-to-human transmission are physically simple, but its global reach has been systemically complex. Similarly, solutions to spreading the virus are physically simple, but ending the COVID-19 pandemic will be systemically and globally complex—and administratively complicated—with profound implications for economies, community well-being, and individual quality of life (QOL). The process of ending this crisis will require courage, resilience, leadership, and perseverance, local and global collaboration among friends and foes, and the buy-in, cooperation, and vigilance of billions of people. The COVID-19 pandemic demands a systemic, global assessment and reckoning. Such reflection and accounting will mitigate the damages of future pandemics—or prevent them—and possibly other large-scale global disasters, as civic representatives, business leaders, and engaged citizens seek to implement best practices. More tangibly, it may serve to enhance and protect health, safety, and well-being for billions of people. This book aims to be helpful toward those objectives and outcomes.

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“Best” Practices

Macro Factors Geo/Environment Population Political/Legal Economic Social/Cultural Education Administration Infrastructure Technology

Community Well-Being/QOL Macro-Micro Links

Goods/Services Assortment Amount Quality Choice

Consumption/Demand

Catalytic Institutions

Marketing Systems

Government

NGO

Business

Distressed

Flourishing

Citizen-Consumers: Served/Under Served Potential Determinants Location/Access Income/Wealth/Capital Social/Cultural Capital Situational Commonalities Transparency/Accountability Motivation Market Literacy/Access

Fig. 1.1 Systemic framework to facilitate QOL in distressed and flourishing communities (Source: Shultz et al., 2017; see also Shultz et al., 2012)

1.2

The Unique Contribution of This Book

An event so consequential as a global pandemic, the scale, scope, and impact of COVID-19 inevitably will produce myriad research projects, analyses, scholarly articles, books, briefs, regulations, decrees, commentaries, and editorials. It currently evokes a continuous cycle of information, often with competing agendas, in both scientific and popular media, especially social media. That torrent of information— including misinformation—is so overwhelming “infodemic” has entered our lexicon. As such, the WHO maintains a website for “Infodemic Management” (WHO, 2021d). So, why this book; what is its unique contribution? How will it be useful to the reader in a world in which one has access to emerging new data, practically in “real time” via numerous sources and digital portals (e.g., CDC Covid Data Tracker, Worldometer, WHO Coronavirus [COVID-19] Dashboard, Our World in Statistics)? This book makes unique and useful contributions in several ways. First, the book shares well-informed, nuanced analyses of the COVID-19 pandemic via a systemic framework for analysis designed to enhance QOL in distressed and flourishing communities (Shultz et al., 2017). This framework, as seen in Fig. 1.1, emerged from decades of research and policy analyses (e.g., Hagerty et al., 2001; Shultz et al., 2012); it melds scholarly perspectives from several academic communities—e.g., macromarketing, sociology, urban planning, economics, psychology, health care, public policy, political science, and environmental and sustainability sciences, among others—with shared interests in individual, community, and societal well-being as aspirational outcomes for research, policy, and

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practice. The framework helps us better understand how catalytic institutions (government, business, and NGOs) influence community well-being and individual QOL. This influence is moderated and mediated by a host of macro factors (factors related to geography and the environment, population, political and legal, economics, social and cultural conditions, education, administration, infrastructure, and technology) which impact the extent to which needs of community residents are met. Versions of the framework have proven to facilitate an initial Gestalt for an array of well-being studies, from the Andes States (Sepulveda et al., 2020) to Zahlé, Lebanon (e.g., Shultz et al., 2020). It also has proven to be adaptive. That is, the framework can be expanded to include the addition of other salient factors, as was done for a sustainability study in Vietnam and the broader Mekong River Basin (e.g., Shultz & Peterson, 2019), or it can be synthesized in ways that permit researchers to focus on a subset of factors, as a research team has done studying refugee assimilation and shared well-being in the Middle East (DeQuero-Navarro et al., 2020). The systemic, holistic, and dynamic conceptualization of community well-being increasingly resonates across a broad spectrum of researchers and their interests (see also Phillips & Wong, 2017; Sirgy, 2021), including scholars studying service ecosystems (Trischler & Charles, 2019), fragile and conflicted states (Luiz et al., 2019), poor communities (Pels & Sheth, 2021), child labor (Maya Jariego, 2021), and disaster management (Arora & Chakraborty, 2021). We believe the COVID-19 pandemic—which has profoundly distressed communities, from small villages to nation states and indeed an interdependent global community—presents a seminal, global event to apply the framework and thus to enable a better and more systemic understanding of this crisis and accordingly some lessons to mitigate or end it. Contributors to the book reported its value in these regards when developing their chapters. Second, a global pandemic necessitates multicountry analyses from leading authorities in those countries. This book therefore shares expertise from exemplary scholars located in a select group of 28 countries representing seven continents.4 Countries were included in this project based on regional representation, variances in socioeconomic development and diversity of culture/ethnicity, political and economic models, variances in interventions to address the COVID-19 Pandemic, and the evolving successes and failures of those interventions. Each country and countless communities in them have been distressed by COVID-19. The level of distress varies widely; several factors affect where people and communities are positioned on a distressed-flourishing continuum. Among those factors are geography, climate and population density; ethnicity and culture; political and legal factors; economic development, infrastructure, health care, and social safety nets; various forms of capital; available goods and services; institutional leadership and collaboration; and baseline health and wellness prior to pandemic—indeed many, if not all, the factors

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Six of those continents are especially well represented. The seventh continent, Antarctica, is not included, but even its remote, small population of part-time residents has not escaped SARS-CoV-2 infection and the pandemic (Power & Dewar, 2021).

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in the framework and potentially others. Responses to the pandemic have varied widely, too. Contributing authors share analyses, denote failures/successes, and offer cases and lessons to mitigate or prevent future pandemics and possibly other crises and thus to restore or to enhance the health, safety, and well-being of community stakeholders. The expertise and reputations of the contributing authors are noteworthy; that they have chosen to participate in this project is also noteworthy. We believe readers will find their analyses and insights interesting and valuable. Below, we offer an overview of the framework and then introduce individual chapters.

1.3

The Framework: Goals, Factors, and Relationships5

The Systemic Framework to Facilitate QOL in Distressed and Flourishing Communities lays out and organizes several factors and forces, and relationships among them, which must be understood and considered by community members and potentially other stakeholders of the community. A brief overview of them follows.

1.3.1

Community Well-Being/QOL

Community well-being/QOL—seen inside a sphere, up and to the right of the model—is the goal. That goal may seem obvious, but the journey to achieve it often is not. Actualization requires several Macro-Micro Links, which must be recognized, understood, valued, and skillfully managed via “best practices.” “Macro Factors” are particularly salient, as geographical or environmental forces tend to be most constant. They often explain why communities are formed and thrive in some locations and not in others. Predictable and temperate climates, abundant water, food, building materials, and other resources often are predictors for flourishing communities. These physical assets make a place habitable; they may provide the foundation (literally) for a community and can sustain a population; again, they are necessary for it to flourish. Behavioral patterns, traditions, societies, and cultures arise from this foundation, as do political, economic, educational, and administrative models to manage resources, which enable a community to thrive. The absence, degradation, dysfunction, mismanagement, or sometimes deliberate destruction of these factors can greatly distress any community. Alternatively, changes to policy and practices can repair or bolster them, which in turn helps the community. Increasingly obvious to us are the game-changing effects of globalization, accordant technology—again, when managed well—and climate change and

5

The text in this section draws heavily from, synthesizes, and expands text previously published in Shultz et al. (2017, pp. 412–418).

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contagions such as SARS-CoV-2, the latter two of which are making environments less predictable. Good management necessitates cooperation among community stakeholders, and leadership from governments, NGOs, and businesses. Most governments now embrace market-oriented economies. Private sector business and entrepreneurship are deemed instrumental to national and community prosperity and improvements to individual QOL. Business is increasingly a catalyst to economic development and community QOL. However, business and the private sector more generally remain either underappreciated, suboptimally managed, or perhaps even nefariously engaged in many communities, hence the representation of the three interdependent “catalytic institutions,” which must cooperate for communities to flourish. These institutions often spark the mix of forces that constitute the Macro-Micro link(s) and thus truly are “catalytic”; they enable communities to create marketing systems capable of delivering an assortment of quality goods and services in amounts and variety that provide community members (citizen-consumers, i.e., community residents) almost countless choices, from building supplies and healthcare products to education and entertainment. “Citizen-consumers” are arbiters of the effectiveness of the catalytic institutions. Distressed communities tend to have disproportionately large numbers of underserved citizen-consumers, who may be disenfranchised from or may not feel as if they are citizens of any community. Several factors potentially determine whether consumers are underserved or well served and, moreover, what variables might be addressed by catalytic institutions to ensure all citizens can be served, so the community may flourish. Location and access, income/wealth/capital, social/cultural capital, and situational commonalities are among those factors. Readers should note the dotted line that connects consumer-citizens to Macro Factors, creating a crucible of sorts in which the three catalytic institutions interact. This arrangement reminds that key predictors are linked via catalytic institutions and the marketing system that emerges from those institutions. The catalysts, the marketing system, and the consumers in that system determine the demand, availability, assortment, amount, quality, and choices of goods and services to enhance community well-being. “Best practices” are sought throughout the system, from production to consumption, to disposal and possibly to reuse in a circular economy. Note that “best” is a relative term, greatly influenced by culture and other factors. Similarly, “appropriate” measures for QOL and “good” or “high” scores on them also might be relative. Flourishing communities tend to have marketing systems that deliver goods and services valued by citizen-consumers of those communities. Perceptions/measures of quality of life accordingly tend to indicate high levels of health, happiness, and satisfaction. Transparency, purchasing power, and market literacy also are important; they also may be unappreciated or dismissed. Flourishing communities have wellfunctioning marketing systems with transparent laws, accounting procedures, and traceable behaviors, thus reducing citizen-consumer risk and enhancing empowerment. Such systems also have—and continually strive to improve—citizen-

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consumers who are market literate, which in turn renders consumers more motivated to participate in and be engaged with responsible marketing activities and stakeholders throughout the system. Through their choices and behaviors, including political participation, consumer-citizens can influence catalytic institutions, and best practices and community well-being. In our view, citizen-consumers of any community aspire to a QOL as measured potentially by many possible indices; they require various goods and services to actualize well-being. A number of endogenous or idiosyncratic factors (e.g., financial and social capital, motivation, literacy) macro factors (e.g., physical, political, economic, social, technological), and catalytic institutions interact to determine whether an appropriate marketing system will emerge and evince best practices to deliver those goods and services in ways that enable a community to recover from distresses and to flourish in ways commensurate with the shared values of the community, as well as generally recognized indices that capture health and wellbeing.

1.3.2

Macro Factors

Macro Factors are fundamental to any community. Their condition or management by catalytic institutions and marketing systems are predictors for existence, assortment, and quality of goods and services available in a community, the extent to which citizen-consumers’ demands are met and thus community members are well served or underserved, and whether communities flourish. Geography/environment: physical assets/liabilities of a community and ecosystem; the size, condition, and topography (e.g., mountainous or flat; inland or coastal); weather (e.g., temperatures, precipitation; weather patterns and cycles); seismic activity (earthquakes, tsunamis); land, soil, and water capacity; foodproduction type and capacity; potable/industrial water; materials for technological application and development; degradation, pollution, and sustainability; and opportunities and threats to the community’s environment. Population: number, growth rate, density, location, and demography—and encroachment on other species that may transmit diseases, zoonotically. Political/legal: a political apparatus to govern; authoritarian vs. democratic; political parties; rule of law and civil procedures; independent judiciary; free and fair elections; violence, war, social unrest, and unexploded ordnance; militias, military expenditures, and expenditures per capita; corruption; trade unions; right of assembly; and civil and human rights more broadly. Economic: hunter-gatherer, agrarian, feudal, command, market, or hybrid economy; emerging, developed, or developing; sectors (e.g., agricultural, industrial, service); private sector (e.g., entrepreneurship, SMEs); economic growth; debt load; trade; per capita income; income growth, purchasing power; income inequality; jobs; and employment. Social/cultural: shared values regarding members, boundaries, organization, purposes, and services of the community and expenditures and artifacts related to them (e.g., parks, theatres, museums, musical institutions, sports and

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social clubs, religious and other social and cultural institutions, demography, and tolerance/xenophobia). Education: a literate and learned community; materials, curricula, and schools, from kindergarten to tertiary education (number, per capita, ranking, accreditation); inclusion, subject-mastery, and graduation rates; teacherstudent ratios; teacher/faculty training, salaries, and teaching loads; and academic freedom. Administration: a recognizable, credible administrative apparatus to enable and to manage civil society to affect community wellness. Infrastructure: buildings, roads, rails, sea and airports, water purification systems, energy supply (number, type, quality, and reliability), Internet, and Wi-Fi. Technology: tangible human inventions to develop resources—including human resources and goods and services—and to affect positively other elements found in the model; sustainable technologies are increasingly valued and valuable.

1.3.3

Catalytic Institutions and Marketing Systems

Catalytic institutions exist in three principal forms. Governments: representative; physical, legal, symbolic, and human presence; recognized authority; and agencies and employees engaged in communities to affect pro-prosocial citizen-consumer outcomes. Transparent and accountable to citizen-stakeholders they represent. Businesses: private enterprises of various size and scope, creating and delivering legal goods and services to the community, generating wealth and largesse, creating jobs, providing tax revenue, infrastructure, and other benefits (e.g., community engagement, social services, and environmental enhancement/repairs). NGOs (nongovernmental organizations): religious institutions, multilateral organizations, aid groups, community groups, and social-service providers, which make contributions to communities where governments or businesses cannot or will not. The coordination of these institutions is vital to the creation and maintenance of a marketing system. Marketing systems are adaptive networks or a matrix of individuals, groups, or entities—including governments, businesses, NGOs, and citizen-stakeholders— linked through policies, participation, and engagement in economic and social exchanges. These interactions add economic value and facilitate personal/community well-being for individuals and institutions through the production, promotion, distribution, sale/purchase, consumption, and disposition of goods, services, and even experiences and ideas, which emerge in response to or in anticipation of demands by citizen-stakeholders (see also Layton, 2015). Marketing systems more generally function best when viewed as prosocial and holistic assemblies or societal endeavors, coordinating and integrating the aforementioned factors, forces, and other systems, with a larger purpose: flourishing communities.

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Goods and Services

Goods and services—their quality, variety efficacy/utility, safety, need-fulfillment, consumer-stakeholder satisfaction, and sustainability—provided or championed by catalytic institutions and the marketing system determine whether a community will flourish. Everything purchased or consumed by an organization or individual in a marketing system moreover could be a predictor or indicator for well-being. Masks and eventually vaccines, for example, are tangible products that enhance health and well-being during a coronavirus pandemic, as well as their promotion, distribution, and consumption. Some goods and services are, of course, more positive or nefarious than others; legal and well-intended services and goods (e.g., social media, medicines) can be abused, quickly turning a flourishing community into a distressed one; some products or services are simply fraudulent, which may increase harm, diminish trust, and exacerbate crisis. As we have noted, the social, cultural, and political structure of a community greatly determines whether any good or service—and the socioeconomic activities and individual behaviors that culminate in the purchase and consumption of them— will distress a community or help it to flourish. Resource allocations, purchases, and expenditures for goods and services, and use of those goods and services, reveal a community’s values and whether it is distressed or flourishing.

1.3.5

Citizen-Consumers

Citizen-consumers are the members and stakeholders that collectively form a community and broader communities that affect them. Their behaviors (e.g., purchases and consumption of goods and services), outcomes from those behaviors, attitudes toward those outcomes, and subsequent behaviors serve as indicators. Several determinants potentially affect whether a community or subsets of citizen-consumers in a community are served or underserved and thus whether a community is likely to flourish. Six particularly salient factors affect them. Location/access: Citizen-consumers must be responsibly and meaningfully engaged in—they must have access to—that which the marketing system provides or could provide. This can occur in physical space (e.g., the purchase and consumption of food, shelter, healthcare) or, increasingly, in cyberspace (e.g., education/ learning, shopping, recreation, and services—including healthcare services and counsel). Income/wealth/capital: These factors greatly influence access to marketing systems. Purchasing power to gain access or to purchase in, to consume in, or have experiences in the marketing system through one’s own resources, family resources, or resources provided by one of the catalytic institutions is vital. In distressed, dysfunctional, or even devastated communities, opportunistic or criminal activity and resources may facilitate access.

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Social/cultural capital: Social and cultural forces affect access to and success in the marketing system. Ethnicity or social class may be determinants in some communities; when they are primary determinants, exclusion, ethnocentrism, xenophobia, and racism also may exist, distressing some if not all community members. Belonging to the dominant ethnic group, religion, or political party, level of education and/or exclusive membership also may afford access, privileges, and desirable outcomes that would be inaccessible without such capital. Communities tend to flourish when institutions—e.g., housing, healthcare, education, jobs, and markets— are accessible and rewards and benefits of the community and its marketing system are then earned or shared. Transparency/accountability: Inclusive, representative, transparent, and accountable governance and management are conducive to flourishing communities. Indicators include rosters, elections, open bids, disclosures, quarterly and annual reports, media access, competition, town hall meetings, regulatory agencies, independent watch groups, and independent media. Motivation: Flourishing communities have citizen-stakeholders who are engaged in the community; they are empowered and motivated to participate and to affect change. Inaccessibility, low purchasing power, the “wrong” social capital, corruption, and opaque and unaccountable governance and management all alienate citizen-stakeholders; they in turn are less motivated to engage. The marketing system then becomes sclerotic; it underperforms or fails to deliver an appropriate assortment of goods, services, and experiences that enable the community to flourish. Appropriate indicators include elections, election turnouts, consumer advocacy, peaceful protests, service organizations, and other forms of community participation, polls, and attitude measures regarding services provided by the marketing system, as well as citizen-consumer social psychological dispositions, and community well-being assessments and helplessness/optimism. Market literacy: Command economies have collapsed or have transformed by instituting radical or gradual market reforms. Every country included in this book is now a market-oriented economy, even if administered by a communist party. The formerly command economies have seen tens of millions of their citizens pulled from poverty. This market(ing) dominant paradigm is omnipresent in physical, cyber, and global space; it has created wealth with enormous capacity to help the human condition. Yet, while poverty reduction is tangible and well-being has been enhanced, more than a billion citizen-consumer stakeholders still are unequipped or poorly equipped to thrive in this space because they lack market literacy and savvy, and some basic protections; they are vulnerable. Such disenfranchisement and exclusion distresses individual people and the communities in which they reside. Moreover, failure to invest in wellness for everyone and to address the factors in the framework that must be addressed to facilitate well-being for entire communities renders all of us vulnerable to global shocks, including pandemics. In the following section, we introduce 28 countries, the authors, and their chapters.

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Country Analyses

Each chapter provides a country-specific analysis with implications for individual QOL and the well-being of communities and country, in response to the COVID-19 pandemic. The authors present a systemic overview; denote challenges, failures, and successes; and offer best cases to mitigate or end the pandemic. To facilitate some uniformity among chapters, the authors were encouraged throughout the review process to follow some guidelines and to focus on especially salient factors in the framework indicating connections to and implications for well-being. The authors also were asked to share lessons useful for responses to future public health crises and potentially other disasters. We should add that the authors were given considerable latitude to develop their chapters and were encouraged to explore unique or arcane issues and factors that affect and will continue to affect the countries they analyzed. Readers might find multiple introductions to and discussions of events to be redundant. However, some readers may choose to download a single digital article rather than purchase or read all articles in a hard copy of the book. Thus, we thought the value of context and clarity regarding the initial outbreak outweighed the potential downside of redundancy. Each chapter moreover underwent rigorous, blind review, so this decision also seemed fair to the authors who worked tirelessly to write their chapters and to revise them in response to comments by reviewers and editors. We wanted as much of the authors’ work to be published as was reasonable and possible. The order of chapters is alphabetical, by country. Spelling, language idiosyncrasies, and evolving terms also should be noted. For example, the specific coronavirus causing the pandemic is abbreviated by the medical community and public health institutions as SARS-CoV-2, the disease it causes is COVID-19, and the pandemic is typically referred to as the COVID-19 pandemic. However, COVID, Covid, and simply “pandemic,” as well as crisis, event, etc., are often used in popular culture regarding all things COVID, from virus, to disease, to pandemic to epoch. The authors were encouraged to use “American English” spelling throughout their chapters and to use conventional terms for the virus, disease, and pandemic. Lastly, the content of each chapter expresses the views of the authors of that chapter and not necessarily the views of the other authors, the editors, or Springer Publishing.

1.4.1

Argentina

Liza Kharoubi Echenique and Jaqueline Pels, in “Antifragility Strategies: The Arbusta Case in COVID-19 Argentina,” find and explore seemingly hidden or overlooked resources for COVID-19 control and mitigation. They introduce us to Arbusta, an Argentine software and application testing start-up to provide jobs to the most vulnerable communities, women in this case. Indeed, Arbusta managed to grow

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and even expand to the USA—during the pandemic. COVID-19 helped or perhaps forced Arbusta to develop distinctive practices, including tolerance, inclusion, and reflexivity, as well as redundancy and plurality of perspectives. The talents of the women were highlighted suggesting interventions that could have made the organization and potentially Argentina less vulnerable and more sustainable. The crisis moreover shows or reminds that technology can help to alleviate some socioeconomic challenges, especially in emerging economies (Kharoubi Echenique & Pels, 2022).

1.4.2

Australia

Michael Polonsky and Virginia Weber, in “COVID-19 Response in Australia: An Examination of State Responses and System Vulnerabilities,” examine resilience and response to the pandemic and how the response has impacted communities around the country. The analysis focuses on complex interrelations among policy, community, and individuals—prior to and during this shock. The authors first discuss how the pandemic has created unique vulnerabilities and resiliencies. They then examine how crisis-specific vulnerabilities and resiliencies interacted with preexisting conditions to determine flourishing and how vulnerabilities were exacerbated or mitigated due to government and business policies. Finally, the authors shed light on the interplay between policy and vulnerability and how this interplay created unforeseen issues in relation to how communities have responded, highlighting the importance of flexibility and agility by response systems that will not undermine flourishing. They conclude with implications regarding the interconnectedness of systems and communities in times of crisis (Polonsky & Weber, 2022).

1.4.3

Brazil

Brazil is a complex society, with deep and challenging socioeconomic inequalities that have plagued the country. COVID-19 has exacerbated systemic shortcomings, notably the federal government’s incapacity to help the neediest Brazilians. This failure triggered urgent and effective responses from key actors in market system catalytic institutions, across various sectors. Their assistance seems largely based on fundamental ideas pertaining to generosity and solidarity, offering help and looking toward future benefits for fellow Brazilians. The underlying premise is that community well-being is only achieved when everyone shares in its benefits. In “Disdain, Generosity and Solidarity as Institutional Responses to COVID-19 in Brazil,” Marcus Wilcox Hemais, João Felipe R. Sauerbronn, Ronan Torres Quintão, and Eduardo Teixeira Ayrosa analyze how the Brazilian federal government, Itaú Unibanco, and the MST—Movimento dos Trabalhadores Rurais Sem Terra (Landless Rural Workers’ Movement)—have reacted during the COVID-19 crisis and

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how their response has affected the quality of life for Brazilians (Hemais et al., 2022).

1.4.4

Canada

Canada is typically regarded to be a flourishing country, but will it flourish after the pandemic? Stanley J. Shapiro and Julie Stanton seek answers to that question in “Canada after COVID-19: A Flourishing Community for Everyone?” Despite many indicators for high quality of life, shortcomings in the healthcare system, the social safety network, and sustainability were apparent before the pandemic. COVID-19 led to even more serious challenges in, for example, seniors care, childcare, paid sick leave, and poverty alleviation. Canada’s plan for “Building Back Better” however offers a plausible way to redress long existing quality of life inequities. Whether and to what extent post-COVID Canada has the political and economic will to better serve the “distressed” segments in an otherwise “flourishing” society remains to be determined (Shapiro & Stanton, 2022).

1.4.5

China

Communities can be placed on a distressed to flourishing continuum. Behavior patterns, traditions, culture, and political/economic systems may enable a community to thrive. In “Catalytic Institutions and Community Resilience: COVID-19, Obstacles, and Adaptive Mechanisms in Wuhan, China,” Jie Gao Driskell, James Gentry, and Rongwei Chu explore and explain the factors that have impact on community resilience, with focus on the case of Wuhan, China. The authors emphasize the importance of key institutions during negative events such as pandemic, and their importance to appropriate policies (Driskell et al., 2022).

1.4.6

Colombia

Colombia has been profoundly and negatively affected by the COVID-19 pandemic. In response to initial infections, the government declared a state of national emergency—e.g., border closings and strict lockdown—to prepare for and mitigate difficulties. Despite nationwide hardships, some initiatives and good practices to enhance well-being have emerged. In “Colombia: Resilience and Well-being in Response to COVID-19,” Andrés Barrios Fajardo, Marcos Ferreira Santos, and Héctor Godoy analyze the impact of the pandemic. Colombia is a country and community that has adapted over time, as a result of the interaction of endogenous and exogenous forces. SARS-CoV-2 is a disastrous exogenous force that shifted

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Colombia from its balanced path. The authors emphasize understanding the factors that made the country both vulnerable to and resilient against the virus, as well as the responses by the government, private sector, and citizens to mitigate it and COVID19 (Barrios Fajardo et al., 2022).

1.4.7

Croatia

In “Croatia: Assessing Resilience and Responses of Firms and Consumers during COVID-19 Pandemic,” Dario Miočević, Ivana Kursan Milaković, Biljana CrnjakKaranović, Mirela Mihić, and Antonija Kvasina investigate responses to the health crisis by Croatian consumers and firms. The authors focus on how resilience drives behavioral intentions of consumers and small-and medium-sized enterprises (SMEs) during the “new normal” resulting from the pandemic. Findings from secondary and primary data indicate that Croatian consumers perceive themselves to be quite resilient, while Croatian SMEs increase the resilience by relying on the self-efficacy of top managers prone to engaging in investment during the COVID-19 pandemic. The study reveals the profile of resilient consumers and firms and how resilience affects their behavioral intentions during this crisis and potential other crises. The authors conclude with some discussion of lessons from key findings, and implications for crisis management, business, governance, marketing, and well-being (Miočević et al., 2022).

1.4.8

Finland

Petteri Repo, Pia Polsa, and Päivi Timonen, in “The Finnish Response to First Wave of COVID-19 Accentuated Persuasion,” examine how Finnish society responded and took action against the pandemic during its first wave. They review key societal and political responses within the systemic framework. The Finnish response was led by the government and prompted dramatic restrictions in personal movement and new arrangements for workers. Significant financial support was given to businesses. Schools went online as did many institutions. Though not initially assured, the effects included fewer deaths and a lower drop in economic activity than in other European countries. Persuasion rather than command was characteristic for the Finnish response. The application of the well-being framework accentuates that provision of goods and services, as well as recreation and cultural life, must be addressed when serving citizens and consumers during pandemics (Repo et al., 2022).

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Germany

In “The COVID-19 Outbreaks in the German Meat Industry: A Culturalistic Explanation,” Michaela Haase and Anna Schade describe a series of outbreaks of the Corona disease among workers in the German meat industry. The authors describe the historical development leading to the series of outbreaks and explain it in terms of a multicausal process. As such, potential causes of the outbreak in terms of commodification and movement are identified; evidence suggests the event occurred because the virus found favorable conditions for its transmission in “Tayloristic” work organizations and working conditions at production sites. That is, the organizations in the German meat industry and Eastern European subcontracting firms engaged in dubious practices, which raise questions about their ethical standards. The authors further conclude workers in that industry do not benefit from legal protection and communal efforts in Germany (Haase & Schade, 2022).

1.4.10 Ghana The Ghanaian response to the COVID-19 pandemic has been shaped by the unique and informal nature of marketing systems prevalent in Ghana and many African countries. In “Ghana’s Response to the COVID-19 Pandemic,” Charlene Dadzie presents a case study on Ghana’s response and management of the pandemic by exploring how a uniquely African marketing system in Ghana facilitated mitigation efforts. In so doing, the author identifies interventions that catalytic institutions implemented to abate the pandemic’s impact on already distressed communities. The chapter concludes with implications for enhancing consumer QOL and identifying best practices (Dadzie, 2022).

1.4.11 India In “Community and Market Development in India during Corona Virus: A Focus on the Migrant Worker (MW) Population,” Nicholas Santos and Subhasis Ray explore how the pandemic in the world’s second most populous nation has impacted a particularly vulnerable group of Indian society. They provide an examination of the pandemic’s devastating impact on the migrant workers (MW) in what is a fourphase “time lapse” journey. The chapter evaluates how the already struggling MW classes of Indian society attempted to cope with the Indian government’s series of lockdowns and policy changes often introduced with very little notice and supporting infrastructure for the MW. The result has been to further exacerbate the already massive social inequalities in the country. As the authors note, though, the

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pandemic has also helped mainstream the inequality narrative to a level that can no longer be ignored (Santos & Ray, 2022).

1.4.12 Indonesia The largest country-archipelago comprises more than 14,500 islands and is the fourth most populous nation in the world. Indonesia is remarkably diverse, geographically and culturally. While this diversity has advantages, it creates administrative challenges during crisis. Primidya KM Soesilo and Fathony Rahman, in “The Pillars of Survival in the COVID-19 Pandemic: The Case of Indonesia,” present several examples of how the COVID-19 crisis is being addressed in such an environment. The authors apply various methods, including content analysis of local and national news and media, and direct observation and interviews to examine the “four pillars,” specifically two catalytic institutions (i.e., government and community), the digital ecosystem, and national values. They conclude with some highlights of implemented actions and programs that are consistent with Indonesian national values and principles (Soesilo & Rahman, 2022).

1.4.13 Lebanon SARS-CoV-2 could not have arrived at a worse time for Lebanon. Amidst the country’s most difficult economic and political crisis in its history—resulting from years of betting on a windfall economic model that relies on imports and external remittances—the onset of COVID-19 compounded existing weaknesses and further increased vulnerabilities. The pandemic is one of many interacting woes the country faces. In “Fighting COVID-19 in a Multi-Crisis Context: The Case of Lebanon,” Georges Aoun and Karine Aoun Barakat provide a glimpse of an increasingly desperate country, as they study the way in which the pandemic was successfully managed in the short term, but the lack of sustainable policies, low government trust, and limited monetary means led to an economic catastrophe and eventual large-scale spread of COVID-19 (Aoun & Aoun Barakat, 2022).

1.4.14 Mexico The impact of SARS-CoV-2 in Mexico has been severe. The devastation includes the largest increase in extreme poverty in Latin America and the Caribbean—with massive unemployment and some of the highest mortality indicators—due to COVID-19. In “Loss of Well-being during COVID-19 Pandemic in Mexico: A Public Policy Analysis Using a Systemic Approach,” Luis Raúl Rodríguez-Reyes,

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Mireya Pasillas, and Keren Camberos examine the systemic loss of well-being due to COVID-19. Findings show that some weak key macro factors, poorly planned policy actions and reforms, and subpar policies for the economy and healthcare caused larger losses of well-being from the pandemic than could be expected. Mexico’s challenge is to make a life-saving policy adjustment to vaccinate the population and provide financial assistance to people and businesses throughout post-pandemic economic reconstruction. Lessons and policy recommendations are shared to improve the ongoing response to COVID-19 and to protect from future negative shocks (Rodríguez-Reyes et al., 2022).

1.4.15 New Zealand New Zealand has been championed as a model in its response to curtail the spread of SARS-CoV-2. Ben Wooliscroft, Alexandra Ganglmair-Wooliscroft, and Sabeehuddin Hasan argue in “COVID and New Zealand: An Outlier Case” that COVID-19 has been (repeatedly) “eliminated” through a combination of border closures, compulsory managed isolation and quarantine (MIQ) upon entry to New Zealand and lockdowns. These measures are possible and effective because New Zealand is an island country, three hours flying time from the nearest other country (Australia). Despite successful early efforts, COVID-19 has repeatedly emerged from MIQ into the community, each time resulting in a lockdown for at least part of New Zealand. The government has supported and stimulated the economy during lockdown. The long-term results of that support however are unknown, to date, though there are worrying signs in some sectors, particularly housing (Wooliscroft et al., 2022).

1.4.16 Russia Alexander Krasnikov, Vera Rebiazina, and Svetlana Berezka, in “COVID-19 Pandemic, Catalytic Institutions, and Consumer Well-Being: Evidence from Russia,” examine the pandemic’s effects on changes in the well-being of Russian consumers. Perspectives from both micromarketing and macromarketing help the authors to identify key topics among studies of consumer behavior during the spread of SARSCoV-2 and to examine changes regarding individual and community well-being in Russia. These topics are further explored using data collected during the COVID-19 outbreak; access to these data moreover enables the authors to compare changes in individual and community well-being across Russia, Brazil, China, India, and South Africa. The research team lastly examines how Russian consumers adjust their behaviors during lockdown. The results illuminate changes to consumer behavior patterns caused by COVID-19 in a transitional economy, with implications for

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the management of health and well-being in Russia and potentially other transitional economies distressed by future health crises (Krasnikov et al., 2022).

1.4.17 Rwanda In “Rwanda Galvanizes Healthcare Readiness, Citizen Support, and Technology to Flatten the Coronavirus Curve in the Land of a Thousand Hills,” June N. P. Francis and Lama Mugabo examine how a poor and landlocked African country has one of the lowest infection rates of COVID-19 in the world. Their analysis includes factors contributing to Rwanda’s successful intervention against the spread of SARS-CoV-2 and highlights Rwanda’s catalytic institutions, which were prepared to provide healthcare because of experience with other infectious diseases, notably Ebola. Rwanda’s response was rapid, coordinated, and scientifically informed; it included supportive social programs, community involvement, innovation, and trust in government and state communications. Lessons from battling Ebola provided a playbook with perhaps superior strategy and tactics to those implemented in more developed countries; as the authors suggest, such lessons were generally not studied and embraced in many other countries, as the pandemic spread globally (Francis & Mugabo, 2022).

1.4.18 Singapore In “Battling COVID-19 Pandemic in a Densely Populated Island Nation: The Singapore Experience,” May O. Lwin, Chitra Panchapakesan, Anita Sheldenkar, Edson Tandoc Jr., Hye Kyung Kim, Shanshan Yang, Zoe Ong, Si Yu Lee, and Melissa Rachel Kwan provide key insights into Singapore’s response to COVID-19, focusing on catalytic institutions’ efforts to bolster the country’s defenses against SARS-CoV-2. The authors share an overview of the pandemic from January 2020 to January 2021, including discussion of governmental initiatives to combat the pandemic. Emergent issues—e.g., grappling with different types of literacies and the rise of misinformation and changes in public and consumer behaviors—are addressed. The impact of COVID-19 on vulnerable groups and how institutions help to mitigate these challenges are also presented. The authors conclude with key insights regarding effective management of future crises. Notably, as of February 2021, Singapore had the lowest COVID-19 case fatality rate among all countries (Lwin et al., 2022).

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1.4.19 South Africa South Africa has faced many pandemics in the past and now is dealing with COVID-19. Stefan Kruger, in “History Repeats Itself: South Africa, an Epic Sighting—COVID-19,” describes the current situation as dire. SARS-CoV-2 and its variant have had a direct impact on communities at large. The South African government has taken measures to combat the spread of the virus, including lockdown and other interventions. The author describes the impact of this novel coronavirus on the health and safety as well as economic impact on South African communities. Kruger discusses policies and programs implemented in many communities, some that worked and others that did not, leading to some conclusions regarding lessons learned and best practices (Kruger, 2022).

1.4.20 South Korea Grace B. Yu and Najung Kim, in “COVID-19 Pandemic and Its Impact on Consumers in South Korea,” describe effects of the South Korean no-lockdown strategy, intended to help Koreans maintain their lifestyle. Statistics however reveal Koreans have suffered considerably and that new consumption patterns have emerged. The authors focus on factors that may account for decreased QOL, new consumption trends, and macro factors that might have better protected consumers. They report decrease in QOL may have been related to reduced income, psychological stress, and isolation. In response, consumers engaged in contactless, anxiety-proof, and egocentric consumption. The authors describe government policies designed to ensure regular economic activity and IT and retailing infrastructures to facilitate online shopping. They argue Koreans’ digital literacy empowered consumers to sustain their lifestyle and safeguard QOL and conclude with suggestions for public policy and marketing considerations to deal with future pandemics (Yu & Kim, 2022).

1.4.21 Spain Spanish society and institutions have been greatly challenged to ensure the wellbeing of citizens while responding to the COVID-19 crisis. In “The Role of Spain’s Catalytic Institutions to Facilitate Community Well-Being during the COVID-19 Pandemic,” María José Montero-Simó, Rafael A. Araque-Padilla, Rosa MeleroBolaños, and Clifford J. Shultz, II analyze Spain’s pre-pandemic situation, including economic crisis and related structural problems, which restricted the possibilities for a strategic response to the pandemic. An initial conclusion from that research is that appropriate disaster conceptualization and assessment of societal vulnerabilities are vital to any effective response. Findings from a subsequent content analysis of

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Spanish news media suggest some important lessons regarding the relationships among disaster conceptualization, factors that generate vulnerability, and coordination of catalytic institutions to guarantee more effective responses to maintain community and social well-being, especially among most vulnerable populations (Montero-Simó et al., 2022).

1.4.22 Sweden Ira Haavisto, Tommi Uimonen, Suvi Karvinen, Hlekiwe Kachali, and Riikka-Leena Leskelädescribe contribute “Case Study: Swedish COVID-19 First Wave Response in European Context.” Their analysis reveals that Sweden initially relied on citizens’ individual responsibility as an intervention strategy rather than mandating safety behaviors. COVID-19 however was devastating compared to the rest of Europe; Sweden experienced the second highest death toll of all European countries, following the Netherlands. COVID-19 is an external event unprecedented in Sweden’s history, which greatly distressed the Swedish healthcare system and the economy. The second wave hit Sweden harder than many other European countries, indicating that herd immunity was not reached despite high numbers of infections from the first wave. The decision to keep Swedish society more “open” did not help soften the economic blow from the pandemic. Eventually, the healthcare system managed to reduce infections and hospitalizations. Lessons learned from the Swedish experience are discussed (Haavisto et al., 2022).

1.4.23 Thailand Thailand was reported to be the first country outside China to detect a case of COVID-19. The Thai government soon implemented measures to prevent the spread of infection, ending the first wave of the outbreak. Authorities then softened the strict lockdown to expedite economic recovery, especially in tourism and related industries. Championed as a leader in Asia and a model by the WHO for its success responding to the pandemic, Thailand has experienced success managing this crisis. In “Thailand and COVID-19 Pandemic: Lessons Learned, Challenges, and the Silver Lining,” Busaya Virakul, Chartchai Na Chiangmai, and Kalayanee Senasu explore the Thai experience with COVID-19, from December 2019 to September 2020. The authors conclude with lessons learned, policy and management implications, the silver linings that can be expected, and some considerations for challenges that will need to be redressed or overcome, going forward (Virakul et al., 2022).

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1.4.24 Turkey Ahmet Ekici, in “Local Level ‘Best Practices’ during COVID-19 and their Impact on Community Well-Being: Cases from the Municipality of Kadıköy-Istanbul,” describes the impact of COVID-19 through the lens of one community, namely, the Municipality of Kadıköy-MK—one of the largest districts in Istanbul—and how it responded to the many challenges posed by the pandemic. The author describes the pandemic-specific programs of MK that best served both advantaged and disadvantaged population groups. As such, best practices of catalytic institutions—government, NGOs, and business institutions—are identified, with implications for management of future pandemics and potentially other crises (Ekici, 2022).

1.4.25 United Kingdom Haseeb A. Shabbir, Michael R. Hyman, and Alena Kostyk, in “A Solidarity-Care Ethics and Human Flourishing Approach to the COVID-19 Pandemic: A U.K. Perspective,” describe the crisis in the United Kingdom. The authors focused on two human flourishing frameworks (macromarketing and the solidarity care framework) and developed an integrated framework by fusing them. They then applied the fused framework to evaluate how the UK’s COVID-19 responses affected community flourishing. Specifically, the authors examine the effect of two competing social forces—Brexit and the Black Lives Matter movement—on pulling Britons toward a flourishing or distressed community (Shabbir et al., 2022).

1.4.26 United States In “A Matter of Trust: The COVID-19 Pandemic in the United States amidst Political and Media Polarization, and a Narcissistic Presidency,” Don Rahtz, Clifford Shultz, and M. Joseph Sirgy explore how America’s institutional vulnerabilities, political polarization, and failed national political leadership—including misinformation—led to devastating consequences for communities throughout the United States. The authors explore the success of the accelerated development of three highly effective vaccines, known as Operation Warp Speed, which provided millions of doses of effective vaccines. While regarded by most observers to be a medical miracle capable of ending the pandemic, its initial distribution was poorly administered. The vaccine also was derided by a significant portion of the population that has chosen not to be vaccinated. These events, discord, and rejection of mitigation strategies result in waves of infections and the possibility of COVID-19 becoming endemic; the authors offer considerations to avert future crises (Rahtz et al., 2022).

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1.4.27 Vatican Though the smallest sovereign state in the world, the Vatican shapes opinion and behaviors of more than a billion people around the globe. In “The Vatican’s Response to the Coronavirus Pandemic: The COVID-19 Commission and Preparing the Future,” Nicholas Santos and Dominic Chai examine the COVID-19 Commission, which is charged by the Vatican with discovering ways to mitigate the pandemic and to prepare a post-pandemic future. Unlike most government responses focused on the well-being of their citizens, the Commission considers the well-being of the entire human family regardless of national citizenship. The authors observe that the Commission functions as a catalytic institution facilitator, bringing together governments, businesses, and NGOs to prepare a future aimed at the common good while ensuring a higher quality of life for all (Santos & Chai, 2022).

1.4.28 Vietnam COVID-19 has had a profound impact on socioeconomic life in Vietnam, a country recognized for successfully controlling the pandemic. Disease prevention and economic growth, which in turn are facilitating community well-being, are significant successes. “Vietnam in the Combat Against COVID-19: Responses of the Government and Cooperation Among Stakeholders,” by Nguyen Thi Tuyet Mai and Mai The Cuong, examines Vietnam’s efforts to contain the pandemic in 2020. The authors are guided by a focus on systemic cooperation to affect QOL. They provide an overview of the main phases and timeline for SARS-CoV-2 infections and then discuss the impacts of the COVID-19 pandemic on its citizens and businesses. The chapter features effective and clever marketing communications aiming at achieving the dual goals of disease control and economic development. They conclude with thoughts on challenges, lessons learned, and implications for policy when coping with the pandemic as Vietnam adjusts to this crisis (Nguyen & Mai, 2022).

1.5

Prologue

Two transcendent themes became clear while writing, editing, and assembling chapters for this book. First, the obvious focus is on health and wellness, which we have generally regarded to be implicit in any systemic initiative to enhance QOL and community well-being, hence our decision not to include health and wellness in the model. We now however add them to the framework, an explicit reminder that some baseline measures for both constructs are important to assess trends and outcomes of institutional responses to a pandemic and other widescale crises that affect human health. Second, all chapters reveal the importance of catalytic institutions to mitigate, control, or end the COVID-19 pandemic. Successes however result

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“Best” Practices

Macro Factors Geo/Environment Population Political/Legal Economic Social/Cultural Education Administration Infrastructure Technology

Community Well-Being/QOL Macro-Micro Links

Goods/Services Assortment Amount Quality Choice

Consumption/Demand

Catalytic Institutions

Marketing Systems

Government

NGO

Business

Distressed

Flourishing

Citizen-Consumers: Served/Under Served Potential Determinants Health/Wellness Location/Access Income/Wealth/Capital Social/Cultural Capital Situational Commonalities Transparency/Accountability Motivation Market Literacy/Access

Constructive Engagement

Fig. 1.2 Systemic framework for constructive engagement to facilitate QOL in distressed and flourishing communities (see also Shultz et al., 2012, 2017; Shultz & Peterson, 2019)

from constructive engagement, requiring motivation by and among catalytic institutions and their stakeholders to engage each other—a spark of sorts to force collaboration, even when actors may not see immediate incentives or gain from doing so— and coordinated institutional policy and behavior to redress crisis. Thus, we add these two factors to a revised framework, as seen in Fig. 1.2, including some emphasis on the indispensable spark to ignite or motivate the catalysts. Constructive engagement evinces resilience and tends to manifest as deliberate and proactive cooperation among catalytic institutions, in coordination with citizenconsumers within the community/country and other stakeholders around the world; awareness of and consideration for macro and micro factors that can help or hinder effective responses; consensual science- and fact-based initiatives—truly “best” practices and related goods and services—to mitigate, control, or end the pandemic; transparency, accountability, and effective communication; valid and reliable measures to assess individual QOL and community well-being; and the extent to which communities and countries are flourishing, over time. The chapters collectively reveal the importance of constructive engagement, regardless of the spark that ignites it; many chapters also reveal the devastating effects when catalytic institutions fail to engage constructively. We revisit and expand these ideas in an epilogue, “Effective Interventions to Mitigate the Ill-Being Effects of COVID-19: Lessons Learned from Countries around the World” (Sirgy et al., 2022), the final chapter of the book. Conflict of Interest The authors have no conflict of interest to disclose.

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Power, M., & Dewar, M. (2021, February 11). COVID has reached Antarctica. Scientists are extremely concerned for its wildlife. PHYS.ORG. Retrieved July 8, 2021, from https://phys. org/news/2021-02-covid-antarctica-scientists-extremely-wildlife.html Rahtz, D. R., Shultz, C. J., II, & Sirgy, M. J. (2022). A matter of trust: The COVID-19 pandemic in the United States in a time of political and media polarization and a narcissistic presidency. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Repo, P., Polsa, P., & Timonen, P. (2022). The Finnish response to first wave of COVID-19: Accentuated persuasion. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Rodríguez-Reyes, L. R., Pasillas, M., & Camberos, K. (2022). Loss of well-being during the COVID-19 pandemic in Mexico: A public policy analysis using a systemic approach. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Santos, N. J. C., & Chai, D. H. (2022). The Vatican’s response to the Coronavirus pandemic: The COVID-19 Commission and preparing the future. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Santos, N. J. C., & Ray, S. (2022). Community and market development in India during coronavirus: A focus on the migrant worker (MW) population. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, Economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Sepulveda, C., Shultz, C., & Peterson, W. (2020). Toward sustainable development for emerging economies: statistical capacity indicators in Chile and the Andean Region. In H. R. Chaudhuri & R. Belk (Eds.), Marketization: Theory and evidence from emerging economies (pp. 235–258). Springer. https://link.springer.com/chapter/10.1007/978-981-15-4514-6_11 Shabbir, H. A., Hyman, M. R., & Kostyk, A. (2022). A solidarity-care ethics and human flourishing approach to the COVID-19 pandemic: A U.K. perspective. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Shapiro, S. J., & Stanton, J. (2022). Canada after COVID-19: A flourishing community for everyone? In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Shultz, C., & Peterson, M. (2019). A macromarketing view of sustainable development in Vietnam. Environmental Management, 63(4), 507–519. https://link.springer.com/article/10.1007%2 Fs00267-017-0971-8 Shultz, C., Barrios, A., Krasnikov, A., Becker, I., Bennett, A., Emile, R., Hokkinen, M., Pennington, J., Santos, M., & Sierra, J. (2020). The global refugee crisis: Pathway for a more humanitarian solution. Journal of Macromarketing, 40(1), 128–143. https://doi.org/10.1177/ 0276146719896390 Shultz, C., Deshpandé, R., Cornwell, B., Ekici, A., Kothandaraman, P., Peterson, M., Shapiro, S., Talukdar, D., & Veeck, A. (2012). Marketing and public policy: Transformative research in developing markets. Journal of Public Policy & Marketing, 31(2), 178–184. http://journals.ama. org/doi/abs/10.1509/jppm.11.007?code¼amma-site Shultz, C., Rahtz, D., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience, and a systemic framework to facilitate Well-being. In R. Phillips & C. Wong (Eds.), The handbook of community Well-being (pp. 403–422). Springer. https:// link.springer.com/chapter/10.1007%2F978-94-024-0878-2_21 Sirgy, M. J. (2021). Macromarketing metrics of consumer well-being: An update. Journal of Macromarketing, 41(1), 124–131. https://doi.org/10.1177/0276146720968096 Sirgy, M. J., Shultz, C. J., II, & Rahtz, D. R. (2022). Effective interventions to mitigate the ill-being effects of COVID-19: Lessons learned from countries around the world. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature.

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Clifford J. Shultz II (Ph.D., Columbia University) is Professor and Charles H. Kellstadt Chair of Marketing at Loyola University Chicago. His scholarly focus is responsible marketing, policy, development, and community well-being in distressed and transforming economies, particularly countries and communities recovering from war and other systemic traumas in Southeast Asia, the Balkans, Latin America, and the Middle East. Research projects include peace-marketing initiatives in Afghanistan, Bosnia, Cambodia, Vietnam, Lebanon, Syria, Colombia, Myanmar, Nicaragua, and Iraq; social traps; the global refugee crisis; pandemics and other public health crises; sustainable agribusiness and tourism; food, water and energy in the Mekong River Basin; plastics pollution; externalities of the FIFA World Cup; intellectual property rights; and constructive engagement for win-win socioeconomic development, social justice, and sustainable peace. Dr. Shultz has over 250 scholarly publications, including books, articles, chapters, and conference proceedings. He served two terms as Editor-in-Chief for the Journal of Macromarketing, as President of the International Society of Marketing and Development, and President of the Macromarketing Society; he currently serves as Associate Editor for the Journal of Public Policy & Marketing and the Journal of Macromarketing, and he serves on several editorial and policy boards. His professional distinctions include two endowed professorships, numerous research grants and fellowships, Fulbright appointments in Vietnam and Croatia, distinguished visiting professorships, best article awards, several commendations for outstanding research, teaching and service, and recognition for extraordinary and sustained contributions to the field of Macromarketing. Dr. Shultz has been invited to lecture, to make research presentations at universities and research institutes, and to counsel governments, NGOs, and businesses on six continents. M. Joseph Sirgy (Ph.D., U/Massachusetts) is a management psychologist and the Virginia Tech Real Estate Professor Emeritus of Marketing at Virginia Polytechnic Institute and State University (USA) and Extraordinary Professor at the WorkWell Research Unit at North West University— Potchefstroom Campus (South Africa). He has published extensively in the area of marketing, business ethics, and quality of life (QOL). His awards include: International Society for Quality-ofLife Studies’ (ISQOLS’) Distinguished Fellow Award, ISQOLS’ Distinguished QOL Researcher, Academy of Marketing Science’s (AMS’) Distinguished Fellow Award, AMS’ Harold Berkman Service Award, Virginia Tech’s Pamplin Teaching Excellence Award/Holtzman Outstanding Educator Award and University Certificate of Teaching Excellence, the EuroMed Management Research Award, and the Macromarketing Society’s Robert W. Nason Award. Best paper awards include articles published in the Journal of Happiness Studies, the Journal of Travel Research, and Applied Research in Quality of Life. His editorial responsibilities include co-founding editor of Applied Research in Quality of Life, editor of the QOL section in the Journal of Macromarketing, editor-in-chief of the Journal of Macromarketing, editor of ISQOLS’/Springer’s book series on International Handbooks in QOL, Community QOL Indicators--Best Cases, Applied Research in QOL--Best Practices, and co-editor of Springer book series on Human Well-Being and Policy Making. Don R. Rahtz (Ph.D., Virginia Tech) is a marketing / marketing communications researcher and is the J.S. Mack Professor of Marketing at William and Mary (USA). His expertise is in integrated marketing communication programs, international competitive intelligence, cultural intelligence, marketing research, survey methodology, analysis, situational awareness, and market assessment. He has had a particular interest in Quality of Life (QOL), environmental issues, economic sustainable development, transitional economies, business/community interface evaluation, and health systems. Presently he serves on the Editorial Review Boards of the Journal of Macromarketing and Applied Research in Quality of Life. He is a regular reviewer for many of the international conferences and journals in the marketing (e.g., Academy of Marketing Science) and quality of life areas (e.g., Social Indicators Research). He has traveled and worked extensively in the developing and transitional world. He has worked on projects in South Asia, North Africa, and Southeast Asia, with a particular focus on Bangladesh, Cambodia, Indonesia, Thailand, and Vietnam. Professor Rahtz has conducted a variety of workshops and seminars, and acted as a

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consultant to businesses in both the public and private sectors concerning the above topics, both in the United States and abroad. In addition, he has produced a number of publications regarding these topics that have appeared in books, academic journals, and the popular press. He is a founding member of the International Society for Quality-of-Life Studies (ISQOLS) where he has served on the Executive Board in a number of positions. He has served continuously as a Board Member of the Macromarketing Society for two decades. He has a long relationship with the International Society of Marketing and Development (ISMD) and currently serves on their board.

Chapter 2

Antifragility Strategies: The Arbusta Case in COVID-19 Argentina Liza Kharoubi Echenique and Jaqueline Pels

Abstract The COVID-19 crisis worsened emerging markets’ major pain points, particularly the precarious labor market and, within it, the situation of women. In this chapter, we focus on Arbusta, an Argentine software and application testing start-up that was born with the mission to provide jobs to the most vulnerable communities, especially women. In the extremely uncertain COVID-19 context, Arbusta managed to grow and expanded from Argentina to the USA. Among the core insights of the Arbusta case is that COVID-19 helped them develop further a set of distinctive practices: adopting an unbiased attitude and reflexivity, as well as redundancy and plurality of perspectives. As a result, the tacit talent of these women came to light. In short, by understanding what COVID-19 revealed about this special organization, we signal to a set of organizational changes what could contribute to weave antifragility nets for a sustainable future. The present crisis has also shown that technology might work as a buffer to alleviate some social and economic challenges, especially in emerging economies. Keywords COVID-19 · Argentina · Antifragility · Unbiased attitude and reflexivity · Tacit talent · Redundancy and plurality of perspectives

2.1

Introduction

As we started writing this chapter, on July 8, we were still under one of the longest lockdowns in the world due to the pandemic. The lockdown started on Friday, March 20, 230 days of lockdown so far. A reputed national newspaper, La Nación, suggested that we were under a state of “hibernation” as far as the economy was concerned. The full effect of the COVID-19 crisis, for Argentina, will probably be long hauled and unpredictable in its outcome. What will hold, wither, be destroyed,

L. K. Echenique (*) · J. Pels University Torcuato Di Tella Business School, Buenos Aires, Argentina e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_2

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or prosper, and for how long? More importantly, what could contribute to weave antifragile strategies for a sustainable future in these conditions? Major pain points in Argentina’s most vulnerable communities worsened during the pandemic; among them is the precarious labor market (unemployment, informal labor, self-employment without social benefits) and, within it, the situation of women (inequalities on the job market) in particular (INDEC, 2020a). These challenges are not unique to Argentina, but common to most of Latin America and emerging economies. Yet, Argentina met the COVID-19 blow in a very different economic and political situation from its immediate neighbors. The new government, elected with 48.24% of votes, was a couple months in power at the beginning of the pandemic, with an International Monetary Fund (IMF) debt to face, inflation flaring up to 48.3% accumulated over 2019 (INDEC, 2020b) and unemployment of 10.6% (INDEC, 2020a). This type of context has been defined as uncertain (Courtney et al., 1997) and, within the QOL (quality of life) literature, characterized as distressed communities (Shultz et al., 2017; Sirgy, 2011). Distressed communities suffer diverse levels of vulnerability which Shultz et al. (2017) argue is the “‘flipside of resilience” (p. 16). In this chapter, we would like to suggest three shifts from the extant QOL approach. The first shift is from focus on communities towards focus on businesses. Our shift in emphasis is aligned with the global change towards a market-based approach to inclusive growth for the poor (e.g., McMullen, 2011), that is, markets viewed as “an engine not just of overall economic growth but also of individual human development and economic empowerment” (Mendoza & Thelen, 2008, pp. 427–428). Moreover, Shultz et al. (2017) argue that business can act as a catalyst to development and community flourishment. We will look at a case that provides a working environment in which people from a distressed community could flourish. Our second shift is from the concept of resilience and the capacity to overcome a disturbance (Norris et al., 2008) to antifragility (Taleb, 2012). Antifragility also relates to a risk management strategy and is associated with shocks, disorder, chaos, uncertainty, and dispersion of outcomes. However, what makes the concept of antifragility interesting is that it has an anticipatory dimension, while resilience has an ex post crisis approach (Taleb et al., 2020). In fact, Arbusta, the case we shall discuss, hires people from the slums where vulnerability and uncertainty are not associated with an external but structural shock, linked to everyday circumstances. Thus, the anticipatory aspect of antifragility becomes essential. Our third shift is related to the role of the vulnerable community, from their citizen-consumer role to employees and what we shall label as their tacit talent. From a business perspective, the present pandemic has shown that technology might work as a buffer to alleviate some social and economic challenges, especially in emerging economies (Asongu et al., 2019). Technology has been crucial to maintain a continuum and a semblance of normality (telehealth, governmental activity, education, business, real-time data, e-commerce, etc.) (Ting et al., 2020). A preponderance of indicators suggest that this trend will continue and hybridize work even more. In other words, technology-based jobs will be one of the main sources of employment in the future (Bloom et al., 2020).

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As stated, in this chapter, we will discuss the Arbusta case. Arbusta1 is a technology-based start-up born with the purpose to provide jobs to the most vulnerable communities, particularly, women. One of the facts that makes this case interesting is that it managed to grow in this extremely uncertain context and, in the middle of the lockdown, is expanding to the USA. We aim at identifying the set of antifragility strategies adopted by Arbusta that became a means to help their employees flourish and, by extension, their communities. Our case study allowed us to point out three such strategies. First, we will highlight how, as a software and application testing company, Arbusta needed to develop an unbiased attitude—adaptable; open to disruption, obsolescence, and failure; and sensitive to cracks spotting and able to change fast. However, what makes Arbusta unique is that they apply the anticipatory job characteristics, reflexively, to their organizational model. This allows Arbusta to address the fragilities of the uncertain environment they operate in as well as the cracks and failures of the current business system. Next, we will point out their pervasive focus and trust on people, specifically low-educated women from marginalized communities. This led to a shift from agile organizational design tools to agile people showing that underprivileged women can be the source of untapped tacit talent. We will show that the technological and the human dimensions can intertwine in a positive, serendipitous, and productive way not only to prevent or mitigate effects of crises but also to achieve community flourishment. Finally, we will show how to be effective, the two antifragility strategies require being combined by a third: a multiplicity of perspectives and the capacity to abandon mainstream linear thinking. More importantly, we will exemplify that the level of uncertainty in social, economic, and political aspects, in emerging markets, necessitates a redundant, multilevel watch on fragilities. We contribute to the QOL literature by showing how a business, adopting a systemic and macromarketing approach (Shultz et al., 2012), performs its catalytic role (Kim, 2015). Specifically, we introduce the concept of antifragility and advocate its adoption due to its extant nature as well as identify three antifragility strategies: (1) developing an unbiased attitude and reflexivity, (2) agile people and recognition of tacit talent, and (3) redundancy and multiplicity of perspectives. We shall contend that the Arbusta case not only shows that the new role business is taking in helping move people (and communities) from distress to flourishment but also, more importantly, we shall claim that learnings from Arbusta, developed in an emerging economy setting, could be a leading case for other impact organizations in the new uncertain COVID-19 environment. In this chapter, first, we will briefly describe some of Argentina’s characteristics. Then, we will introduce the Arbusta case and discuss the insights from the Arbusta case and how they hold a dialogue with extant literature. Next, we present the limitations of the study and we wrap up with a set of conclusions and managerial implications.

1

https://arbusta.net.

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2.2

L. K. Echenique and J. Pels

Argentina, an Uncertain Context

There are different schemas and criteria to analyze and classify a country and the well-being of their people (e.g., the Sustainable Society Index2). However, as stated in the introduction, our focus shifts from communities and society at large to the role of business; thus, we will look at Argentina as the environment in which Arbusta operates. The discussion of the environment-organization relationship is not restricted to the field of marketing. Moreover, organizational theorists and strategic management scholars have had a leading role in documenting the importance of the environment. The 1960s highlighted the importance of the environment (Dill, 1958; Thompson, 1967), the 1970s looked at the determinants of the environment (Duncan, 1972; Pfeffer & Salancik, 1978), the 1980s tried to answer the question of whether an external objective environment existed (Bourgeois III, 1980; Mintzberg, 1987; Smircich & Stubbart, 1985; Weick & Daft, 1983), and the 1990s described the environment as a continuum that starts with the extra environment, the macroenvironment, the task environment, the auto-setting, and, finally, the organization proper (Thorelli, 1995). At the turn of the millennium, Pels and Kidd (2012) drew on the extant literature to provide a schema to characterize emerging markets and low-income consumer sectors. More recently, Shultz et al. (2017) and Shultz and Peterson (2019) suggest a framework of QOL predictors to achieving a community’s well-being. We shall be drawing on the latter frameworks. If we apply the QOL framework, it seems that Argentina checks both positively and negatively in the most salient factors. Positive factors are related to the geographical/environmental, population, culture, lack of violence, education, and technological coverage. As far as the Geographical/Environmental condition is concerned, Argentina would not be that ill positioned among emerging countries. The climate is temperate overall—although it is very diverse, humid in the Pampas, subtropical forests in the northeast, dry desert in the northwest and mountainous, and oceanic in the South. There is no major seismic activity and no dramatic droughts. Moreover, Argentina has many physical assets, biodiversity, and resources from its lush land (lakes and rivers, fertile plains, wood, natural gas and oil, minerals); the infrastructure, urban roads, airports, and boat transport are good enough. Regarding population, the density is low (15.9 inhabitants/km2), the second lowest in the southern cone (CAC, 2018). The country’s cultural capital is rich and lively with more than 1500 theaters, 50% in Buenos Aires only, a variety of museums and wellknown traditional and contemporary musical festivals. Violence between different religious and ethnic communities is virtually nonexistent. Violence due to drug trafficking is on the rise, but not reaching levels of international concern. Educationally, Argentina traditionally has a valuable education system, a free public university system, and a texture of free public and private institutions for elementary and primary levels. Finally, technological coverage, connectivity, and mobile 2

http://www.ssfindex.com/ssi/framework.

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penetration are relatively well distributed. While 60.9% of Argentinian urban households have a computer, 82.9% use the Internet and 84% have mobile phones (INDEC, 2019). Dysfunctional aspects seem to be related to those dimensions, labelled as general business environment by Pels and Kidd (2012), that is, a regulative system, sociopolitical governance, and socioeconomic system. With regard to the regulative aspects, Argentina ranks sixth in Latin America in the capacity to combat corruption index (Simon & Aalbers, 2020). According to this report, Argentina’s weakness is clearly identified as regulatory and, particularly, the lack of independence of the judicial institutions and their inefficiency to combat white collar crime. Additionally, according to Transparency International (2020), Argentina ranked 66th over 180 countries. On the sociopolitical dimension, Argentina has had a turbulent twentieth century with military coups as well as guerrilla terrorism; however, since 1983, it has had a democratic government. Pels and Kidd (2012) note that the market being governed by strong governmental regulations rather than by competition is an issue to consider in emerging countries. Argentina is no exception as it has shown a strong tendency towards political interference on economic policy (Gerchunoff & Torre, 2018). On the socioeconomic dimension, the weakness of Argentinian currency is evidenced by a long record of devaluations and defaults over the last 20 years (INDEC, 2020b). These economic crises have a ripple effect on unemployment as well as non-registered or informal labor (35.8%) (INDEC, 2020a). Last but not the least, following the Shultz et al. (2017) framework, Argentina ranks low in terms of cooperation among what they have labelled the “catalytic institutions” (p. 21): government, businesses, and nongovernmental organizations (NGOs) (GPEDC, 2020). In summary—in spite of no adverse climate and natural conditions, good levels of education, cultural capital, and access to technology, as well as not having issues regarding the population and ethnical/religious differences—we have shown that Argentina has a set of systemic fragilities related to the political, economic, and regulative systems as well as low coordinating mechanisms, which affect the QOL of the Argentine population, particularly that of the most vulnerable communities.

2.2.1

Argentina and COVID-19

COVID-19 has made Argentina’s fragilities phosphorescent and has pressured the system further as the lockdown measures are reinforced. During the second quarter of 2020, urban poverty reached 40.9% of the population, extreme poverty increased to 10.5%, and the country suffered a decline in a gross domestic product (GDP) of 16.2%, the largest retraction in its history (World Bank, 2020). A particularly critical region is the province of Buenos Aires, which holds 38% of the Argentine population (IGN, 2020). Due to the restrictive COVID-19 measures, 21% of the working

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population could not go to work (INDEC, 2020a), and, when data are discriminated by gender, we see that the economic and social impact has been higher on the female population, reaching 28.5% (INDEC, 2020a). An International Labor Organization (ILO, 2020) report states that job-generating sectors such as commerce, tourism, hotels, catering, transport, domestic work, and cultural activities were among the hardest hit. Workers in these areas, in particular those who are self-employed or who work in smaller enterprises, are especially vulnerable to this crisis. The official 2020 unemployment statistics in Argentina do not consider people who did not look for a job because of the COVID-19 mobility (e.g., public transportation restrictions); thus, the 11.7% official unemployment value (INDEC, 2021) does not reflect the situation. Alternative sources estimate a 29.3% unemployment (Arositio, 2020). However, the group that was most seriously affected by COVID-19 was the large informal economy, with 33.6% of non-registered workers losing more than 50% revenues, and 43.2% up to 50% (Resico et al., 2020). These economic data, combined with high inflation rates (42.8% in June, INDEC, 2020b), place women from humble backgrounds in an extremely strenuous situation. Regarding health conditions, Argentina, which has suffered more than 53,000 deaths due to COVID-19 (Ministry of Health, Argentina, 2021), ranks among the nations with the highest number of death per millions of inhabitants. The ILO report (2020) highlights that Argentina’s public health care system, although universal, has structural flaws, such as high levels of fragmentation, disparities in capacity, and inadequate care. Overall, 21% of Argentine households do not have health coverage and 19% cannot afford medicines; its health system has performed unevenly among the different regions of the country (CAME, 2020). Thus, we will argue that Argentina turns out to be an exemplary time-pressured uncertainty lab. It is a country of liminalities, ash-born, currently bordering default, while, as we shall show, simultaneously creating technological unicorns. Albeit challenging, we argue that the complex situation provides an opportunity to understand what resists and develops in Argentina. Thus, studying cases, such as Arbusta, becomes relevant, particularly its antifragility strategies, which create options, economic opportunities, and growth. Moreover, we will argue that the world is becoming, globally, both more uncertain and technological. Thus, insights from the Arbusta case become interesting beyond emerging economies. The Arbusta case highlights that, with their antifragility strategies, they are “not hurt” by COVID-19 and thus need not “heal”; furthermore, they benefit from crises (in general) and grow from them. This is an invitation to observe regularities on how some technological and innovative organizations responded to extreme crises. We shall discuss these in the next section.

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The Arbusta Case Brief Background to the Argentine Technological Context

Argentina is a world-class actor with five technology unicorns OLX, Globant, Mercado Libre, Auth0, and, recently, Transparent Business—the first pink tech unicorn. Moreover, Argentina’s technology and knowledge services were, in 2019, the third export sector, after the agricultural and automobile sectors (Argencon, 2020). An asset for Argentina, during COVID-19, was the high Internet penetration and the knowledge-based service expansion. Interestingly, in Argentina, technology seems to be gender neutral as there is just a 0.2% difference concerning usage of mobile technology (Argencon, 2020).

2.3.2

Brief History of Arbusta

Arbusta, founded in 2013, opened offices simultaneously in Rosario and Buenos Aires. It specialized in four areas: applications QA services, machine learning, digital interaction, and data services. One of its main sources of revenues is related to data cleaning and quality for mobile applications. This is relevant as mobile devices are rapidly substituting conventional computers (Mobile Industry Impact record, 2020); putting Arbusta in the forefront of novel services. Their clients are big players in Latin America, namely, Mercado Libre, Disney, Natura, Fox Sports, Valtech, and L’Oreal, among others, including major Argentinian banks. Their revenues reached the million US dollars’ threshold in 2018 and it doubled in 2019. In September 2020, in the midst of the pandemic, Arbusta allied with a US technology Company, Together W/, to provide integral digital solutions for the global market. Additionally, they announced more hires and growth. Today, it employs 300 people across Argentina, Uruguay, and Colombia. Already in 2018, 61% of their employees were women, an unusual fact for a technology company. However, what makes Arbusta unique is that, beyond being conscious of the gender-positive technology bias, it scouts the disadvantaged and vulnerable contexts looking for 18–28-year-old single-parent females. The only condition they request is that the women must be native millennials. Their recruitment campaigns are unconventional, as they work with NGOs who operate in the shanty towns and hand leaflets in the slums. Arbusta sees a lot of value in this particular profile. It argues that there is huge untapped knowledge in these women. Paula Cardenau, one of its founders, explains they take these women 100% as they are and invite them to tap into their personality, their past, all that they are. In short, Arbusta deeply believes that it is people who make the company and the difference. So much so that, a couple weeks before the quarantine, Arbusta created a specific business unit devoted to talent empowerment,

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called GROW (acronym for goal–reality–options–will). Its aim was to reinforce agile learning and quick progress of increasingly autonomous talents. Furthermore, Arbusta’s founders are deep believers that people are an indivisible whole and that the personal and the professional dimensions should not be disentangled. Thus, they help their staff develop and grow socially, technically, and economically. Understanding Arbusta’s indivisible approach is essential to understand its choices, success, and the changes they introduced during the COVID-19 pandemic. Their real investment is in processes that facilitate the release of the tacit dimensions in helping people unfold their talents and grow. The benefits are immense: commitment and concentration for the company and personal growth, openness, and availability for the people. Moreover, the positive consequence on acceptance of differences spills over to diversity in general. Finally, the benefits go beyond Arbusta and its workers impacting their communities and society at large.

2.3.3

Arbusta and COVID-19 Impact

Two of Buenos Aires’s shanty towns, Villa 31 and Villa 1–11-14, were among the most impacted by COVID-19. Thus, the lockdown was extremely strict, presenting Arbusta with great challenges. Beyond the human concerns, there were the businessassociated problems. Before the COVID-19 outbreak, Arbusta was highly dependent on physical proximity and face-to-face encounters: for mentoring, coaching, and shadow training. This raised questions such as how to help their staff and how to address a context that was becoming even more uncertain. Seemingly against all odds, and against even Paula’s expectations, not only could they maintain their own style of proximity working (100% remotely), but they even reaffirmed their caring culture and responsibility for each other. This was achieved after conducting several changes. At the operational level, Arbusta shifted from a production line structure to a matrix structure. Figure 2.1 shows their new organizational matrix. The matrix form allowed them to integrate a multiplicity of perspectives and the capacity to abandon mainstream linear processes, both in terms of organizational structure and their internal culture. Following the classical matrix rationale, they built autonomous project-related groups, called squads, which nurture from diverse organizational functions (e.g., automatization, testing, communication). However, the matrix was not what made the organization antifragile per se, but its internal structure. Arbusta redesigned roles, which previously (following the linear structure) had been job specific and developed squads with built-in redundancy, understood as the capability of switching roles as requested by circumstances. In a volatile COVID-19 context, this redundancy provided robustness. Aligned with the redundancy logic, Arbusta changed the within-team rationale; it empowered the squads and invited them to collective reflections. Arbusta believes that innovation is serendipitous and can come from everywhere, from the analyst to the directory team.

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Fig. 2.1 Arbusta’s squads https://arbusta.net/en/methodology/ (Source: Arbusta, 2021)

Additionally, consistent with Arbusta’s focus on people and all their traits and needs, each squad was incentivized to develop empathic behavior in order to create social buffers. COVID-19 has unveiled the contextual complexity; for example, new hires have only met the teams digitally, so far. Using vulnerability as a starting point and as a challenge to overcome, it became a means towards envisioning different solutions and, with them, new opportunities. Arbusta founders insist on the fact that there is value in changing perspectives, the manner in which one looks. Federico Seineldin, another founding partner, expresses it clearly, “by broadening and changing our views we open new perspectives unconventional approaches, that enable new opportunities and, with them, transformations. We learn from the women we hire; we see untapped talent in them” (March & Vulcano, 2020, p. 83). In other words, it enabled them to address fragilities and work from fragility rather than forecasts. Finally, as Federico said, “we are an evolving organization” (March & Vulcano, 2020, p. 119). As stated in “Introduction,” Arbusta, a software and application testing company, adapted testing skills (adaptability, open to disruption, obsolescence, failure, cracks spotting, and ability to change fast), reflexively, to their organizational model with the goal of developing an unbiased attitude to address environmental uncertainty. Not surprisingly, their starting point is unpredictability. Paradoxically, in Arbusta, COVID-19 seemed to have accelerated their problem solving format. Among the challenges Arbusta faced was to provide connectivity in

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the shanty towns where their staff lived. More importantly, it shows their employees that they could work remotely, in teams, and deliver top-quality results. It is the set of characteristics mentioned above (and discussed in the next section) that allowed Arbusta to reach the goal of not losing staff and, additionally, gaining new customers and growing in the midst of the COVID-19 pandemic. The testimony of Arbusta highlights the importance of providing the proper environment to let knowledge emerge and people grow into empowerment. More importantly, it offers insights on how to achieve a virtual business environment that allows people to flourish. Arbusta does not measure quality of life variables; they believe that they see their staff grow in every exchange and thus they are not focused on external reports. Moreover, Arbusta does not see the social/quality of life dimensions as something to show to third parties; they believe that the holistic development of people is the ultimate goal of a firm and this includes the development of all human dimensions (March & Vulcano, 2020). However, these testimonies from Gonzalo and Laura can provide evidence of their impact: “Arbusta invites you to go beyond what you ever thought you could do. It provides opportunities, trust, it is the beginning of something big, it is personal development and growth” (ibid, p. 48). “I never thought of myself as a leader, as someone who could help others develop, they helped me believe in me” (ibid., 51).

2.4

Discussion

We follow the argument of Shultz and Peterson (2019) that business can act as a catalyst for some of the SSI Dimensions, particularly, in the crossroads between human and economic well-being. We have shown that Argentina provides a setting of contextual uncertainty and social vulnerabilities, which increased under the extreme situation of the pandemic. Evidence from the Arbusta case allows us to suggest adopting an antifragility perspective, rather than resilience. In this section, we will develop the abovementioned concept of antifragility as well as discuss the three core antifragility strategies elicited from the Arbusta case: (1) developing an unbiased attitude and reflexivity, (2) agile people and recognition of tacit talent, and (3) redundancy and multiplicity of perspectives.

2.4.1

Antifragility

Arbusta understood that making vulnerabilities visible and loud was important. In fact, it is a first step to think about antifragility. Nicholas Nassim Taleb (2012), in Antifragility: Things that gain from Disorder, makes a series of distinctions to position the concept. First, he describes the fragile versus the antifragile as follows: “The fragile is what is hurt a lot more by extreme events than by a succession of intermediate ones. (...) For the antifragile, shocks bring more benefits (equivalently

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less harm) as their intensity increases (up to a point)” (p. 270). His second distinction is between antifragility and resilience; resilience is healing from shock, and antifragility is being prepared for an extreme shock (Black Swan or fat tail event) and benefit from it. Third, Taleb also distinguishes antifragility from mere robustness; the latter only resists (until a certain level of pressure) but does not create value from destruction. Finally, he argues that risks cannot be measured, while fragility can. He explains that we should turn from managing risk, which he considers epistemic arrogance, to managing vulnerabilities and measuring fragility. For example, fragility can be measured in relation to “sensitivity to variability”; in other words, if a firm cannot tolerate variability, it is fragile. Based on the above distinctions, Taleb advocates non-predictive decision making, that is to say, to detect fragilities, analyze them, try to reduce, or harness them. This calls for a preparation and is essentially anticipatory. He explains what this preparation would consist of the following: First is a change of perspective, focusing on fragilities and vulnerability rather than forecasting; non-predictive decisionmaking is an essential turn in organizations. Second is not trying to suppress the risk but use it to open the mind to different options, favoring serendipity and welcoming chance opportunities. Third, is “skin in the game”—take the full weight of responsibility and never let others be harmed from decisions, by building the necessary buffers. This view has already been advocated by Hannah Arendt (1954, section I) who argued that a crisis becomes a disaster only when we respond to it with preformed judgments, that is, with prejudices. Such an attitude not only sharpens the crisis but makes us forfeit the experience of reality and the opportunity for reflection it provides. Building on these arguments, we shall advocate that managing vulnerabilities and seeking to reduce them can drastically change the way we approach crises, not only in emerging economies. Beyond efforts to eliminate or at least reduce bias, Arbusta changed its perspective on talent and developed a working style that valued multiplicity of perspectives, agile people, and redundancy. We shall discuss these next.

2.4.2

Unbiased Attitude and Reflexivity

Arbusta welcomes and does not stigmatize error in the organization. Instead they developed human strategies, or buffers, to contain the negative effects and impact mistakes clients could have, without punishing the employee. Errors can lead to serendipitous discoveries—and major scientific discoveries are certainly evidence for this. Taleb indeed calls for this unfocused, open predisposition and explicitly invokes “The great discoverer Pasteur, who came up with the notion that chance favors the prepared, understood that you do not look for something particular every morning but work hard to let contingency enter your working life” (Taleb, 2008, p. 208). Taleb (2008) invites to develop strategies that might welcome and collect opportunities: it is about “maximizing the serendipity around you” (p. 203). This posture when applied towards fragility and vulnerability translates into greater

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awareness of our cognitive biases and openness to the potential of our neighbors. Moreover, Taleb argues that innovation requires attentive and careful research, mental and physical preparation, and an ethical posture towards fragility and vulnerability. There is a technology of fragility at stake: a certain type of cognitive search, a certain type of interpersonal discourse, and a certain type of posture towards uncertainty. Arbusta worked extremely well on developing linguistic interactions to create a culture that could absorb certain kinds of shocks and transform vulnerabilities. The writings by Maturana and Varela (1987) and Dávila and Maturana (2019) help us deepen this concept at work in Arbusta. Reflexivity and recursive language are antifragile; they create a form of collective strength. Dávila and Maturana (2019) explain that conversations build new realities. Although words are intangible, they can touch; they might even hurt but they can also heal. The preparation consists in encouraging and fomenting more recursion in organizational culture and conduct: this logic is perfectly visible in the matrix and organizational dynamics of Arbusta, in the new relational space. Supported by the Arbusta case, we will argue that knowledge-based organizations have built-in skills, though often untapped, skills that allow them to navigate, and even to grow, through extreme crises such as COVID-19. This technology of fragility would be perfectly reproducible in other types of industries and organizations since it is based on rediscovering the burgeoning potential of reflexivity in conversation. However, this requires a change in perspective on how to cultivate technology and business-related talents.

2.4.3

Tacit Talent

What is particularly interesting is that Arbusta pooled talent, which was both tacit and invisible; furthermore, nobody acknowledged it or looked at these women from vulnerable contexts. Drawing from Polanyi’s (1966) concept of tacit knowledge and Merleau-Ponty’s (1964) concept of the “invisible,” we propose the concept of “tacit talent,” mentioned above. In the introduction to his book The Tacit Dimension, Polanyi (1966, p. 10) writes “If we know a great deal that we cannot tell (...) the idea of knowledge based on wholly identifiable grounds collapses” and provides an example: “the transmission of knowledge from one generation to the other must be predominantly tacit” (ibid, p. 10). In other words, not all can be translated into transferable and commoditized knowledge objects. Polanyi (1966) sees uncertainty as knowledge potential and Merleau-Ponty (1964, pp. 162–170) describes it as a torsion, a weaving, (“entrelacs”) interlacing the visible and the invisible. Polanyi’s tacit knowledge is about transmission and being aware that knowledge is essentially intersubjective. The relational space is what made Arbusta unique in that it illuminated the value of the people, which proved to be particularly relevant, in times of emergency and

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uncertainty. In short, Merleau-Ponty (1964) and Polanyi (1966) enable us to conceptualize this change of dimension from tacit knowledge to tacit talent. Drawing on and combining both, we define tacit talent as an expertise an individual has but was not considered a talent, not even by the individual. More importantly for the wider objective of this chapter, it means that talents have both a tacit part and an explicit part, the latter being expressed in the curriculum vitae. Moreover, normally, firms hire people based on their explicit talent. However, it is the tacit talent of underprivileged women that is central to the implementation of antifragility strategies. Going beyond the Arbusta case, we will argue that in emerging economies a large number of people lack formal academic knowledge, epistemē, but have vast experience in their daily encounters with and problem solving responses to uncertainty. As stated, this tacit (invisible) dimension is the talent about which companies do not even know and the women do not see or value. Yet, the Arbusta case highlights that such failure by some companies and/or oversight by women might be the primary factors to spur innovation, change, and creativity, the agility needed in developing antifragility. Thus, to start leveraging organizational antifragility, it is necessary to acknowledge that people who live in uncertain contexts have developed skills to handle volatility, which need to be made visible.

2.4.4

Redundancy and Plurality of Perspectives

As one of Arbusta’s founders’ states “we are not a bridge between communities, we are a new path” (March & Vulcano, 2020, p. 40). This new antifragility path is built adopting a multiplicity of perspectives, abandoning mainstream linear thinking, and creating redundancy. Arbusta showed the benefits of having dynamic teams, squads that were empowered, through collective reflection, to explore alternatives. Moreover, these squads had built-in redundancies that provided robustness. Taleb (2012, p. 380) argues that “we need to build redundancy, a margin of safety, avoiding optimization, mitigating (even removing) asymmetries in our sensitivity to risk.” Arbusta creates internal redundancy and external redundancy, which operate at various levels (as inter-organizational and intra-organizational cooperation) and are at the core of its problem solving speed and greater profitability. Taleb (2012) also recommends a collective approach to antifragility as the individual is more fragile than the group. Similarly, Nonaka and Hishigushi (2001) advocated the importance of cooperation and the acknowledgment of cross fertilization and learning from other actors. These skills will allow for “different (and also stronger) organizations” (p. 288). Nonaka and Hishigushi (2001), p. 288) put it very clearly at the end of their book, in the form of a challenge to developing economies, stating

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that there is a need to know more about how concepts such as Ba3 and coevolution can help small- and medium-sized firms and developing regions. This approach is also aligned with Taleb’s (2012) notion of the power of optionality: “(the) ability to switch from a course of action is an option to change. (...) Optionality will take us many places, but at the core, an option is what makes you antifragile and allows you to benefit from the positive side of uncertainty, without a corresponding serious harm from the negative side” (p. 171).

2.5

Limitations and Future Research

The chapter provides a set of insights that we claim contribute to the extant knowledge in the QOL field. However, it is not free from limitations. The main limitation we identify is methodological. Case studies are suggested as the preferred mode, for example, when the investigator has little control over events and when the focus is on a contemporary phenomenon within a real-life context, specifically when the boundaries between phenomenon and context are not clearly evident (Yin, 2003). The phenomenon studied in this chapter has these characteristics. There is no interference in the decision making process, and it was not a designed experiment. Case studies have also been suggested, where existing knowledge is limited (Bonoma, 1985). The literature review suggested that the debate within the QOL literature, on these topics, is still in its infancy. There are different types of case methods that address a wide range of research problems, for example, exploratory cases, theory building cases, theory testing cases, and theory extension cases (Stake, 1995). In the latter case, the aim is to refine theories in light of new observations, showing to what extent the theory can be generalized. In this chapter we use the case method with a theory extension goal. However, Arbusta is but one case, very contextual and within an idiosyncratic culture, stemming from the people involved themselves. The extreme personalization of the organization necessarily means that it will be unique. Thus, it is convenient to replicate similar studies in order to both validate that the antifragility strategies elicited are not contingent or idiosyncratic and to explore if there are additional antifragility actions beyond those identified in Arbusta. Beyond the methodological limitations, Arbusta, itself, though laudable for its achievements, does present weaknesses. A first challenge they will need to address is whether the model as it stands can support the high levels of growth it is experiencing, without sacrificing some of its QOL goals. As we have shown, Arbusta goes beyond providing technology-based jobs to shanty town women, a superficial QOL limited to income and social security. Arbusta believes that people are an indivisible

“Ba” is a Japanese word. It means a shared space for emerging relationships. Not necessarily a physical space. It was first introduced by the philosopher Kitaro Nishida and then translated to management by Nonaka and Konno (1998).

3

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whole and thus aim at helping their staff develop as human beings; this is a holistic QOL perspective. To achieve the higher goal of shifting from a muted and invisible to resonant and flourishing existence, Arbusta nurtured an active listening and empathic work environment. Covid-19 remote work conditions challenged Arbusta, leading it to develop mechanisms that acted as buffers to contain the negative effects and impact of mistakes resulting from isolated work (e.g., not being able to ask their work neighbors questions). Growth will also challenge Arbusta. It will require them to develop mechanisms that act as enablers of a full QOL development. As soon as anonymity or indifference—in which rapid growth might generate—seeps in, those resonant and listening spaces might crack or disappear. In a nutshell, breadth might come at the risk of depth. The challenge is then how to protect and continue generating those resonant spaces, which are transforming the individuals’ relation to their world, through an accelerated growth process. Last but not the least, Arbusta’s work with the NGOs (who operate in the shanty towns in their recruitment campaigns) could be used as a stepstone to enhance the QOL of the community at large. Arbusta has strong relationships with two shanty town key players: the NGOs and Arbusta’s working women. In short, a small network is already in place that could be empowered, through additional alliances, to help the communities achieve higher levels of well-being.

2.6

Conclusions

We agree with Taleb’s (2012) view that we cannot reduce uncertainty, but we can reduce fragility and vulnerability. Uncertainty belongs to life and if we could reduce it, in the process, we would be also diminishing opportunity, serendipity, and chance. Thus, in the sake of preserving the creative aspects related to life, the focus should be on minimizing its negative effects. This shift in rationale implies a change of mindset. For individuals and communities to flourish, it is necessary to allow serendipitous creativity and antifragility to emerge. Moreover, risk should not be totally suppressed or controlled. In Argentina, COVID-19 has reignited the scars of several economic crises and political crises—it has also triggered reflex collective agile behaviors. The Arbusta case in the context of the pandemic has demonstrated that for business to play its catalytic role, it seemed necessary to weave a redundant organizational structure, wrapping talents in opportunities to discuss, propose, connect, and grow, in other terms, to create options and nest freedom within the organization by replacing the process, the design, the straight line with the stochastic impermissibility of people and encounters. Arbusta has tapped into potent, overlooked resources with an acute awareness of how to control vulnerabilities and create optionality for and with people: female youth, invisible talents mixed with visible ones. Additionally, processes must be socially constructed; policies and practices must be proactively redesigned to foment these processes. Moreover, they must

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incentivize and empower people to explore new opportunities through complex, pluralistic, and collaborative systems approaches. The Arbusta case shows that leading technology businesses offer a model of accommodation and adjustment to change, a complex arrangement of circuit breakers that have developed skills to gather emergent information (as well as distortions and emergency temporalities). Last, but certainly not the least, in Argentina, technology tends not to be a traditional business sector. It involves a much younger generation, whether in or beyond the C-suite; emerging trends suggest this generation seems to be more concerned about the societal impact and wellness that results from their work, rather than traditional measures of professional growth. A different generational approach to sustainable, fair, and inclusive issues in business that affect well-being therefore also necessitates novel perspectives on development. Arbusta knew how to seize the generational opportunity, hiring those who neither work or study, single mothers with dependent children, centennials, and millennials, and link the technological sector with social impacts. It played its catalytic role, providing opportunities and legitimacy to this often-stigmatized generation, in vulnerable communities. In short, the challenges and suffering resulting from the SARS-CoV-2 pandemic also created opportunities to explore how a technology and knowledge-based services business, in an uncertain environment, helped vulnerable women and their communities to flourish. Arbusta’s emergence is not an abstraction; those who are emerging are people.

References Arbusta. (2021). Methodology. https://arbusta.net/en/methodology/ Arendt, H. (1954). The crisis in education, between past and future. Penguin. Argencon. (2020). Argenconomics: Estudios económicos sobre la industria del conocimiento. Informe 2019. https://www.argencon.org/argenconomics/ Arositio. (2020). El desempleo en Argentina. https://www.agrositio.com.ar/noticia/212785-eldesempleo-en-argentina-seria-del-293-si-se-toma-en-cuenta-la-pea-que-no-pudo-buscartrabajo-por-la-cuarentena#:~:text¼El%20desempleo%20en%20el%20segundo,abril%20y%20 junio%20de%202019.&text¼As%C3%AD%20que%2C%20si%20esa%20gente,empleo%2C %20lo%20habr%C3%ADa%20hecho%22 Asongu, S. A., Anyanwu, J. C., & Tchamyou, V. S. (2019). Technology-driven information sharing and conditional financial development in Africa. Information Technology for Development, 25(4), 630–659. Bloom, N., Hassan, T.A., Kalyani, A., Lerner, J., & Tahoun, A. (2020). The geography of new technologies. Institute for New Economic Thinbloomking Working Paper Series (126). Bonoma, T. V. (1985). Case research in marketing: opportunities, problems, and a process. Journal of Marketing Research, 22(May), 199–208. Bourgeois, L. J., III. (1980). Strategy and environment: a conceptual integration. The Academy of Management Review, 5(1), 25–39. CAC, Camara Argentina de Comercio y Servicio. (2018). América del Sur y la Argentina: una comparación regional. Unidad de Estudios y Proyectos Especiales. https://www.cac.com.ar/ data/documentos/3_América%20del%20Sur%20y%20la%20Argentina%20una%20 comparación%20regional.pdf

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CAME. (2020). Impacto de la pandemia COVID-19 sobre el sistema de salud argentino. https:// www.caeme.org.ar/impacto-de-la-pandemia-covid-19-sobre-el-sistema-de-salud-argentino/ Courtney, H., Kirkland, J., & Viguerie, P. (1997). Strategy under uncertainty. Harvard Business Review, 75(6), 67–79. Dávila, X., & Maturana, H. (2019). Historia de nuestro vivir cotidiano. ed Paidos. ISBN: 978-956998-721-2. Dill, W. R. (1958). Environment as an influence on managerial autonomy. Administrative Science Quarterly, 2(4), 409–443. Duncan, R. B. (1972). Characteristics of organizational environments and perceived environmental uncertainty. Administrative Science Quarterly, 17(3), 313–327. Gerchunoff, P., & Torre, J. C. (2018). Argentina: The politics of economic liberalization. In The changing role of the state in Latin America. Routledge, 115–148. GPEDC, Global Partnership for Effective Development Cooperation. (2020). https://www. effectivecooperation.org/landing-page/monitoring-data IGN, Instituto Geográfico Nacional. (2020). Población https://www.ign.gob.ar/ NuestrasActividades/Geografia/DatosArgentina/Poblacion2 ILO (International Labor Organization). (2020). https://www.ilo.org/wcmsp5/groups/public/%2D %2D-ed_emp/documents/publication/wcms_754689.pdf INDEC. (2019). Acceso y uso de tecnologías de la información y la comunicación. Ciencia y Tecnología, 4(83). INDEC. (2020a). Mercado de trabajo. Tasas e indicadores socioeconómicos. Trabajo e Ingresos, 4(5). INDEC. (2020b). Inflación https://www.indec.gob.ar/indec/web/Nivel4-Tema-3-5-31 INDEC. (2021). Mercado del trabajo https://www.indec.gob.ar/indec/web/Nivel4-Tema-4-31-58 Kim, J. Y. (2015, April 7). Comments by president of the World Bank on extreme global poverty, Center for Strategic and International Studies, Washington, DC. March, C., & Vulcano, A. (2020). La potencia del talento no mirado: la experiencia de Arbusta, una empresa latino americana de tecnología, ed. Temas Julio. Maturana, H. R., & Varela, F. J. (1987). The tree of knowledge: The biological roots of human understanding. New Science Library/Shambhala Publications. McMullen, J. S. (2011). Delineating the domain of development entrepreneurship: a market-based approach to facilitating inclusive economic growth. Entrepreneurship Theory and Practice, 35(1), 185–193. Mendoza, R. U., & Thelen, N. (2008). Innovations to make markets more inclusive for the poor. Development Policy Review, 26(4), 427–458. Merleau-Ponty, M. (1964). Le visible et l’invisible. Tel Gallimard. Ministry of Health, Argentina (2021). COVID-19 cases. https://www.argentina.gob.ar/coronavirus/ informes-diarios/reportes/febrero2021 Mintzberg, H. (1987). The strategy concept i: Five ps for strategy. California Management Review, 30(1), 11–24. Mobile Industry Impact Record. (2020). https://www.gsma.com/betterfuture/2020sdgimpactreport/ Nonaka, I., & Hishigushi, T. (Eds.). (2001). Knowledge emergence: social, technical and evolutionary dimensions of knowledge creation. Oxford University Press. Nonaka, I., & Konno, N. (1998). The concept of “Ba”: Building foundation for knowledge creation. California Management Review, 40(3), 40–54. Norris, F. H., Stevens, S. P., Pfefferbaum, B., Wyche, K. F., & Pfefferbaum, R. L. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology, 41(1/2), 127–150. Pels, J., & Kidd, T. (2012). Characterizing emerging markets. Organizations and Markets in Emerging Economies, 3(2), 8–22. Pfeffer, J., & Salancik, G. R. (1978). The external control of organizations: A resource dependency perspective. Harper & Row Publishers. Polanyi, M. (1966). The tacit dimension. Routledge.

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Resico, M. F., Ravier, A., & Esteban, C. (2020). Informe de economia e institutiones. Pontifica Universidad Católica Argentina. Shultz, C. J., & Peterson, M. (2019). A macromarketing view of sustainable development in Vietnam. Environmental Management, 63(4), 507–519. Shultz, C., Deshpandé, R., Cornwell, T. B., Ekici, A., Kothandaraman, P., Peterson, M., Shapiro, S., Talukdar, D., & Veeck, A. (2012). Marketing and public policy: Transformative research in developing markets. Journal of Public Policy and Marketing, 31(1), 78–184. Shultz, C., Rahtz, D., & Sirgy, J. (2017). Distinguishing flourishing from distressed communities: vulnerability, resilience and a systemic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), The handbook of community well-being (pp. 403–422). Springer. Simon, R., & Aalbers, G. (2020). The Capacity to Combat Corruption (CCC) Index, AS/COA AntiCorruption Working group, Americas Quarterly and Control Risk. https://www. americasquarterly.org/wp-content/uploads/2020/06/2020_CCC_Report.pdf Sirgy, M. J. (2011). Theoretical perspectives guiding QOL indicator projects. Social Indicators Research, 103, 1–22. Smircich, L., & Stubbart, C. (1985). Strategic management in an enacted world. The Academy of Management Review, 10(4), 724–736. Stake, R. (1995). The art of case study research. Sage. Taleb, N. N. (2008). Black swan: The Impact of the highly improbable. Penguin. Taleb, N. N. (2012). Antifragile: Things that gain from disorder. Penguin. Taleb, N.N. Norman, J., & Bar-Yam, Y. (2020, January 26). Systemic risk of pandemic via novel pathogens – Coronavirus: A note. New England Complex Systems Institute. Thompson, J. D. (1967). Organization in action. McGraw-Hill. Thorelli, H. B. (1995). The ecology of organizations. Advances in Strategic Management, 1, 415–441. Ting, D. S. W., Carin, L., Dzau, V., & Wong, T. Y. (2020). Digital technology and COVID-19. Nature Medicine, 26(4), 459–461. Transparency International. (2020). Corruption perceptions index 2019. https://www.transparency. org/files/content/pages/2019_CPI_Report_EN.pdf Weick, K. E., & Daft, R. L. (1983). The effectiveness of interpretation systems. In K. Weick, R. L. Daft, & K. S. Cameron (Eds.), Organizational effectiveness: A comparison of multiple models. Academic Press. World Bank. (2020). https://www.worldbank.org/en/country/argentina/overview Yin, R. K. (2003). Case study research, design and methods (3rd ed.). Sage.

Liza Kharoubi Echenique (Ph.D., MBA) is a Part-Time Professor of Philosophy and Business at the University Torcuato Di Tella Business School, Buenos Aires, Argentina, a conference speaker, and an Independent Business Consultant. Her research interest is in building a different approach to Philosophy from Business and providing access to philosophical literature to business practitioners: she believes that bridging these two communities who hardly ever speak might be a game changer for a more resonant future. She has been conferencing in international institutions such as ParisSorbonne, University of Auckland, Massey University, RMIT, Harvard University, University of Oxford, Université Montpellier III, Université d’Aix-Marseille, Université d’Avignon, Leeds University, University of Kent, Université National Cheng Kung University, Regina University, Brunel University, Université Laval [[email protected]]. Jaqueline Pels (Ph.D.) is a Full Professor of Marketing at the University Torcuato Di Tella Business School, Buenos Aires, Argentina. She is Director of the Inclusive Business Think Tank (ENI-DiTella). Her research interest is in the areas of inclusive business, emerging economies, marketing theory, relationship, and networking marketing as well as the Service Dominant logic. Her publications have appeared in leading international journals including Journal of the Academy of Marketing Science, Marketing Theory, Journal of Business Research, Journal of Business and Industrial Marketing, European Journal of Marketing, Journal of Relationship Marketing, amongst others. She has served on the Editorial Boards of the Journal of Marketing, Marketing Theory, Journal of Business and Industrial Marketing, amongst others [email: [email protected]].

Chapter 3

COVID-19 Response in Australia: An Examination of State Responses and System Vulnerabilities Michael Polonsky and Virginia Weber

Abstract This chapter examines Australian response systems to the COVID-19 global pandemic and how these responses impact on community outcomes, such as flourishing and distress. Most notably, this analysis focuses on the complex interrelations between policy, community, and individuals both prior to and during a major external shock or crisis. In particular, we first discuss how the nature of a given crisis such as a pandemic can create unique vulnerabilities and resiliencies within a community. We then examine how these crisis-specific vulnerabilities and resiliencies can interact with pre-existing vulnerabilities and resiliencies within a given community to determine flourishing and how vulnerabilities can be exacerbated or mitigated as a result of government and business policy decisions. Finally, we use a case study to shed light on how the interplay between policy and vulnerability can create unforeseen issues within crisis response systems, highlighting the importance of flexibility and agility in developing resilient crisis response systems that will not undermine flourishing. We conclude with a discussion of implications regarding the interconnectedness of systems and communities in times of crisis. Keywords COVID-19 · Vulnerability · Community flourishing · Policy · Government

3.1

Australia in COVID-19

Like all countries around the world, the COVID-19 novel coronavirus pandemic has had a significant impact on all aspects of life and the economy in Australia. Early on, there was governmental recognition of the systemic threat that the pandemic represented. It was also clearly recognised that addressing this would require a multi-dimensional approach for dealing with the health impacts, spread of the

M. Polonsky (*) · V. Weber Department of Marketing, Deakin University, Melbourne, VIC, Australia e-mail: [email protected]; [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_3

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illness, and the secondary implications on individuals and society arising from restrictions on economic and social activities. As of 27 January 2021, there have been 28,780 positive cases detected, 909 deaths, and 12,778,139 COVID-19 tests undertaken with a 0.2% positive rate (Health, 2021). Australia’s first case appeared in January 2020 (Price et al., 2020), and the first wave was ‘controlled’ in April 2020 with community spread eliminated (Beck & Hensher, 2020), with the second and subsequent waves impacting a range of cities and locations, including a second 112-day lockdown in Melbourne, Victoria (BBC News, 2020; Giles et al., 2020) and additional sporadic lockdowns in other states and regions. The effects of this are still being felt into 2021, with many restrictions only being relaxed again in January/February 2021 (O'Mallon, 2021), although sporadic infections still occur, arising from the management of international quarantine, resulting in short-term lockdowns or raising of restrictions (Murray-Atfield & Kinsella, 2021). Thus, this global external shock resulted in a major political, economic, and social response within Australia, testing community resiliencies and exposing new vulnerabilities and existing systemic inequalities. Based on this, it is not surprising that the events related to the COVID-19 pandemic response have impacted on every Australian in some way or another: physically, economically, socially, and psychology. For example, healthcare workers in Australia are under extreme physical and psychological stress dealing with the pandemic (Halcomb et al., 2020), whereas school children have an increased level of anxiety and social isolation resulting from online learning (Flack et al., 2020). This is not to mention the significant financial and psychological stress from those who have lost their jobs (Collie et al., 2020) or the communities that rely on tourism which have dried up due to domestic and international travel bans (Flew & Kirkwood, 2020). The pandemic and associated impacts have also resulted in increased suicides in Australia as well (Welfair, 2020). Unfortunately, many of the negative impacts of COVID-19 disproportionally impact those in low-income occupations, or those working part time, even though (as will be discussed) governments and businesses did implement policies to support those most affected (Mills et al., 2020). In the following sections, we briefly discuss the literature on vulnerability and community resilience and provide an extension of a model of community outcomes in response to major external shocks such as global pandemics. This is followed by an examination of specific Australian response systems to COVID-19 which highlights specific resiliencies and vulnerabilities exposed by these responses. We then provide a case study examining the nature of some unique and pressing vulnerabilities. Finally, we conclude by providing implications for policy and marketers.

3.2

Community Vulnerability and Flourishing

Community vulnerability and resilience are factors which can determine whether a community will progress toward positive outcomes such as flourishing or more negative outcomes such as becoming distressed (Shultz et al., 2017). In this section,

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we discuss determinants of vulnerability and resilience from a theoretical lens and highlight the role that external shocks have in creating and exacerbating vulnerabilities for specific communities. We then present a model for predicting these outcomes.

3.2.1

Determinants of Vulnerability and Resilience

Societal vulnerability exists in many forms; it may be ongoing and systemic, or it may occur as the result of specific circumstances. Owing to the complex and diverse nature of vulnerability, it can be difficult to narrowly define this construct (Füssel, 2007). In the present context, we focus in particular on how individuals and specific communities within society may be more or less at risk to negative outcomes as a result of external strains, whether these are global- or society-level shocks or more targeted policy or community changes (i.e. threats; see Downing et al., 2005). The United Nations (United Nations, 2004) argues that there are four major determinants of vulnerability in response to a crisis: physical, economic, social, and environmental (see also Cutter, 1996; Füssel, 2007; Klein & Nicholls, 1999). In the present chapter, we focus predominately on economic and social determinants of vulnerability. As described below, Australia has benefited in its response to the COVID-19 crisis its physical and environmental placement (i.e. its geographic distance); however, there are numerous insights which can be gleaned through a detailed examination of the socioeconomic factors which have determined community impacts of the pandemic in Australia and the Australian pandemic response. Vulnerability at the socioeconomic level is argued to be a result of both internal (income, social networks, access to information) and external (government policies, aid, and economic) factors (Füssel, 2007). While these can operate as separate determinants of community outcomes, it is often the case that government policies will differentially impact different communities as a function of pre-existing systemic vulnerabilities (Small et al., 2020; Van Lancker & Parolin, 2020). For instance, children in lower-income households (internal) are typically at a greater risk of experiencing food insecurity, an effect which has been exacerbated by school closures (external) as a result of the COVID-19 pandemic in many countries (Van Lancker & Parolin, 2020). In this way, external factors such as economic downturns and government policies have a causal impact whether pre-existing vulnerabilities become exacerbated, which may be particularly true in times of crisis. Additionally, we highlight that people who may not have systematic vulnerabilities can become vulnerable when large external shocks are present, either as a function of the shock itself or as a result of the policy response. For example, while vacationers are not a systemically vulnerable group, they experienced a unique circumstantial (responsebased) vulnerability as a result of being prevented from returning home across state borders that closed on short notice (BBC News, 2020c). Building from this, in the present work, we focus on internal vulnerabilities as pre-existing vulnerabilities which exist within a community and vulnerabilities that

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arise from the pandemic and consider external factors as having a causal impact on how these vulnerabilities, in turn, relate to community outcomes. We argue that when an external shock such as the COVID-19 pandemic is present and acting as a stressor on a system, government and industry policies determine whether pre-existing vulnerabilities are mitigated or exacerbated, or whether new groups become vulnerable, and thus whether vulnerable communities increase, those who are vulnerable can flourish, or newly or existing vulnerable communities become distressed in response to crisis. Research suggests that communities are considered resilient when they are able to respond to external stressors and shocks with favourable outcomes, creating a capacity to ‘bounce back’ from these shocks (Sherrieb et al., 2010). In this way, vulnerability and resilience are frequently considered as opposite ends of a single continuum (Shultz et al., 2017). Diverging slightly from this approach, we argue that vulnerability and resilience are opposing ends of a spectrum in aggregate, but their determinants and role in community flourishing will not always be on opposite ends of the same spectrums. Put simply, while a community that is less vulnerable is one that is more resilient, it is nonetheless the case that not having a specific vulnerability does not inherently mean one has a specific resilience. For example, if a secondlanguage community is vulnerable due to a lack of comprehension of government messaging regarding a crisis, this does not inherently make the majority-language community inherently resilient. Thus, we focus on resiliencies as a community’s ability to adapt and respond to shocks in a way that will promote a transition toward flourishing. Although similar in kind to a single-continuum approach, this highlights that vulnerabilities and resiliencies in response to any given shock will look slightly different depending on the nature of that shock and what determines increasingly negative or increasingly positive community outcomes. There are numerous models for what factors determine resilience, we focus on resilience as it pertains to navigating external shocks (Sherrieb et al., 2010) and promotes long-term flourishing (Shultz et al., 2017). While some of the factors which determine resilience will be the same as those determining vulnerability (i.e. biophysical and socioeconomic factors; Füssel, 2007; Shultz et al., 2017; United Nations, 2004), we also highlight some specific community capacities which determine and facilitate resilience. At the community level, these include economic development, social capital, information and communication, and community competence (Sherrieb et al., 2010). Building from this prior literature on community resilience, we examine how economic factors (business and industry) and government policy can have a positive and catalysing impact on resilience in response to a negative shock. To the extent that the economy (business and industry) and government are highly interwoven systems, these two elements function together to have a large impact on community vulnerabilities and resiliencies (Shultz et al., 2017). We extend from this to examine how these catalytic institutions (i.e. business and government) act in a manner which uses community resiliencies to their full capacity, promoting long-term flourishing, or in a manner which does not take advantage of these capacities, resulting in less positive long-term outcomes.

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53

Community Outcomes in Response to External Shocks

Shultz et al. (2017) propose that a flourishing community is one which has ‘demonstrated temporal sustainability’ and ‘a capacity for continued growth and resiliency’ in terms of its indicators of well-being; whereas they propose that a distressed community is one where these indicators of well-being are in a negative state, and growth, empowerment, and resilience are inhibited or diminished (Shultz et al., 2017, p. 11). They provide a model which highlights that flourishing and distress are not necessarily static states but that communities exist in a state of transition and flux. In this way, individuals and communities may move between states, potentially as a result of shocks (i.e. they become more vulnerable) and policy actions (i.e. they ideally become more resilient, although policy may have a negative impact as well). We build from their model here but diverge in meaningful ways. Our divergence is predicated on the notion that a broad-sweeping crisis such as the global COVID-19 pandemic results in rapid responses and policies, each of which has the potential to newly create unique sets of vulnerabilities for specific communities even as it aims to protect the entirety of the community from systemic threat. Of course, systems may already disadvantage some communities more than others; thus, any additional factor may disproportionally impact on more vulnerable members of society. However, the existing pandemic may be one such case where a small change can have an accelerating rippling effect, resulting in a tsunami of vulnerability and responses. Thus, we propose a model (Fig. 3.1) of community outcomes (flourishing and distressed) which focuses in particular on outcomes in response to large external shocks (see also Norris et al., 2008). While external shocks are included as an input to Schultz and colleagues’ model (Shultz et al., 2017), we redefine this model to focus on the shock as impacting not only the state of transition but also the community vulnerabilities and resiliencies and include a component to this model for the policies from the government and the business community which arise in response to such shocks. These additional factors (policy decisions) are discussed with regard to their catalytic institutions (government, businesses, and NGOs) and how they feed forward into the complex interplay between vulnerability/resilience and community outcomes. As such, our model focuses in particular on specific responses to negative external shocks as the core determinant of communities’ transition to flourishing or distress—still in view of pre-existing vulnerabilities and resiliencies but also with regard to newly created vulnerabilities and resiliencies. We highlight the manner in which policies by catalytic institutions create a feedback loop in relation to communities’ vulnerabilities and resiliencies such that these policies will impact on communities in terms of forming, exacerbating, or mitigating vulnerabilities, and in turn, the community response and recognition of vulnerabilities may prompt revision and redevelopment of policies imposed by these institutions. To demonstrate the functions of our model, we provide an examination of the Australian response systems and policies that highlight how the structure of the

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External

Transitional  Ascending

Flourishing

Distressed

Descending 

Vulnerabilities and Resiliencies

Policies: Government and Business

Fig. 3.1 Model of community flourishing experiencing a shock (see also Shultz et al., 2017)

system and its linkages itself can be assessed in terms of vulnerability and resilience. We further provide a case study analysis which will examine the how interlinkages between individual actors (i.e. consumer citizens; Shultz et al., 2017), policies, and industry can have a large impact on community response to these shocks. In particular, we show that a system is vulnerable when singular negative shocks in one area have a high degree of detrimental spillover onto other areas, whereas a system is resilient when such shocks can be isolated without detrimental spillovers. In the following sections, we validate this model by discussing the Australian response to the global pandemic as a major external shock and examine how the unique factors related to this crisis have determined which communities are more and less vulnerable and how policy has then exacerbated and mitigated vulnerabilities and resiliencies. We discuss the role this relationship between policy and vulnerability/resilience has in fostering transitions toward flourishing and distress for Australian communities.

3.3

Australian Outcomes

In this section, we examine Australia’s COVID-19 pandemic responses in several important areas, including government responses, healthcare, movement of people (domestic and international), employment, and industry. We discuss these responses as they pertain to our model of community outcomes in response to external shocks and stressors. Following this, we provide a more in-depth case study to examine the interrelations among the various linkages outlined in the model.

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3.3.1

55

Australia and the Australian Government’s Responses

Australia has a number of macro factors which have made it more resilient to widespread contagion of the pandemic. These include physical, environmental, and governmental factors (Füssel, 2007; United Nations, 2004), as follows: First, in terms of geography, Australia, unlike many other countries, had some distinctive strengths in addressing this challenge. First and foremost is the fact that Australia is an island. Thus, unlike many other nations, there are limited entry and exit points to the country. This allows the government to control the entry of travellers, both international and returning Australians (Adekunle et al., 2020) and travel within and between states (Beck & Hensher, 2020). Second, in terms of population, Australia has relatively small population, of 24 million people, with a low population density of three people per square kilometre, with 85% of the people living within 50 kilometres off the coast (Glen, 2014), with only five cities having a population of more than one million people. Thus, there is a reasonable concentration of people in a few locations. The large size of the country also meant that control of movement of people between states was generally possible, as compared to other countries, although this did cause issues for populations on the border of two states (Victoria Government, 2020a). Third, in terms of government systems, like many nations, the Australian response was a multifaceted activity involving a range of restrictions and supports. These were implemented at both the national and state/territory level. While there were already ongoing discussions coordinating a range of policies, as a result of COVID-19, the government formed a ‘national cabinet’ including the prime minister and leaders of each state (Moloney & Moloney, 2020).1 This national cabinet met weekly during the early months of the pandemic to ensure there was not only coordination but a sharing of experiences and ideas, although states also were implementing policies slightly differently and responded to outbreaks as they arose differently depending on the severity of the spread of the illness which varied over time and location. Australia benefited from a good relationship between the federal government and seven states and territories, especially during the pandemic (Moloney & Moloney, 2020). Thus, while much of the actions were undertaken at the state level, these were broadly coordinated and supported across the states, although some gaps in coordination between states and the Federal government did inadvertently contribute to the spread of the virus (Quigley et al., 2020). As will be discussed, each state imposed slightly different approaches, especially in response to outbreaks in the second wave, although these tended to be very similar arising from the intergovernmental cooperation.

1

See https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_ Library/pubs/rp/rp2021/Chronologies/COVID-19StateTerritoryGovernmentAnnouncements for a full list of activities undertaken by States and Territories up to June 30, 2020.

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Businesses also cooperated with governmental policy, including banks offering loan deferrals (Association, 2020) and utilities offering payment deferrals, as well as even private landlords agreeing to reduced individual rentals (Victoria Government, 2020b), with governments implementing eviction mortems (Victoria, 2020). Thus, government support was complemented by actions of other sectors or catalytic institutions, as these were referred to in Schultz et al. (2017). Fourth, in terms of the interaction between governments and publics, there is generally—although not universally—a high degree of trust in the Australian government (Henriques-Gomes, 2020). Australia already has a very high degree of involvement in individual rights and commerce, with this potentially leading to a higher compliance with mask and home lockdown measures (Thomas et al., 2020). It is sometimes being suggested that Australia is the nanny state, overly protecting Australians (Hassard, 2015). As such, citizens may be less ‘individual’ rights focused as compared to other countries, even though a range of protests of control did occur (Bongiorno, 2021).

3.3.2

Healthcare

The COVID-19 novel coronavirus is after all a health issue that had flow on effects to the economy and human activity. The initial restrictions on movements were designed to limit the spread of the illness and to minimise the possibility that the healthcare system would be overwhelmed with COVID-19 patients. Thus, the Australian healthcare system geared up for the increased COVID-19 patients and at the same time cutback and then stopped elective surgery to ensure there was appropriate capacity (Mills, 2020). In Australia, masks were required in many settings and within states in some cases it was a requirement to wear masks anytime you left the house, excluding exercising outside (Kinsella & Handley, 2020). These rules were then relaxed over time, and masks are still required in some states when going to food stores, shopping malls, and religious services (Kontominas, 2021) or in response to flare ups (MurrayAtfield & Kinsella, 2021). Businesses were also restricted in terms of the number of patrons who could be inside. While there has been some backlash and protests about mask rules, there generally has been compliance and limited violent outbursts (Thomas et al., 2020) as has occurred in other countries. The government increased resources for testing sites, including drive-in sites, which were designed to limit the spread of COVID-19. Some states were able to process upwards of 20,000 tests a day and get results back to people within 24 h, where initial testing was taking 3–5 days to get results with fewer tests being undertaken (Ting et al., 2021). The expedited testing and results also resulted in less pressure on individuals quarantining, reducing both stress and the costs associated with taking leave from work. The Australia healthcare system is highly socialised, which allowed a more active government involvement. For example, the government allowed patients to receive

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telehealth appointments (which previously were precluded from the public healthcare system), which then became covered by the healthcare system (Dalzell, 2020). This was designed to protect doctors and patients but also ensure that people did not neglect other health issues during the pandemic. The government also increased spending on mental health, increasing the number of visits with mental healthcare professionals that people were eligible for, from 10 to 20 visits (Health, 2020a). This ensured that there were additional supports put in place for those directly and indirectly affected by the virus. Like many other countries, the government also invested in a number of potential vaccines and treatments. One of the locally developed vaccines was cancelled while in trials, because there was an increased chance that people would end up getting false-positive HIV results. It was feared that this would impede people taking this vaccine and make treating HIV more difficult (BBC News, 2020d). The government did not rush to grant emergency approvals for vaccines, and the first vaccines were only approved in late January 2021 (P. M. Australia, 2020a), with initial distribution planned for March 2021. Thus, the Australian government took a very cautious approach. To maintain vigilance, the government has implemented a waste treatment testing scheme, which they use to identify areas where potential infections may exist, by identifying the virus or fragments of the virus in wastewater. The government then actively promotes testing in the arse to try and catch limit any outbreaks (Hamilton-Smith & Rendall, 2020).

3.3.3

Movement of People: International

Australia took some of the most severe restrictions on movement in the world. Not only did it limit international travellers entering the country, but it also limited the number of Australians that were allowed to re-enter Australia from overseas. Additionally, it restricted the movement of Australians leaving Australia such that even those exiting the country were required to apply for a permit and not all were granted (Affairs, 2021). The rationale for this restriction of free travel is that once people leave, they will want to return. As such, they may become stranded overseas due to the travel caps on returning flights or return and bring in new variants of the disease. As such, the policy is designed to prevent these individuals from potentially becoming vulnerable and protect Australia from new infections (Taylor, 2021). While this has allowed Australia to maintain relatively low numbers of positive cases—evidence of overall resiliency to the pandemic—it has nonetheless caused many disruptions for industry and individuals. The national cabinet set the numbers of people who can enter Australia, as all need to go into mandatory quarantine. There has been criticism from those stranded abroad about the numbers of people that are allowed to return to Australia, with it suggested that there, even in January 2021, are 36,000 Australians who want to return to Australia but are unable to do so (Taylor, 2021). The reduced numbers allowed in also have meant that airline profitability has declined, with many airlines

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bumping economy passengers and only offering first-class or business-class tickets. Initially, the Australian government chartered several flights (which it has done since on several occasions) to bring back Australians stranded overseas, and initially, it set up regional quarantine centres (Tillett & McIlroy, 2020). The government then reverted control of quarantine to state governments, but the numbers allowed to return were set nationally. There have been some exemptions, such as chartered flights to bring seasonal workers to Australia (Bolton & Stünzner, 2020) and players and their support teams for the Australian Open (Judge, 2021). The latter two of these have been criticised in the media as it was seen to give celebrities priority over Australians seeking to get home (AAP, 2021). Anyone who has permission to enter Australia is required to quarantine for 14 days in specified quarantine hotels, which initially were funded by the various state governments, but in July, the policy changes such that visitors and returning Australians had to pay several thousand dollars to cover the costs of mandatory hotel quarantine in specified hotels (Baker, 2020). As will be discussed later in the chapter, the quarantining of visitors was designed to control the spread of the virus, but many of the outbreaks that have occurred result directly from infected people in quarantine spreading COVID-19 to the wider population (Murray-Atfield & Kinsella, 2021). In a number of cases, this has occurred as the result of inappropriate interactions between the security guards and hotel staff with those being quarantined (Hollingsworth, 2020).

3.3.4

Movement of People: Domestic

While the federal government has restricted travel into and out of Australia, it also impacted on domestic governmental behaviour (P. o. Australia, 2020b). In conjunction with state governments, the federal government implemented a number of restrictions on gatherings, forcing a number of businesses to close and required all citizens into forced lockdowns. For example, people were required to work from home unless they were classified as essential workers (Guven et al., 2020) and were restricted from visiting nursing homes (Comas-Herrera et al., 2020) or remote indigenous areas to protect vulnerable communities from the virus. In other places such as Melbourne, they implemented a second lockdown where curfews were put in place, restricting movement (Kinsella & Handley, 2020). The lockdowns and other restrictions resulted in substantial layoffs. This includes the hospitality sector. This is important, as this sector employs a large proportion of people including many low-wage workers, thus who are already in a vulnerable position (Am & Watts, 2021). There were also an encouragement and then requirements for people to begin working at home, with individual states also imposing further restrictions. These moves cause significant workplace issues, to be discussed below. Restrictions were put in place over activities such as leaving home, with some states allowing one person to leave home for up to 1 hour a day for essential goods

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and not allowing visitors. Restrictions were also placed on the number of people at weddings (five people) and funerals (ten people) (Reardon, 2020). This created significant stress on individuals. For example, in the case of large families, not all of the deceased siblings and children could attend the funeral or had to miss these because of restrictions on interstate travel (Mullins, 2020). Given the federated nature of Australia, while activities were implemented in a coordinated way with the government through the national cabinet, state governments also had the ability to act independently (Moloney & Moloney, 2020). For example, a number of states put in place a hard border that prevented people travelling into that state or entering the state and having to undertake a 14-day quarantine, even if a person is a resident of the state. Western Australia (WA) restricted travel from all states for several months, and those that were allowed to enter WA had to go into mandatory quarantine. While this started to relax at one point, it was then reimposed because of community outbreaks in other states (McNeill, 2020). All state lockdowns meant that there were roadblocks at state borders and people without permits traveling interstate were prohibited entry, in some cases even if they were residents of the state. As a consequence of interstate lockdowns, there were numerous examples of people being prosecuted for breaching these restrictions, with many people fined and others even arrested or incarcerated. This caused significant difficulties for the movement of people, workers, and industry, given that in many instances, communities spanned boarders, requiring specialised permits and making travel exceptionally time consuming (Victoria Government, 2020a, 2020b). In some instances, these hard borders were imposed with only 24–48 h notice. This was especially difficult after people started travelling with the relaxing of restrictions, only to have to ‘rush home’ to be allowed to enter their home state or entering and quartering for 14 days. This is in addition to the economic impacts on tour operators who lost business and had been hoping for a normalisation of travel, after earlier lockdowns (Kinsella & Reardon, 2021). Moreover, in some cases, state governments put in place more narrowly defined restrictions on smaller local government areas, as the result of ‘clusters’ of COVID-19. For example, prior to the initial restrictions, two public housing communities of approximately 3000 people were put under mandatory lockdown, with only a few hours of notice, and this was supervised by the police and the healthcare workers (Weedon, 2020). This was widely criticised by individuals and the news media, particularly because the majority of those living in these public housing communities were low-income families, immigrants, and refugees, many of whom did not have a fluent grasp of English and some of whom were from nations with excess military and police brutality (BBC News, 2020). As such, the government response once again disproportionately impacted the most vulnerable communities within Australia and did so with the greatest and most stringent restrictions; in a review of the actions, it was identified that this breached individuals’ human rights (BBC News, 2020). Even after relaxing the initial lockdowns after the first wave of the virus, these types of restrictions were reimposed at the state and local level on numerous

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occasions. With one of the longest being a 112-day second-wave lockdown in Victoria (BBC News, 2020). Victoria’s second-wave lockdown represents both resilience, as it is estimated to have saved 37,000 people from becoming infected with COVID-19 (Scott & Kent, 2020), while at the same time creating a systemic mental health crisis, as one estimate highlights that the mental and emotional strain of lockdowns and the overall COVID-19 response will lead to an increased suicide rate of 1191 deaths in the state of Victoria (in which Melbourne is situated) in 2021, which totals more than the number of COVID-19-related deaths in the entire country to date (McGhee & Robb, 2020). A detailed discussion of the example of South Australia’s second lockdown provides more details on the vulnerabilities associated with imposing snap lockdowns, often without full information.

3.3.5

Employment

One of the major impacts of COVID-19 has been on the increased level of unemployment, which is directly related to the closing or restricting business activities, increasing vulnerabilities among a wide range of Australians and triggering a wide range of policy responses. In February 2020, the unemployment rate was 5.1%, increased to 5.4% on April to 5.4%, and then peaked at 7.5% in July 2020 (Statistics, 2021). As of January 2021, it remained elevated at 6.5%. The effects were felt across the economy, with many casual, part-time, and low-paid jobs in hospitality and retail being the first to go (Am & Watts, 2021). Flow-on effects were felt in a wide range of areas, for example, restrictions on travel resulted in a university funding shortfall from international students not being able to get to Australia; it has been suggested that Australian universities will end up reducing academic and administrative staffing numbers through voluntary or forced redundancies by up to 20,000 (Bolton, 2020). In the airline sector, Qantas cut 6000 jobs and temporarily stood down another 15,000 workers (Butler, 2020) and Virgin airlines temporarily stood down 12,000 workers and went into voluntary administration (Khadem, 2020). We highlight that while airline travel and university workers would not typically be considered among society’s vulnerable, it was the unique features of the COVID-19 pandemic and the Australian government’s response to the pandemic which impacted these industries and created new circumstantial vulnerabilities which have impacted on workers in these industries. Businesses were also required to put in place work-at-home arrangements, which involved significant changes to both their business and their employees’ structures and activities, with 35% of Australians working at home in September 2020 (Davies, 2020). Notably, work-at-home changes already were occurring in some sectors, such as telecommuting or flexible working. However, the changes required significant restructuring of businesses and business activities. It seems reasonable to argue that these changes never would have been considered in the absence of COVID-19 forcing these changes, or if they had, it would never have occurred so quickly. As

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the work-at-home restrictions have eased, some businesses are questioning whether they need to go back to face-to-face work (Davies, 2020), with some businesses actually closing head offices. The government also instituted targeted policies to mitigate vulnerabilities and systemic issues which may arise as a result of broader policies such as working from home. For example, they instated a subsidy for day care centres (Duffy, 2002). This was important for two reasons. Firstly, with the lockdown restrictions, many children were staying at home, making the running of centres not economically viable, and thus, the scheme supported jobs in the sector. Secondly, childcare centres were critical for allowing essential workers (i.e. warehousing and distribution, online retailing, pharmacy, doctors, food retailers, etc.) to be able to undertake activities supporting the economy in lockdown, rather than staying at home watching their children (Noble, 2020). Thus, this subsidy assisted in creating more equity within the existing employment systems, as it is typically women and lower-income earners who are hit the hardest by the virus (Pankhurst, 2020) and thus are unduly impacted by restrictions to affordable childcare services. The rapid response of the government to the pandemic and the swift shift in employment circumstances for many Australians has also provided evidence of flexibility and responsiveness of the government to industry changes. In particular, the federal and state governments instituted a wide range of financial support mechanisms to assist workers and employers (P. o. Australia, 2020b). For instance, the Australian Taxation Office implemented revised rules to allow workers to deduct work-at-home costs, making it easier for individuals to claim expenses without keeping receipts (Office, 2020). In some cases, government taxes were reduced or rebated to businesses. The government also instated a range of loan and grant schemes to support business. The most significant government scheme was a wage support scheme (JobKeeper) for business whose revenue declined by a specified amount (Spies-Butcher, 2020). The money was given to business and was required to be paid to workers. This was perceived to be more beneficial than the money going directly to workers, as going through the business meant that individuals maintained ‘employment’, even though they may not still be actually working. Indeed, some employees made more under the scheme than they would have if they were working (McIlroy, 2020). On the other hand, the rapid changes and decisions imposed by the government also uncovered systemic issues related to employment. There was initial confusion about which industries were able to claim JobKeeper, and these rules were changed several times as limitations in addressing the needs of specific vulnerable groups were identified (Jacobson, 2020). While the intent of the scheme was to maintain employee–employer relationships, some businesses used JobKeeper support as a way to ‘force’ employees to work more, as they were being paid a fixed amount no matter how many hours they worked, the scheme subsidised many part-time staff as if they initially worked more hours, and some individuals could make more money with the JobKeeper scheme than they made when working (Riga, 2020). Unfortunately, there were some unscrupulous individuals and businesses who fraudulently

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claimed they had business or exaggerated the numbers of employees that they had to abuse the system (Ziffer, 2021). As is often the case when there are systemic inequalities within a population, some individual segments were more negatively affected by these policies than others. The support systems provided by the government were also restricted from some types of employees and from certain types of employers. For example, international students and some migrant categories were precluded from receiving federal government funding. This exacerbated pre-existing issues in particular because these groups were often employed in low-paid retail jobs that ceased with lockdowns (Salim, 2020). In the case of university students, some universities and other non-governmental intuitions stepped in to assist this vulnerable group, although some states implemented support funding as well (Melbourne, 2021). This highlights the integration between the different catalytic institutions of government, industry, and NGOs as being necessary for an adaptive response to a large external chaos. On the employer side, there was a distressing sector-wide effect when industries were not eligible for government supports. For example, university staff were explicitly ineligible from JobKeeper supports, resulting in substantial numbers of casual/sessional instructors (i.e. part-time adjuncts) having their hours cut or contracts terminated, some of which occurred even after semesters had started (Harris et al., 2020). As such, the support policy itself exacerbated pre-existing vulnerabilities for those with part-time or short-term employment, even while it benefited other communities and industries. The compounding impact of decreased international student enrolments (as a function of a lack of government support for their employment) alongside a lack of government support for the higher-education-sector employees through JobKeeper has made it so a previously flourishing sector (higher education) is now in a state of transition, with many elements of this community in distress (i.e. loss of employment, stability, and funding). Thus, this interplay between policy response to a shock and the needs of different communities highlights the how essential it is to have a targeted and flexible decision-making from catalytic institutions. Furthermore, government supports such as JobKeeper were designed to assist people who were ‘laid off’ and not support those who had COVID-19. As a result, more vulnerable low-wage earners who might be infected were not always getting tested, as they could not afford to take the time off work if they were sick or take the time off work for the isolation period that was required after one was tested until being informed of the test result. In many instances, the virus was spread by people who were already unwell but still working (Boseley, 2020). As an adaptive response, the Victorian government (where these problems were most prominent) instituted a scheme to support people not working whether they have COVID-19 or while waiting to get their tests, which was critical to stopping the spread (Services, 2020). While there were many negative employment activities enhancing or creating vulnerabilities, there was an expansion of some business activity, as many businesses were focused to be online only and then needed additional staff to assist with filling online orders, creating new opportunities for those who lost their jobs. There

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were, in fact, some collaborative activities between business downsizing and upsizing. For example, a major food retailer and other firms worked with Qantas airline to offer jobs to staff that the airline laid off (Marin-Guzman & Baird, 2020). The restrictions in hospitality saw a massive increase in takeaway food and home delivery, resulting in an increased employment. Although the way gig workers were paid meant many of these new ‘contractors’ struggle to make minimum wages, thus resulting in them still facing vulnerabilities (Feng, 2020).

3.3.6

Industry: Individual Sectors

One economic sector that was especially impacted was the agricultural sector as it traditionally relies on temporary visa holders (such as backpackers) and certain types of temporary migrants from the pacific islands to pick fruit (Fowler, 2020). Restrictions in travel meant that there were no backpackers or temporary migrants to take on these jobs. The government sought to attract Australians who had lost their jobs, but this was unsuccessful and those that did undertake these jobs complained about exploitation, which had previously been highlighted by workers (Derwin, 2020). This underscores the interplay between pre-existing vulnerabilities and newly created ones: the sector itself had not previously been vulnerable due to the availability of migrant workers; however, the workers themselves had been vulnerable. In the context of border closures, policies designed to assist the sector and those who had been made vulnerable (i.e. lost employment) were unable to address the pre-existing vulnerabilities within these systems and so exacerbated the vulnerabilities created by the pandemic response. To mitigate potential distress, address the farmers difficulties, and create jobs, the Australian government has since instituted special charter flights and quarantine systems to allow pacific islanders to enter to assist these communities (i.e. business and pacific islanders) who have traditionally relied on this work (M. Bolton & Stünzner, 2020). It is still unclear if there are sufficient numbers of people to undertake these tasks, and it has highlighted broader structural problems paying low wages within the sector which will continue to undermine flourishing if unaddressed as this sector moves forward. Individual state governments have also sought to implement programs to assist particular sectors recover post-lockdowns. For example, the Victorian government had a scheme where individuals could apply for a $200 voucher to subside them vacationing in regional Victoria. This was designed to ‘help drive visitation to regional Victoria and support businesses and communities to recover’ (Victoria Government, 2021a). This highlights a need for long-term and continued supports to vulnerable communities or sectors not only during but also after a crisis or crisis response has occurred. This continued support may help a community in the state of transition between flourishing and distress move more clearly toward flourishing.

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Summary

The Australian experience highlights the interconnected nature of the response across the various sectors of the economy. Individuals are affected negatively and positively across these interactions. Individual cooperation with parts of the system and each other is therefore essential in addressing the complexities. Unfortunately, this means that the system is also dependent on individuals. For example, an individual who is feeling unwell and goes to work, rather than getting tested, has the potential to initiate a new outbreak. In fact, many of the outbreaks and clusters are the result of individuals’ unintentional or intentional actions (Murray-Atfield & Kinsella, 2021). In the following section, we examine how the actions of single actors can have a large impact on the overall system.

3.4

Case Study: The Single Lie That Shutdown a State

This case study of a policy response decision by an Australian state government is designed to demonstrate the complex interrelations between policy, business, and individual actors who may or may not be vulnerable in the presence of specific shocks. In particular, we examine how the systems in place were vulnerable to bad actors in their determination to be resilient to the external threat of the pandemic. To do so, we first provide a background of the events and the evolving narrative surrounding them to highlight specific actions and factors which linked together to create a government response that impacted hundreds of thousands of people as a result of a single community member’s lie. Finally, implications for vulnerability, resilience, and the importance of flexibility and agility in policy responses to crisis are discussed.

3.4.1

Background and Evolution of Events

On 16 November 2020, a man living in Adelaide (South Australia) told a lie. Under ordinary circumstances in an ordinary year, his lie may have been somewhat innocuous, irrelevant in terms of real-world consequence. However, these were not ordinary circumstances, and this was not an ordinary year. This particular individual was infected with COVID-19 in the year 2020. In Australia, when an individual tests positive for COVID-19, the government seeks to identify that individual’s movements, including who they may have interacted with socially, in retail environments and even in public transportation or public spaces. Government employees then contact individuals and family members who have interacted with the individual testing positive, referred to as this person’s close contacts. This contact tracing needs to be undertaken in a tight time frame to

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limit any potential spread of infection (Fitzgerald, 2020). At the same time, the government publicly promotes the locations and times where potential for infection occurred, encouraging people attending the locations to get tested and be vigilant regarding COVID-19 symptoms. In the present case, as reported by Australian news media (Harmsen, 2020), the infected individual in question worked two jobs. He worked both as security in Australia’s hotel quarantine system for returning international travellers (Moloney & Moloney, 2020) and also worked at a local pizza establishment. A co-worker of his at the pizza establishment also worked in the hotel quarantine system, but most importantly at a separate quarantine hotel site. A cluster of COVID-19 cases identified was linked to hotel quarantine, where the individual’s pizza co-worker worked. This co-worker was found to have tested positive. Later, the individual in question also tested positive, but he worked at a separate quarantine hotel, which had no other positive cases. This baffled contact tracers as to when and how he contracted the disease. The only connection they could find was that the individual had indicated to contract tracers that he purchased a takeaway pizza from the establishment where his colleague worked. He did not admit that he also worked at this pizzeria. This lie is significant, as it implied he had only casual contact with a potential infectious person when he picked up his pizza order. In actuality, he worked in close proximity to the other infected worker, over several days. According to government tracing guidelines, this would have been classified as being a ‘close contact’ requiring him a quarantine for 14 days. Thus, his close contact easily explains how he became infected. Unfortunately, because of the lie, contract tracers were concerned that there was a new highly contagious strand of the disease that could be caught through casual interactions. As such, the pizza establishment was considered a ‘hotspot’, and it was suggested that anyone who visited it should be tested and quarantine for 14 days. The South Australian government, concerned that this was a specially infectious strain of COVID-19, put the entire state of South Australia of 1.8 million residents under a sudden 6-day lockdown, which was proposed to be a ‘circuit breaker’ to stop the spread (BBC News, 2020c). These forms of lockdowns have been used as part of the COVID response in Australia to stop the chain of transmission by briefly closing down all non-essential contact (i.e. closing most retailing environments) (BBC News, 2020). These lockdowns aim to strike hard and fast so that the spread ends quickly, rather than engaging less restrictive lockdowns which may remain in place much longer (Lytras & Tsiodras, 2020). A similar type of outbreak in Victoria resulted in a 112-day lockdown (BBC News, 2020), which South Australia wanted to prevent. The South Australia government imposed lockdown restrictions such as only leaving the house for essential reasons, only a single person per household leaving per day, mask wearing, closure of hospitality outlets (restaurants, cafes) and schools, cancellation of elective surgeries, and more (Siebert & Brice, 2020). In response, neighbouring states such as Victoria gave less than 24 h notice before establishing a “hard border” between Victoria and South Australia, which included checkpoints at

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all transportation hubs and roadways connecting the two states. This meant that individuals were not allowed to enter Victoria from South Australia and that those who had entered recently were required to quarantine for 14 days (ABC, 2020). The imposition of the South Australian lockdown announcement resulted in panic buying of essential goods and masks, travel cancellations, dangerous driving as individuals changed plans mid-trip trying to beat the imposition of travel bans, and stress among many individuals for their homes, employment, and livelihoods, especially in communities that were on the border, where individuals made frequent trips between the states (Collins et al., 2020). It ultimately came out that the individual lied about catching COVID-19 by ‘just picking up a pizza’ (Harmsen, 2020). Thus, the South Australia governments snap’s decision with regard to implementing a hard lockdown and responses from other states (ABC, 2020) were unnecessary, as it was then clear that the man was a close contact of an infected individual, rather than being infected with a particularly transmissible new strain of COVID-19. The South Australian premier and government argued that the situation and its outcomes were the result of this single actor: ‘The selfish actions of this individual have put our whole state in a very difficult situation’ (Dow et al., 2020). The lockdown and hard border between states were then quickly cancelled.

3.4.2

Implications and Vulnerabilities

Communities are multifaceted systems with multiple actors, governments, businesses, NGOs, media, communities, etc. These actors will interact to determine the resilience of community to shocks and therefore determine whether a community flourishes or does not (Shultz et al., 2017). In order to understand how the actions of a single individual impacted the lives of hundreds of thousands—and in order to determine where the vulnerabilities are present and how to mitigate future negative outcomes arising from similar cases—the system itself must be examined. First, it is clear that contact tracing was exceptionally vulnerable to dishonesty, with a lack of safeguards in place to double check the veracity of information provided to tracers, taking each statement on faith. It is furthermore clear that at least some individuals felt motivated to be dishonest. This implies that individuals believed that information revealed to contact tracers could and would be shared with other government agencies (e.g. policing and enforcement). It also implies that individuals feared repercussions from admitting to actions that should have been precluded (e.g. working two jobs, leaving home quarantine, inappropriate social distancing behaviour on the job, etc.). The implication is that for a system to function and flourish, certain elements of this system must necessarily remain separate and distinct from one another. In particular, healthcare professionals are typically held to strong limits of confidentiality so as to encourage important disclosures from individuals who may fear repercussions resulting from those disclosures. The South Australia case highlights

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that crisis-response systems such as contact tracing must be treated separate from other aspects of the government, much in the same way that healthcare remains separate from policing. The systems would be best set to have contact tracers make clear to all individuals with whom they interact that any information provided to them will not and cannot be given to other government agencies for the purpose of policing, visa expulsion, or any other legal consequence. However, it is also important that individuals believe this, which may not be the case when dealing with vulnerable communities. Similarly, crisis-response systems such as contact tracing must also have policies in place to protect vulnerable communities such that those working in these systems cannot and will not disclose private information to other individuals, agencies, and employers. To the extent that trust on behalf of individuals and communities within Australia has been integral to allowing the government to move swiftly with an agile and effective response, this trust is a resiliency that must be repaid by protecting the vulnerable communities. Where trust is eroded, situations such as deceit and fear of repercussions can undermine the capacity for the government to make informed decisions. Second, beyond the contact tracing system, the integration of government, policy, community, and industry must be examined. The ability of a community to respond to a crisis will necessarily depend on the actions of individuals and catalytic institutions within those systems. However, the degree of dependence between the inputs and the overall systemic response may vary. Resilient systems need to be able to implement supportive actions but also must be robust to the inappropriate actions of actors, as in the South Australia case. If any one bad actor or element of the system can create a negative shock which ripples over into massive negative impacts on the greater rest of the system, the system itself may be overly sensitive to single actors. In the case of South Australia, the implication is that the government was overly cautious and responsive to a single weakness in the system (i.e. a breakdown in contact tracing). Instead of using geographically narrower lockdown zones (Knaus, 2021) or targeted ‘blitz’ testing as seen in other states (Ilanbey & Towell, 2020), the South Australian government took a response that lacked agility, using a wide-sweeping lockdown measure which impacted hundreds of thousands of people. Notably, in the current pandemic, all governments are vulnerable to an evolving information, a series of unknown unknowns. Even when individuals follow each stringent protocol and rule, breaches may still occur. For example, the most recent case in Victoria found that the employee did everything correct and still became infected, potentially due to new variations of the virus being more transmissible (Scott et al., 2021). As such, governments must be ready to respond in an agile and targeted way to the evolving unknowns (veritable or deceitful) so as to limit negative spillovers and tsunami-sized waves of negative outcomes arising from overresponsive systems. This is particularly true when these responses (e.g. lockdowns and shutdowns) exacerbate pre-existing vulnerabilities and harm more disadvantaged communities. Third, beyond the occurrence (contact tracing) and response (lockdowns), it is fundamental to examine the prior circumstances which gave rise to the present case

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so as to understand how the system created a situation in which these issues arose. That is: is it simply the case that some individuals are bad actors who seek to undermine systems, or are there circumstances which give rise to an increased likelihood of inappropriate behaviour (deceit) in response systems such as contact tracing? On the one hand, it is fair to say that the individual should be culpable for their lies given the magnitude of negative impacts experienced on South Australians and others. This opinion persists despite the fact that it was later determined the individual will not face any criminal charges, as the South Australian police said there was not enough evidence to prove an offence has occurred (Eugene Boisvert & Brice, 2020). On the other hand, it may be overly simplistic to place the blame solely in the hands of ‘the selfish actions of this individual’ (Dow et al., 2020). Indeed, researchers at the McKell Institute in Australia have publicly argued (Kurmelovs, 2020) that the blame for the South Australia case rests with the employment sector rather than with the individual: It seemed like the authorities were saying: largely this is the fault of the person who lied to us. . . The danger here is that this is portrayed as the actions of one person when it actually points to some more systemic issues with the way we work. . . The fact remains that this kind of thing could happen tomorrow, or next week, or in the future as long as we have workers who are engaged on contracts, as casuals, with no securities who are being put on the frontline of a global health pandemic.

This analysis argues that the employment systems in Australia created unique vulnerabilities related to the pandemic response. In the present case, one reason the individual in question lied was because they needed to take on two jobs to make ends meet, even though as a hotel security guard they were not supposed to have other employment. This is not unusual: a large proportion of Australians (including over 130,000 South Australians) work more than one job (Batchelor, 2020). This occurs predominately in industries that are low paying, making the people need more than one job to survive and thrive in Australia. Thus, this systemic casualisation of essential but low-paid jobs created a situation in which a member of a vulnerable group was placed in a position where he was doing what was needed for survival (working multiple jobs) but could not safely disclose this information for fear of retribution and negative consequences. Although culpable as an individual actor within the system, it must be noted that the linkages between the employment/business landscape, government policies, and a lack of trust in these systems on behalf of vulnerable populations all created the perfect storm that gave rise to the South Australian lockdown. The intersection between these systems is ultimately what made it possible for a single lie to so negatively impact on others. As further evidence of this being a systemic (rather than isolated) issue related to the present crisis, a similar situation occurred within Victoria during the first wave of the COVID-19 response in Australia. In particular, the aged-care sector in Australia has a highly casualised and part-time approach to employment. This lack of stability means that many nursing home employees work at multiple locations. In Victoria, this resulted in exacerbating the spread of the illness in the aged community, where

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much of the spread was a result of workers spreading the virus between facilities. Indeed, of the 820 deaths in Victoria to date, 647 (79%) of those have been in agedcare facilities (Victoria Government, 2021b). This systemic issue has since been identified and the practice is now being prohibited (Health, 2020b); however, the deeper issue of unstable part-time work in other sectors remains unexamined.

3.5

Lessons from the Australian COVID-19 Response

The Australian experience highlights how shocks to the system such as pandemics affect all aspects of the national system. Although there are still criticisms that things could have been better coordinated (Moloney & Moloney, 2020), Australia had benefits over many other countries such that there was a high degree of cooperation between the various institutions and the various levels of government, with limited party politics associated with responses. Additionally, Australians have largely been supportive of the governments’ policies and actions, with limited substantive resistance in response to large-impact policy decisions such as ongoing border closures and longer-term social distancing measures. As such, policy initiatives have been able to focus on addressing the crisis rather than seeking to ensure people comply with policies. This suggests that, in part, the ability for a government to foster resiliency within communities relies on the trust on the part of those communities, so as to foster a system where all actors are engaging in good faith with the existing structures and supports. Critical implications arising from this work are with regard to the nature of vulnerable communities in times of crisis and external shocks, such as the COVID-19 global pandemic. First, it remains clear that communities who were initially vulnerable appear to be more heavily affected by the crisis and the flowon consequences in the economy. For example, the health impact and death rate among seniors from COVID-19, especially in residential care, were much higher than for the broader community (Health, 2021). As another example, it was the low-income professions that were especially hurt by business shutdowns (i.e. the lockdown response), placing these individuals at further risk (Mills et al., 2020). Second, the present analysis demonstrates that there are individuals who previously were not in the systemic vulnerability category, who became vulnerable as a unique feature of a particular crisis, such as travellers who are abroad in times of border closures or such as the regional tourism operators who were affected by international and domestic travel bans (Victoria Government, 2021a). As such, our model highlights that vulnerabilities can be created as a result of unique elements of a crisis and as a result of government and business response systems as they attempt to navigate such crises. The current analysis also highlights how the complex nature of macro elements demands an integrated response by the catalytic institutions—government (federal and state), business, and non-profits—in order to transition toward flourishing postcrisis. As seen in the Australian response, when these intuitions are able to work

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together and adapt policies as unforeseen impacts arise, this agility affords the system a greater degree of resilience to external shocks, and this agility translates into more positive community outcomes. Indeed, policies that are rigid can create gaps (e.g. international students being left without employment or government support), and so coordinated approaches between the catalytic institutions lead to more agile, adaptive responses and assist in these gaps being addressed (e.g. universities and other institutions stepping in to assist international students, thus reducing their vulnerability). The present analysis also emphasises a need for targeted initiatives to assist sectors that have been significantly affected not only during (Duffy, 2002) but also after a crisis. While responses in the catalytic institutions such as JobKeeper have helped to mitigate distress on behalf of more vulnerable communities, the Australian response provides many examples of ongoing efforts to aid vulnerable communities as they emerge post-crisis. As one example, the Australian government has poured funding into mental health resources in response to concerns of long-term impacts from lockdown isolation and job loss (Hunt, 2020). As a second example, vouchers for regional travel in Victoria after the extended lockdown are one system through which the state government is working with industry to assist a sector (tourism) which has struggled as a result of pandemic-response decisions (border closures; Victoria Government, 2021a). Ongoing measures such as this, particularly when they target vulnerable communities, should aid in the redevelopment of industry post-crisis and promote longer-term community flourishing.

3.5.1

Role of Marketing

Australians have been largely supportive of government actions, even when there have been multiple lockdowns and a loss of business and economic growth. However, it is unclear if this community support will continue over time, as individuals can become burned out or desensitised to these shocks to the system (Marsh, 2021). As such, there is an important ongoing role for marketers. Marketers are designed to be effective communicators with target audiences. As such, marketing has a critical role in getting information to communities, vulnerable and otherwise, during crises such as the COVID-19 pandemic (Lee, 2020). This informational role is especially important in the current pandemic, as there are sporadic infections that need to be responded to by the community. Ongoing engagement, following any restrictions related to social distancing is also essential. Furthermore, existing analysis implies that current information and communication are too complex for the average Australian to understand (Ferguson et al., 2021), and there is a need to communicate with indigenous communities who are not English speakers (Zwartz, 2021). Thus, marketers have a role to play in effective communication of the various restrictions and requirements. Notably, as the vaccine rollout commences in Australia, it is important to encourage people to participate, as without significant compliance, herd immunity

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will not be achieved (Crowe & Mannix, 2021). Marketers and in particular social marketers can assist in designing better, less complex communications for governments so as to help sidestep some of the vaccine rollout issues that other countries have already begun to face (Mackrael & Monga, 2021). A balanced communication strategy needs to be used to counter the anti-vaccination messages being disseminated, and it has even been suggested that anti-vaccination groups’ communication should be restricted (Margo, 2020). Marketers are also essential in ensuring that there is an effective policy designed to address market inequities, such as assisting in the designing of policies to address sectors or individuals who have been effective (e.g. the regional voucher scheme). Policy needs to be developed that addresses vulnerabilities during the pandemic, such as support for newly unemployed (Spies-Butcher, 2020), tax policies to support struggling small businesses (Australia Government, 2020), or support for employees working at home (Office, 2020). There are also a range of roles for marketres in addressing vulnerabilities coming out of the pandemic, such as encouraging Australians to go on a vacation in regional areas in Australia to support regional communities (Victoria Government, 2021a). Marketers and policy makers, therefore, have to collaborate to identify how policy can address vulnerabilities and build resilience in the community, to allow people to more effectively engage. Such innovations hopefully will address vulnerabilities systematically, rather than simply limit the negative impact of the shock caused by COVID-19.

3.5.2

Conclusion

Australia is credited with being one of the top ten countries that has best controlled the spread of COVID-19 (Yosufzai, 2021). Their polices have, however, also been some of the most restrictive with regard to managing peoples’ movements and thus the negative impacts on communities, especially the vulnerable. The response across institutions has sought to limit the negative impacts. There has unfortunately been an increased vulnerability, both for those who were already vulnerable and the newly vulnerable. The pandemic has highlighted structural issues that need to be addressed in the future. For example, the implementation of the JobKeeper program has resulted in a debate regarding welfare support for the unemployed (Quiggin et al., 2020) and may end up with the government increasing this support post the pandemic. Thus, the vulnerabilities of some communities may in fact be indirectly reduced over the long term as the result of the pandemic. Notably, some forms of vulnerability may exist only in the short term. For example, if domestic and international travel restrictions are reduced, then the economic issues in the Australian regional tourism sector may be eliminated. However, the government has sought to implement supports in the short term to address the vulnerability of the sector (Victoria Government, 2021a). On the other

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hand, however, these systemic issues that were highlighted by the pandemic will remain an ongoing problem that needs further attention. For example, the reliance on backpackers and people from the pacific island to pick fruit in Australia highlights the problems in this sector that will continue even after the COVID-19 pandemic subsides (Derwin, 2020). Moving forward, hopefully as things improve in the government and other institutions, Australia is in a position to maintain their cooperative nature of addressing vulnerabilities. It is hoped that there will be a realisation that the greater good is better served by cooperating rather than politicking or criticising aspects of the response that have not been as effective. The pandemic creates an opportunity to review initiatives and develop new systems to adapt, both to situations of shock and helping those who are vulnerable. For example, during the crisis, the Australian found emergency housing for a number of homeless people and the initiatives will continue post the pandemic (Brkic, 2020). Thus, hopefully, this experience will result in more resilient and collaborative systems that are better able to deal with shocks. Conflict of Interest We have no known conflict of interest to disclose.

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O'Mallon, F. (2021, January 27). NSW to relax restrictions from Friday, masks remain in some settings. Financial Review. https://www.afr.com/policy/health-and-education/nsw-to-relaxrestrictions-from-friday-masks-remain-in-some-settings-20210127-p56x8p Pankhurst, H. (2020, September 30). Forget notions of coronavirus as a great equaliser – women are hardest hit yet again. The Guardian. https://www.theguardian.com/global-development/2020/ sep/30/forget-notions-of-coronavirus-as-a-great-equaliser-women-are-hardest-hit-yet-again Price, D. J., Shearer, F. M., Meehan, M. T., McBryde, E., Moss, R., Golding, N., . . . Wood, J. (2020). Early analysis of the Australian COVID-19 epidemic. eLife, 9, e58785. Quiggin, J., Klein, E., & Henderson, T. (2020, July 2). Forget JobSeeker. In our post-COVID economy, Australia needs a ‘liveable income guarantee’ instead. The Conservation. https:// theconversation.com/forget-jobseeker-in-our-post-covid-economy-australia-needs-a-liveableincome-guarantee-instead-141535 Quigley, A. L., Nguyen, P. Y., Stone, H., Lim, S., & MacIntyre, C. R. (2020). Cruise ship travel and the spread of COVID-19–Australia as a case study. International Journal of Travel Medicine and Global Health, 9(1), 10–18. Reardon, A. (2020, March 25). Funeral providers adapt to coronavirus as gathering limit lowered to 10 people. ABC News. https://www.abc.net.au/news/2020-03-25/funeral-providers-try-toadapt-to-new-coronavirus-restrictions/12089162 Riga, R. (2020, April 24). What you can do if your employer is ripping you off with the JobKeeper subsidy. ABC News. https://www.abc.net.au/news/2020-04-23/how-to-report-a-jobkeeper-dis pute-if-youre-being-exploited/12173560 Salim, N. (2020). COVID-19 pandemic sees international students unable to return home, surviving on free food. ABC News. https://www.abc.net.au/news/2020-11-28/international-students-facefinancial-difficulties-in-pandemic/12922142 Scott, S., Clark, E., & Lloyd, M. (2021, February 4). Experts say 'clearly aerosol transmission' of COVID-19 is the gap in Australia's hotel quarantine system. ABC News. https://www.abc.net. au/news/2021-02-04/covid-19-aerosol-spread-concerns-in-melbourne-hotel-quarantine/131200 58 Scott, S., & Kent, L. (2020, August 4). Melbourne's stage 3 lockdown prevented thousands of coronavirus cases, research data shows. ABC News. https://www.abc.net.au/news/2020-08-04/ melbournes-coronavirus-lockdown-worth-it-burnet-institute-data/12521434 Services, D. o. H. (2020). $450 coronavirus (COVID-19) test isolation payment. https://www.dhhs. vic.gov.au/employee-isolation-payment-covid-19 Sherrieb, K., Norris, F. H., & Galea, S. (2010). Measuring capacities for community resilience. Social Indicators Research, 99(2), 227–247. Shultz, C. J., Rahtz, D. R., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In Handbook of community well-being research (pp. 403–421). Springer. Siebert, B., & Brice, R. (2020). South Australia ordered into six-day lockdown amid coronavirus outbreak. ABC News. https://www.abc.net.au/news/2020-11-18/sa-ordered-into-major-lock downs-amid-coronavirus-outbreak/12894666 Small, F., Mehmet, M., & Kleinschafer, J. (2020). The circle of vulnerability and the myth of choice. Journal of Social Marketing, 10(4), 489–506. Spies-Butcher, B. (2020). The temporary welfare state: The political economy of job keeper, job seeker and'snap back'. Journal of Australian Political Economy, 85, 155–163. Statistics, A. B. o. (2021, January 21). Labour Force, Australia. https://www.abs.gov.au/statistics/ labour/employment-and-unemployment/labour-force-australia/dec-2020 Taylor, J. (2021, January 9). Australians stranded overseas say slashing arrival caps makes returning home 'near impossible'. The Guardian. https://www.theguardian.com/australianews/2021/jan/09/australians-stranded-overseas-say-slashing-arrival-caps-makes-returninghome-near-impossible

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Thomas, T., Wilson, A., Tonkin, E., Miller, E. R., & Ward, P. R. (2020). How the media places responsibility for the COVID-19 pandemic–An Australian media analysis. Frontiers in Public Health, 8, 483. Tillett, A., & McIlroy, T. (2020, January 29). Coronavirus evacuees to be quarantined on Christmas Island. The Finical Review. https://www.afr.com/politics/federal/australians-to-be-quarantinedon-christmas-island-20200129-p53vqb Ting, I., Scott, N., Workman, M., & Hutcheon, S. (2021). Charting the COVID-19 spread in Australia. ABC News. https://www.abc.net.au/news/2020-03-17/coronavirus-cases-datareveals-how-covid-19-spreads-in-australia/12060704?nw¼0 United Nations. (2004). Living with risk: A global review of disaster reduction initiatives. In United Nations International Strategy for Disaster Reduction. United Nations. Van Lancker, W., & Parolin, Z. (2020). COVID-19, school closures, and child poverty: a social crisis in the making. The Lancet Public Health, 5(5), e243–e244. Victoria, C. A. (2020). Victorian eviction moratorium extended - News alert. https://www. consumer.vic.gov.au/latest-news/victorian-eviction-moratorium-extended-news-alert Victoria Government. (2020a). Information for cross border communities. https://www. coronavirus.vic.gov.au/information-cross-border-communities Victoria Government. (2020b). Making a temporary rent reduction agreement. https://www. coronavirus.vic.gov.au/making-temporary-rent-reduction-agreement Victoria Government. (2021a). Regional travel voucher scheme. https://www.vic.gov.au/regionaltravel-voucher-scheme Victoria Government. (2021b). Case locations and outbreaks. https://www.dhhs.vic.gov.au/caselocations-and-outbreaks-covid-19#aged-care-facilities Weedon, A. (2020, July 17). Melbourne's tower lockdowns reveal the precarious future of Victorian public housing. https://www.abc.net.au/news/2020-07-17/melbourne-victoria-pub lic-housing-social-mix-redevelopment/12459870 Welfair, A. A. I. o. H. (2020). The use of mental health services, psychological distress, loneliness, suicide, ambulance attendances and COVID-19. https://www.aihw.gov.au/suicide-self-harmmonitoring/data/covid-19 Yosufzai, R. (2021). Australia among top 10 countries ranked for pandemic response, NZ tops list. SBS News. https://www.sbs.com.au/news/australia-among-top-10-countries-ranked-for-pan demic-response-nz-tops-list Ziffer, D. (2021, January 29). JobKeeper payments for prisoners, the dead and other fraud cases probed by ATO. ABC News. https://www.abc.net.au/news/2021-01-29/ato-probes-jobkeepercash-for-prisoners,-dead-and-other-fraud/13096864 Zwartz, H. (2021). In the NT community of Wadeye, a new superhero joins the fight against coronavirus. ABC News. https://www.abc.net.au/news/2021-02-06/nt-captain-sanitiser-corona virus-message-wadeye-tik-tok/13106068

Michael Polonsky is an Alfred Deakin Professor of Marketing and Head of Department at Deakin University in Melbourne, Australia. Michael has taught in the USA, South Africa, New Zealand, and several universities in Australia, and into programs in Singapore, China, and Malaysia. Michael’s research focuses on understanding and addressing social and environmental issues across a wide range of domains including pro-environmental consumption, health contexts, and policy impacts on refugees. Virginia Weber (Ph.D.) is a Lecturer in Marketing at Deakin University in Melbourne, Australia. With a background initially in social psychology, Gini’s research interests span social influences on consumers, identity, social media, and sustainability. Consumer wellbeing is at the heart of this research, with a focus on various forms of transgressions and consumer coping. Gini is also the Director for the Bachelor of Marketing (Psychology) and works with organizations and agencies to improve societal wellbeing through the application of consumer psychology.

Chapter 4

Disdain, Generosity, and Solidarity as Institutional Responses to COVID-19 in Brazil Marcus Wilcox Hemais, João Felipe R. Sauerbronn, Ronan Torres Quintão, and Eduardo Teixeira Ayrosa

Abstract The deep and challenging social and economic inequalities that plagued Brazil throughout its history became even more evident with the advent of COVID-19. The Brazilian federal government’s incapacity to help those in need triggered actors from various sectors of society to respond with necessary urgency and efficacy. The assistance these marketing system catalytic institutions have offered to Brazilian society seems to be based on distinct grounding principles, herein called generosity and solidarity. While generosity entails offering help, looking toward future benefits, solidarity is based on an orientation surrounding collectivity, through which individuals help one another, since no community can achieve well-being if all who are part of it do not share in its benefits. In this chapter, we analyze how the Brazilian federal government, Itaú Unibanco, and the Movimento dos Trabalhadores Rurais Sem Terra (MST, Landless Rural Workers’ Movement) have reacted during the COVID-19 crisis and how this response has affected Brazilians’ quality of life (QOL). Keywords COVID-19 · Generosity · Solidarity · Catalytic institutions · Landless Rural Workers’ Movement

M. W. Hemais (*) Business Administration Graduate Program, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil e-mail: [email protected] J. F. R. Sauerbronn Business Administration Graduate Program, Universidade do Grande Rio, Macae, Brazil e-mail: [email protected] R. T. Quintão Federal Institute of São Paulo, São Paulo, Brazil Business Administration Graduate Program, Centro Federal de Educação Tecnológica de Minas Gerais, Belo Horizonte, Brazil E. T. Ayrosa Business Administration Graduate Program, Universidade Positivo, Parana, Brazil © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_4

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Introduction

Brazil has a long history of social and economic inequalities, being one of the most unequal nations in the world in terms of income distribution (United Nations, 2020). As a result, some communities in the country live in a well-being state, with quality of life (QOL) indicators that are at par with rich European countries and the United States (Cafardo & Palhares, 2019). However, other communities live immersed in a state of deep ill-being, with standards comparable to the poorest countries in Africa (Borges & Ayuso, 2018). Such inequalities have become even more evident with the advent of COVID-19 and are very much likely to deepen, since the pandemic is expected to make Brazil recede, in the next one or two years, to socioeconomic levels of decades ago (Trisotto, 2020). From the countless possibilities for analysis of the effects of the pandemic on people, regarding particularly the social and economic dimensions of the Brazilian case, we draw a reflection based on the macromarketing perspective. Researchers in the field of macromarketing have long been concerned with societal and sustainability aspects of markets (Klein & Laczniak, 2020; Layton & Grossbart, 2006; Nason, 1989, 2006). This interest led to exploration of issues usually overlooked in other marketing disciplines (Shapiro et al., 2009) and a systemic approach to marketing (e.g., Fisk, 1967; Bartels, 1970; Layton, 2007, 2009, 2014, 2019; Wooliscroft, 2020). According to Layton (2009), a marketing system reflects the unique social matrix in which it is embedded. Many societies have seen the emergence of marketing systems as a result of specific arrangements for each location and time. Additionally, Layton (2009) posits the institutional framework of the marketing system is responsible for the transformation of resources into assortments of goods, services, ideas, and experiences that provide the basis for growth and improvements to QOL. Therefore, the ways governments, businesses, and social movement act is determinant for community well-being, since these three “catalytic institutions” essentially lead the marketing system and are primary change agents of it (Shultz et al., 2017). Considering this macromarketing perspective in the case of Brazil during the COVID-19 pandemic, one can see how the Brazilian federal government of Jair Bolsonaro proved itself unable to adequately help those who were in need, which inspired different actors to come forward and to provide assistance. This assistance tended to take two forms: (1) various corporations, such as Itaú Unibanco, donated billions of reais (i.e., Brazilian real) to help communities in ill-being (Kafruni, 2020) and (2) NGOs and social movements, such as the Movimento dos Trabalhadores Rurais Sem Terra (MST, Landless Rural Workers’ Movement), helped Brazilians in need, all over the country, with donations of raw and cooked food, support to local farmers, and access to doctors (Console, 2020; Tarlau, 2020). In this chapter, we analyze how the Brazilian federal government, Itaú Unibanco, and the MST have reacted during the COVID-19 crisis and how their actions have affected the QOL of the local population. While the Brazilian government has largely given up acting as a leader for the marketing system, Itaú Unibanco and

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the MST subsequently occupied this space and indeed have been catalytic while seeking to rebalance the system and to generate well-being. The endeavors of both of these institutions, however, are based on different approaches, which we have named “generosity” and “solidarity.” Generosity entails a quid pro quo exchange, with some form of benefit expected as a result of a determined action in an individualistic nature inherent to market principles (Jordan, 2020). Solidarity works with a focus on collectivity in which individuals help one another, with the understanding that no community can flourish unless all members of the community benefit (Arnsperger & Varoufakis, 2003). We hope that by discussing how these institutions act to lead the marketing system in a critical situation as the pandemic, we can increase understanding of marketing systems and reinforce its importance for marketing theory and practice and ultimately community well-being. The remainder of our chapter is divided into the following sections. Section 4.2 discusses the evolution of the COVID-19 crisis in Brazil; in Sect. 4.3, we analyze how the three catalytic institutions—the Brazilian government of Bolsonaro, Itaú Unibanco, and the MST—participated in the fight against the coronavirus pandemic. Finally, in Sect. 4.4, we share some lessons learned and our final thoughts.

4.2

COVID-19 Pandemic in Brazil: Effects over QOL

Brazil had its first registered case of COVID-19 on February 26, 2020. The patient was a 61-year-old man from São Paulo who had returned from a trip to Italy. Following this first incident, the virus spread quickly, and within 1 month, the number of confirmed cases was in the thousands, with all 27 Brazilian states registering infected patients and deaths reaching the hundreds (Sanar Saúde, 2020). This was the beginning of what has come to be Brazil’s worst human tragedy to date. To better understand this misfortune, it is important to analyze how the Brazilian economy and the health system were affected by the pandemic and how they, in turn, affected the QOL of the local population. The quick advance of the virus in Brazil made government officials realize the need for adequate measures to contain its spread. Therefore, the federal Health Ministry recommended on March 13 the start of social distancing, cancelling large events, closing universities and schools, restricting non-essential commercial activities, while encouraging home -officing and the use of the Internet for work-related meetings or transmitting events (Ministério da Saúde, 2020). Governors and mayors would have the responsibility of implementing these recommendations in their states and municipalities, as they saw fit. In Rio de Janeiro and São Paulo, for instance, the cities with most cases of COVID-19 at the time, non-essential commerce was closed on March 24 (Máximo, 2020; Nitahara, 2020). If social distancing meant encouraging people to stay at home whenever possible, it also meant closing bricks-and-mortar commercial establishments to further guarantee the population would stay at home. The downside to these closures, however,

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was the effect such decision would have over the Brazilian economy. In April 2020, economic activity had a record drop of 9.73% (Oliveira, 2020a). By May, the average income of Brazilians fell by 82% (Platonow, 2020). By June, the International Monetary Fund predicted Brazil’s gross domestic product would retract by almost 10% in 2020 (Gerbelli, 2020)—which can be partly explained by the fact that thousands of companies had to file for bankruptcy and eight million jobs were lost in the country due to the pandemic (Garcia, 2020). Those more dramatically hit by job losses in Brazil were of the poorer strata of the population. On average, unemployment affected five times more the poor than middle and higher socioeconomic classes (Instituto de Pesquisa Econômica Aplicada [IPEA], 2020). This was compounded by the fact that many poor people depended financially on their elders who were retired and had earnings—often the only income of a family—drastically reduced. Thus, when older people were the ones most infected and killed by COVID-19 in Brazil, many families were left with nothing, depending on donations to survive (Machado, 2020a). Projections were that the number of Brazilians in conditions of extreme poverty would double in 2020, reaching 9.5% of the population (Chade, 2020). Even when the poor managed to keep their jobs, in most cases such employment was mostly manual labor, which required a physical presence in their work locations. Accordingly, millions of poor Brazilians would leave their homes and go to work daily via crowded public transportation; they would interact with colleagues in closed environments and be exposed to many other individuals going shopping, as in the case of essential-service store clerks. The chances of SARS-CoV-2 infection among the poor in Brazil therefore were twice as much as their peers in better-off conditions (Sakamoto, 2020). Those who could stay at home, in relative safety, and work using computers, phones, and the Internet in their improvised offices were of middle and higher socioeconomic classes. Public policies looking to implement home-officing in Brazilian favelas were simply not forthcoming (Rodrigues, 2020). However, estimates suggest more than 20 million Brazilians migrated to some sort of remote work, most of them being professionals from the education sector or holding jobs of strategic or tactical nature in companies, as well as administrative support and mid-level technicians (Alfageme, 2020). As a result of less time in traffic and less social interactions in the workspace, many of these privileged Brazilians believed they increased their work productivity (Gattis, 2020) and, in some cases, even improved their QOL, given the chance of having more time with and being closer to family members (Meirelles, 2020). The possibility of distancing oneself from society working at home was not the only element that differentiated the better-off and the worse-off during the COVID19 pandemic. Access to medical aid when one was infected with the virus also had different outcomes for these groups of individuals. In Brazil, the Sistema Único de Saúde (SUS, Unified Health System) is the free public healthcare system that is offered to everyone. However, given its scrapping over many years, which led especially to the decay of hospital infrastructure, only those who can afford to hire health plan operators have access to a private network of doctors and top-notch

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hospitals. Brazilians who use SUS, therefore, are the poor who have no alterative and depend on the public system for treatment. During the pandemic, when increased demand stressed medical infrastructure, the differences in service quality between public and private hospitals also increased. Despite doctors, nurses, and technical staff that work in SUS being among the best in Brazil, they had to treat patients with COVID-19 under work conditions that were far from ideal. In the first month of the pandemic, the healthcare system did not have enough personal protective equipment (PPE) for hospital staff or respirators for patients, all of which had to be bought overseas, while the local industry adapted to this new demand (Veiga, 2020). Together, the lack of appropriate equipment to treat COVID-19 patients, the long-lasting decay in public hospitals, and the quickly rising number of infected Brazilians needing medical care helped to form a worrying scenario. Public hospitals were quickly flooded with COVID-19 cases, which resulted in many states reaching their maximum capacity of beds to treat these patients (Brugnolo, 2020). This overflow prevented cases from being admitted to hospitals, which further resulted in a significant number of Brazilians dying at home, without proper medical care (Madeiro, 2020). To overcome this limitation, temporary hospitals were built in the states most affected by the spread of the virus, which eventually helped to unburden the system. However, such public hospitals still had insufficient equipment and even personnel to treat patients, similar to the older public hospitals. Tragically, in state-run medical facilities, only 34% of patients admitted with COVID-19 survived, while in the private sector, 51% survived (Faria & Yukari, 2020). The “standard” Brazilians victimized by COVID-19 that died in SUS were poor, black men (Soares, 2020a). During the period we wrote this chapter, the number of deaths in Brazil due to COVID-19 grew from around 90,000, by the end of July 2020, to over 420,000, in May 2021. The number of Brazilians infected by the virus in the course of these 10 months has risen from three million to over fifteen million. The spread of the virus eventually did decrease, and Brazil was able to lower its death counts, but the country entered a second wave, which has been much worse than the first. Unfortunately, we are now part of a small group of countries that has had over 4000 deaths by COVID, in at least one day (Lima & Cardim, 2021). Adding insult to this injury, President Bolsonaro declared he will not take any anti-COVID vaccine (Barifouse, 2020). As we shall see in the next section, Bolsonaro’s behavior downplaying the seriousness of the virus was a constant during the crisis and influenced the government’s fight against the pandemic.

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Macromarketing and the Role of Catalytic Institutions in Marketing Systems

Brazilian society and markets have been severely affected by the pandemic, and institutions must respond accordingly. Macromarketing offers the possibility of a broad approach to understanding how market components are addressing the pandemic and the possible consequences for society. Macromarketing research is based on three empirical foundations: markets are systems; markets are heterogeneous; and the actions of markets’ participants have consequences in other instances of the markets (Mittelstaedt et al., 2006). The systemic nature of markets is a foundation of the macromarketing field (Layton, 2007); the formation, development, and evolution of marketing systems are topics frequently addressed in its literature (e.g., Kadirov, 2018). The Brazilian marketing system is our unit of analysis. Accordingly, we present the country’s unique conditions that define the social and economic environment surrounding Brazilian markets by summarizing the particularities of the Brazilian marketing system during the pandemic. Again, our aim here is to explore the actions of government, a bank (Itaú Unibanco), and a social movement (MST) during the pandemic. These three components are “catalytic institutions” (Shultz et al., 2017), which play an important role in shaping Brazil’s marketing systems. Catalytic institutions establish ways to transform the available resources into marketing systems’ assortments of goods and services that could promote community well-being and, through their leadership and collaboration, are paramount for a community to flourish. The advance in COVID-19 in Brazil made it clear this crisis had an unprecedented degree of complexity. It also made evident the government alone would not to be able to resolve problems caused by the pandemic. The maintenance of the marketing system thus depends on the coordination of the catalytic institutions’ actions (Shultz et al., 2017). Based on such understanding, in the following sections, we describe and analyze how the Brazilian government of Bolsonaro, Itaú Unibanco, and the MST acted during the pandemic and the effects on lives and markets in Brazil.

4.3.1

Government: Disdain Against COVID-19—Case of the Bolsonaro Government

The grave economic and health scenario Brazil experienced due to COVID-19 did not go unnoticed by the Federal Government. Worried about how this would affect his image, as soon as the first numbers started to indicate how hard the country would be hit by COVID-19; President Jair Bolsonaro, considered to be an extreme right-wing politician elected to run the country in 2018, strongly positioned himself against what he called the “hysteria” surrounding the virus, saying that it should be treated as nothing but a “common cold” (Martins, 2020). To avoid the economic

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downfall, Bolsonaro contended that commerce should not be closed, which also meant opposing social distancing—contradicting recommendations by the World Health Organization and his own Minister of Health at the time, Luiz Henrique Mandetta. One of the measures he took in this direction was to add originally non-essential commercial activities—e.g., beauty salons, barber shops, and gyms (Azevedo, 2020)—to the list of essential services, allowing them to function as if there were no coronavirus. The Brazilian Federal Court of Justice, however, had determined that decisions regarding the types of commerce that could operate during the pandemic were up to governors and mayors, many of which did not comply with Bolsonaro’s decree (Oliveira, 2020b). In an attempt to “prove” his point that COVID-19 was nothing to be worried about, Bolsonaro would regularly appear in public, draw agglomerations—always dismissing the face mask—and hug, kiss, and take selfies with his supporters. Such actions confused many Brazilians, who did not know if they should follow the president’s behavior or comply with social distancing strongly recommended by Luiz Henrique Mandetta. From the beginning of the pandemic, Mandetta, an orthopedist and medical doctor, held daily TV press conferences to give updates and instruct Brazilians on the need to wash their hands with soap or to clean them with hand sanitizers, use face masks when in public spaces, and avoid social interactions as much as possible. In Mandetta’s press conferences, social distancing was always deemed necessary, not only to reduce exposure and thus the spread of the virus but also to reduce or slow the number of infected individuals, thus “flattening the epidemic curve,” and to avoid the collapse of the health system (Croda et al., 2020). Bolsonaro’s actions, therefore, worked against such orientations, signaling to the population that they could socialize and demand their governors and mayor to open local commerce, resulting in public disagreement between the president and Mandetta. In fact, Bolsonaro championed “herd immunity,” defended by federal representative Osmar Terra: the pandemic will only end when 70% of the population has been contaminated (Samuel, 2020); in his logic, it would be better not to avoid contamination. The disagreements between a scientist and an extreme idealogue boiled over when Bolsonaro demanded the drug hydroxychloroquine become a standard treatment against coronavirus, despite the lack of clear scientific evidence indicating its efficacy. Mandetta, who opposed such treatment, was fired on April 2020, when Brazil had 30,000 confirmed cases of the virus and almost 2000 deaths (Machado, 2020b). Nelson Teich, an oncologist, was appointed the new Minister of Health, with promises of being aligned with the president, believing, for example, social distancing and commercial activities were not mutually exclusive. However, Teich also disfavored hydroxychloroquine and thus resigned only 27 days after joining the government, leaving the Ministry of Health without a minister during the pandemic, for the second time. By then, Brazil had already reached 218,000 registered cases of COVID-19 and almost 15,000 deaths (Marins, 2020). General Eduardo Pazuello, a soldier on active service who does not hold a medical degree, was given the position as an interim in June, being named a full minister in September. Pazuello nominated nine other military personnel to key positions in the ministry, none of them with a

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medical background (Lara, 2020). Such facts help to explain why 82% of Brazilians disapproved Pazuello as head of the ministry (Pereira, 2020). Bolsonaro’s argument to keep Pazuello as a minister was that Pazuello possessed exceptional logistics knowledge, which would be important when Brazil started vaccinating its population. However, when distribution of vaccines finally began in the country, in March 2021, such knowledge was not clearly demonstrated. Brazil’s vaccination program was slow to begin, irregular, and never really took off. Apparently, the logistics expert did not plan the program adequately; problems emerged and compounded. Syringes, freezers, and cotton were not bought beforehand, making it impossible to apply vaccines once they were made available (Biernath, 2020). Pazuello also sent vaccines to the state of Amapá, which were supposed to be directed to Amazonas, at a time when the latter was going through a complete crash in its healthcare system due to the pandemic (Igor, 2021). Under pressure, Bolsonaro removed Pazuello and nominated the cardiologist Marcelo Queiroga to be the fourth minister of health during the pandemic (Verdélio, 2021). The negationist stance Bolsonaro adopted toward the pandemic throughout this extreme chapter of Brazilian history was constant. Brazil has suffered from his policies; only the United States has reported more COVID-related deaths than Brazil. But the country’s path to such a position was unique. Differently from most countries’ epidemic curve, which grows steadily until it reaches an apex, followed by decreasing numbers of infected and deceased, Brazil did not experience a downward trend. After the country reached more than 1000 deaths in 1 day (May 19, 2020), it stayed at this plateau for 15 weeks; only then did the curve slowly trend downward. However, the curve did not follow this path for long, and in December 2020, the death counts started to rise once more, and Brazil entered the “second wave” of COVID-19. Meanwhile, Bolsonaro scorned those who questioned his lack of planning to stop the spread of the virus, since according to him: “everyone is going to die someday” (Tajra, 2020). When asked by a reporter to comment on the milestone of 40,000 infected cases Brazil had reached on April 20 and what were his predictions regarding further cases, Bolsonaro responded by saying he did not have the answer, since he was not a “gravedigger” (Soares, 2020b). When another reporter asked him to comment on the 5000 deaths the country had reached on April 28, the president angrily jokingly replied: “so what? I’m sorry. What do you want me to do? I am ‘Messias’ (his middle name, which translates to Messiah), but I can’t perform miracles” (Tajra, 2020). Even after testing positive for COVID-19, Bolsonaro did not stop chiding his critics; he medicated himself with hydroxychloroquine and said that because of this treatment, he was feeling “perfectly well” (Mendonça, 2020). Bolsonaro’s list of antagonistic remarks is long. However, when Brazil reached the milestone of 100,000 deaths, Bolsonaro said nothing. He just tweeted. But instead of an official announcement, he congratulated the football team he supports, Palmeiras, for having won the São Paulo state championship (Lima, 2020a)— perhaps helping to explain why many Brazilians believe Bolsonaro was to blame for the country reaching 100,000 COVID-19 deaths (Augusto, 2020). This could

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also explain a report from the international press that states Bolsonaro is the “worst Covid president in the world” (Moore-Smith, 2020). During arguably the worst public health crisis in Brazilian history, the Bolsonaro government did little to try to minimize the negative effects of the COVID-19 pandemic. It has thus given up a position of leadership in administering the market for pandemic mitigation and relief in Brazil, when it could have become the main driving force of such a system. But as Luiz Henrique Mandetta stated, “Bolsonaro threw in the towel of combating the pandemic in the beginning” (Amado, 2020). When Brazilians most needed the governmental institutional framework that affects the marketing system to create/apply technology and knowledge for improvements in their QOL (Layton, 2009), the government was largely absent. Considering that most Brazilians have a modest participation in the local market as consumers—given they do not have health plans, private doctors, or much-needed medicines or even financial means to guarantee a healthy QOL under such difficult conditions—the government is obligated to offer them subsidies to enhance their health and wellness. Well-being in Brazil therefore depends on how much the government is involved with achieving such societal status, and currently, there seems to be a scarce focus in this sense. In a country such as Brazil, where much of the population struggles to survive in distressed situations, the lack of involvement by the government in fomenting improvements in peoples’ QOL does not necessarily or automatically mean that other actors (e.g., companies, NGOs) will constructively engage. Thus, those who vitally depend on such public help remain vulnerable. As we have suggested, the disdain of the Bolsonaro government to act accordingly against the spread of COVID-19 has brought negative consequences. Fortunately, aid has come from other institutional actors, as we shall discuss next.

4.3.2

Business: Generosity Against COVID-19—Case of Itaú Unibanco

Since the beginning of the pandemic in Brazil, donations were collected, mostly contributing to health and social causes. In just over 3 months, six billion reais were raised (approximately, 1.2 billion US dollars), with the private sector contributing over 82% of that amount (Reis, 2020). Corporations from the financial sector donated the most resources (28%), followed by food and beverage (13%) and mining (9%) sectors (Associação Brasileira de Captadores de Recursos, 2020). Itaú Unibanco, a private bank and the most profitable financial institution in Brazil, made the largest donation during the pandemic: one billion reais (192 million US dollars); in other words, 3.5% of its net income of 28.4 billion reais in 2019 (Bronzati, 2020). The amount was transferred from the bank to its philanthropic foundation (Fundação Itaú Social), which became responsible for managing the funds. In order to direct how the donation would be spent, a group of seven leading

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Brazilian medical doctors were called upon to form the committee of the Todos pela Saúde (All for Health), the initiative created in April 2020 by Itaú Unibanco to help fight the advance in COVID-19 in Brazil (Américo, 2020). Most companies donated money directly to public institutions, such as federal and state hospitals; Itaú Unibanco decided on a different approach. The bank’s president stated that the decision to make the donation was not agreed upon with the Ministry of Health or with the government more broadly, but the bank was compromised in helping to fight the pandemic “in the different social classes and support public health initiatives” (Todos pela Saúde, 2020c). The bank preferred to let the committee of doctors allocate the resources as it saw fit, based on technical criteria, guaranteeing that since the bank’s money was being used for such generous acts, it was not going to risk having a donation be embezzled (Sutto, 2020). Itaú Unibanco accordingly fell under some criticism for this approach and the amount it donated. Despite the bank’s donation being the largest by a corporation in Brazil, the amount was only a small portion of the company’s wealth—again, 3.5% of its 2019 record-breaking profits (Drska, 2020). The Todos pela Saúde initiative by Itaú Unibanco is organized based on four main pillars: • Inform—elucidation and guidance on the correct use of face masks • Protect—purchase of personal protective equipment and prevention actions • Care—purchase of hospital equipment and testing of the population and help in the construction of receptive centers • Restart—support of epidemiological and COVID-19 treatment research Each of these pillars warranted different actions. For the “Inform” pillar, as one example, videos were shot and aired on social networks and television channels with Brazilian celebrities/artists either singing or talking about the need to wear face masks to protect against COVID-19 (Todos pela Saúde, 2020a). The “Protect” pillar, for its part, was focused on the distribution of over a million face masks to metro users in Rio de Janeiro and the purchase of over 90 million personal protective and hospital equipment, in order to distribute them to the Brazilian states most in need of help and to aid their medical workers and coronavirus-ridden patients (Todos pela Saúde, 2020b). The initiative, however, mostly concentrated its efforts on the “Care” and “Restart” pillars. Hundreds of millions of reais were invested to build test processing centers, finance the production of vaccines against COVID-19, and encourage research on the virus, among other projects. In just a month after its creation, the Todos pela Saúde had already invested 80% of its resources in activities related to these pillars (Koike, 2020). Shareholders of the bank and other companies donated an extra 242 million reais (46.5 million US dollars) to help sustain the initiative (Conselho Nacional de Secretários de Saúde, 2020). The willingness of the Todos pela Saúde to invest in ways to help fight the pandemic contrasted with how the Bolsonaro government did not seem to have a clear plan in this sense. Of the almost 40 billion reais (7.7 billion US dollars) the government had cleared the Ministry of Health to use for such investments, less than 30% of it had been spent after 4 months into the pandemic (Cavalcanti, 2020). Itaú

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Unibanco was thus “covering the deficiencies” (Batista, 2020) of an inoperative government and assuming a responsibility that should have been borne by the latter. There are plans for the Todos pela Saúde to continue, even after the fight over COVID-19 is won. Itaú Unibanco, however, does not intend to make new donations to the initiative (Koike, 2020). Such corporate generosity was seemingly a one-off of this kind by the bank but should not be seen as the only case. After the initial urge of help, corporations as a whole in Brazil have slowed their rates of donations; in June 2020, for instance, collections fell 88% in relation to the month before, at a time the average number of daily deaths in the country was still climbing during the “first wave” (Carvalho, 2020), and this scenario did not change throughout the “second wave,” given donations never went back to the levels seen in the beginning of the pandemic (Bolzani, 2021). Aid to tackle the problems caused by COVID-19 is still going to be needed by Brazilians for the foreseeable future, but the focus of corporate attention does not seem to be on this kind of generosity, anymore. In the end, Itaú Unibanco’s actions during the pandemic had an agenda: to rebalance the marketing system in Brazil. Investing in medical technology and improving the supply of healthcare services sought to restore an “old normality,” since the previous marketing system’s outcomes guaranteed profit for this company and the pandemic was adversely affecting it. Even if these generous actions bring positive results of community well-being for another generation, which the company seems to be striving for, the ultimate goal is to reestablish the marketing system to a level equivalent to the one that existed before the pandemic. Itaú Unibanco is thus acting to reduce the problems people experience during the pandemic, while promoting its brand and generating goodwill among current and potential consumers. This business model should not necessarily be condemned, since companies must be concerned with the survival of their enterprise and Itaú Unibanco is in some ways acting for the welfare of the community. This is the reasoning behind generosity: to generate a feeling of being indebted to the donor, and although the debt can last for a long time, the donation has only happened once. Benefits clearly exist for the parties involved, but long-term reciprocity by those receiving help from the other seems to be requisite in this relationship.

4.3.3

Social Movement: Solidarity Against COVID-19—Case of the Movimento dos Trabalhadores Rurais Sem Terra (MST)

Inequality in Brazil does not emerge only in the distribution of income; it also occurs in the failing of land distribution (Capetti, 2019). In Brazil, 10% of rural properties occupy 73% of the national agricultural area and hold 40% of the country’s unproductive land (Carta Capital, 2015). However, according to the Brazilian

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Constitution, rural property that is not fulfilling its social function1 (i.e., unproductive land) should be expropriated by the government in order to carry out agrarian reform (Presidência da República, 2020, article 184). The concentration2 and model of land use in Brazil are a reflection of the prioritization of the agricultural (production) policy of the Brazilian governments on agrarian (land) policies, favoring economic growth, land concentration, and inequality rather than development, inclusion, and nature conservation (Pinto et al., 2020). In the late 1970s, the Brazilian government adopted a model of farming mechanization and selective agricultural modernization, intensifying the severe exclusion of small agriculture business from the Brazilian agrarian model that led to rural flight, exportation of production, intensive use of pesticide, and concentrating not just the land but the financial subsidies for agriculture (Stedile & Fernandes, 2005). Regarding this context, in 1984, the social-political movement called the Movimento dos Trabalhadores Rurais Sem Terra (MST) emerged in Brazil. The movement aimed to achieve land distribution reforms in the country, to redistribute unproductive lands that were in the hands of a small group of landowners/corporations or of the government and grant them to families to cultivate and live off such areas, called rural settlements (Landless Rural Workers’ Movement [MST], 2020c). The settlement is a portion of land for a group of peasant families to live off, work, and produce, giving the land a social function and guaranteeing social rights, such as home, school, and food, besides a better future for such families (MST, 2020b). The movement has settled in lands a total of 350.000 families and has created 100 cooperatives, 96 agro-industries, and 1.9 thousand associations and built more than 2000 public schools in camps and settlements. It has also offered access to education to 200,000 children, teenagers, youth, and adults, enhanced literacy of 50,000 adults, and trained 2000 students in technical and higher education courses and has partnerships with over 100 undergraduate courses from public universities across the country (MST, 2020a, 2020b). According to in capitalist societies, private property has significant value, above all others, including that of human life. The MST’s actions put this value into perspective and propose an inversion of priority, placing life and the right to work as priorities over the right to property. The MST is neither the first nor the last to question private property. MST’s activism projects beyond an agrarian reform, perhaps bringing to focus the destiny of humanity itself. The MST strengthens national discussions about a popular development project for Brazil, which seeks to break with the current mentality of colonized people. That discussion can affect decision-making, the necessary choices to build a new conception of development and concurrently to revisit the idea of nation—including social justice, solidarity,

1

According to Araújo (1999), the social function of the land is the correct economic use and fair distribution, in order to serve the well-being of the community by increasing productivity and promoting social justice. 2 In Brazil, 1% of rural properties occupy almost half of the Brazilian rural area (Capetti, 2019).

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equality, and participation—to ensure the Brazilian people are subjects of and have some control over their own destiny (cf. ). The movement seeks to raise consciousness around the collective fight for a more egalitarian society. The MST pressures the state to attend to all Brazilians, particularly rural workers, with a basic health system. Such attention demands public policies and guarantees food safety and appropriate living conditions as preventive measures against ill-being. Noteworthy is the understanding that “MST has, as its bedrock, the values of solidarity, humanism and internationalism” (MST, 2020c). The MST seeks to build relationships based on solidarity and social justice, two of the main values of the social movement (Stedile & Fernandes, 2005). The settlement, for the MST, is the result of society’s solidarity, so the movement seeks to return this solidarity into practical everyday needs, such as “establishing a blood donor bank for public hospitals in the cities close to the settlements or being the first volunteers to provide help in cases of natural disasters” (Stedile & Fernandes, 2005, 123). Given this background, the MST naturally engaged the fight against COVID-19 in Brazil. To combat the pandemic and its economic and social consequences, the MST adopted solidarity actions, for example, focusing on food donations from its own settlements to vulnerable families and helping working-class peoples to maintain social isolation during a period when the income of many workers was compromised (Engelmann & Ferreira, 2020). The solidarity occurred nationally but also internationally, including other Latin American countries and Africa, where the MST also is engaged (Praveen, 2020). By September 2020, in Brazil, the MST had donated about 3300 tons of food (Brasil de Fato, 2020). The MST is proactive; according to a representative of the national coordination, “solidarity is not giving what is left, because there is nothing ever left” (Ramos, 2020). The tangible donations (e.g., food) made by the MST during the pandemic is the result of its organization, articulation, and efficacy with society. The MST also administered solidarity campaigns coordinated with other movements, to gather financial donations from society and subsequently to increase the donation of food. This effort supplemented their own production and distribution and other marketing efforts, which were impacted by the pandemic. Among them, we highlight the articulation to support the campaign “Periferia Viva (Solidarity to fight the coronavirus)”, which involved, in addition to the MST, the Movement of Workers for Rights (Movimento de Trabalhadores por Direitos [MTD]), the Movement for Popular Sovereignty in Mining (Movimento Pela Soberania Popular na Mineração [MAM]), the Movement of People Affected by Dams (Movimento dos Atingidos por Barragens [MAB]), the Movement of Small Farmers (Movimento dos Pequenos Agricultores [MPA]), and the Popular Youth Uprising (Levante Popular da Juventude) (Brasil de Fato, 2020). The organization of the MST, together with its national dispersion (it is located in several states of the country) and experience with agricultural food storage and distribution, allowed the movement to make donations to the working class and rural communities directly impacted by COVID-19 (Lima, 2020b). According to Débora Nunes, associated with the national coordination of the MST:

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M. W. Hemais et al. In each suburb area, food was donated from the movement; the population also understood the importance of the struggle and the organization. While the government did not give answers to society (during the pandemic), the workers and rural workers, many times, provide hope and happiness of full tables in the end of the day for many families (Marinho, 2020)

As a result, the food donation solidarity actions by MST helped the country to minimize the impacts of the pandemic on the poorest populations of society, which has suffered severe losses, including access to food. In 2018,3 10.3 million Brazilians starved in the country (Sampaio, 2020); in 2020,4 during the pandemic, that number increased to 19 million, with almost 117 million people—more than half the households in the country—facing some food insecurity, including a drop in food quality/amount, restricted access to food, and in some cases severe deprivation and hunger (Gandra, 2021). The increased food insecurity during the pandemic further worsened the situation of social vulnerability for a significant portion of the population. The solidarity actions by the MST were fundamental to guarantee food on the tables of the families that received the donations, renewing their hopes and providing dignity to the poorest and most deprived population in the country. The MST’s active involvement to help those in need during the pandemic has been praised. Pope Francis was among the admirers. The Pontiff sent a message through Cardinal Michael Czerny to the MST, on July 25, 2020, whereby he expressed “joy at the kind gesture of food distribution being done by the families of the Agrarian Reform in Brazil.” He continued: Sharing of the produce of the land to help needy families on the peripheries of cities is a sign of the kingdom of God that brings about solidarity and fraternal communion. . . Sharing produces life, creates fraternal bonds, transforms society. . . We hope that this gesture of yours will multiply and encourage other groups to do the same, [and finished by adding] because ‘God loves a cheerful giver’ (2 Cor 9: 7) (Vatican News, 2020)

The MST’s solidarity actions during the pandemic are part of a grander plan the movement has for creating a Popular Agrarian Reform, which aims at the democratization of access to land, the distribution of wealth, and the defense of the rights of rural and forest-native peoples (Stropasolas, 2020). Popular Agrarian Reform also advocates the elaboration of public policies for the dissemination and strengthening of solidarity economy and the production of healthy food, generating work and decent employment and food for society (Lima, 2020b). The struggle for social transformation means changes in the inner structure of Brazilian society and a national development project with social justice. It is the struggle for a more fair and fraternal society, which seeks to solve the serious structural problems of the country, such as social and income inequality, discrimination of ethnicity and

3

National Survey on Food Insecurity in the Context of the Covid-19 Pandemic in Brazil, conducted by the Brazilian Network of Research on Sovereignty and Food Nutritional Security (Rede Brasileira de Pesquisa em Soberania e Segurança Alimentar e Nutricional—Rede Penssan). 4 Family Budget Survey (FBS), released on Thursday (the 17th) by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística [IBGE]).

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gender, the concentration of communication, and the exploitation of urban workers (MST, 2020c). The MST’s actions aim to provide well-being to all community members, not only those who are consumers or potential customers. Their actions are based on humanity, justice (versus injustice), and equality (versus inequality) and are driven by social and collective interest (versus individualism). The MST is acting not only to mitigate the consequences of the pandemic on people’s lives but also on the market and using it as a tool for change. The actions of solidarity are long-term actions and seek to generate community well-being that is more permanent. MST clearly is acting not just to restore the marketing system as it was before the pandemic but also to build a new one, which involves a different role in coordinating the resources and outcomes of the marketing system. The lack of interest from the government and the short-term perspective of corporations in addressing Brazilian social inequalities are turning social movements, such as the MST, into increasingly important players for the marketing system and, consequently, for community wellbeing.

4.4

Lessons and Final Thoughts

The lack of appropriate action by the Bolsonaro administration to help distressed Brazilians during the coronavirus crisis created a possibility for other actors to step forward and to occupy a space of positive—indeed catalytic—prominence, which in many other countries was/is filled by government officials and initiatives. The ways both Itaú Unibanco and the MST rendered aid in this context were based on a distinct set of principles, one in the nature of generosity and the other based on solidarity. Both approaches seek to improve the quality of life of distressed communities. However, it seems the acts associated with generosity are more focused on shortterm results, while those related to solidarity seek long-term changes. Solidarity, therefore, would seek real systemic transformations in markets. Such transformation would enable communities to truly flourish and thus to maintain levels of well-being, while also sustaining societies even during crises. We are not dismissing the value of generosity; on the contrary, we recognize that such acts are vital when our fragilities are most exposed. However, precisely because this kind of behavior is typically only awarded attention when communities are in most need of help but then shortly afterwards is dismissed, its results are limited. Therefore, generosity tends to reinforce the system that maintains inequality because it does not endure in its promises of help. Only through abiding commitments can societies find a way out of their ills. As we discussed, despite all the help/donations by Itaú Unibanco during the COVID-19 pandemic, the bank does not intend to continue making donations to the Todos pela Saúde program; that is, most of the money has already been allocated, at a moment Brazil is in its second wave of contagion, with many more deaths than during the first. Comparatively, the type of help the MST is offering distressed communities complements what the movement has historically done: food

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donations, access to better living conditions, and championing a decent healthcare system for all have always been at its core. Therefore, even when this pandemic ends—hopefully sooner, than later—the MST will continue QOL-enhancing practices until every Brazilian, especially those in poor rural conditions and communities, has attained a dignified level of existence. Historically, in Brazil, gains obtained through the marketing system have excelled when all three catalytic institutions (government, companies, and NGOs) are in sync. Especially in situations of crisis, when communities were most distressed, such togetherness has been fundamental for appropriate responses. Again, this is not the case now in Brazil during the COVID-19 pandemic, resulting in many deaths and much damage to our society. What was learned from all this is that if we truly are to improve the QOL of our peoples, the first step in such direction seems to be harmonizing the roles of each actor. If we are to consider Itaú Unibanco as representative of a catalytic institution that shapes the marketing system characterized by Shultz et al. (2017), it seems that such actors must understand that in this fragile moment of our lives, focus must be on community well-being and traditional measures of commerce. Even if this happens just for a glimpse of a moment, the sheer volume of resources it can raise in a short period is fundamental to bring some relief to the healthcare system, at a time when the government is incapable of doing the same. On the other hand, we can also envision the MST as a catalytic institution, even if this might mean stretching its scope. The movement seems to have understood, more than ever, that striving for collective betterment of QOL and social conditions is both necessary and possible to improve the lives of all Brazilians, including people otherwise disregarded or disdained by the current Brazilian government. Nonetheless, the actions of solidarity the MST has conducted during the pandemic point to an alternative way to achieve community well-being, one that should be included in the shaping of marketing systems. We believe, therefore, that the solidarity model the MST adopts is one that deserves much attention by marketing and QOL scholars, policy makers, and practitioners, given its grand focus on complete societal inclusiveness. Lastly, what can we say are the lessons learned from the role of the Bolsonaro government during this pandemic? Well, not much, except that his administration does not seem to be a representative of the type of government institution Shultz, Rahtz, and Sirgy (Shultz et al., 2017) characterize as being catalytic toward the formation of a Brazilian marketing system to address the needs and well-being of all stakeholders of that system. Harmonizing with others does not seem to be characteristic of this government. Bolsonaro demonstrates to have another understanding of what is QOL and who is entitled to it, which is exclusive for a privileged few. Brazil will continue to have flourishing and distressed communities during his time in office, but Bolsonaro’s actions heavily favor the privileged few in communities that flourish, despite so many Brazilians struggling to survive in distressed communities. Nevertheless, just as the pandemic inevitably will end, so will Bolsonaro’s authoritarian government. By then, we might be able to see clearer how to amend the distortions from which Brazil suffers and, through the engagement of (a new)

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government, companies, and social movements, start to construct systemically a flourishing community in which all Brazilians enjoy high QOL and well-being. In short, our hope is that solidarity will prevail! Conflict of Interest No conflict of interest.

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Platonow, W. (2020, July 2). Rendimento médio de brasileiros cai a 82% em maio devido à covid19. Agência Brasil. https://agenciabrasil.ebc.com.br/economia/noticia/2020-07/rendimentomedio-de-brasileiros-cai-82-em-maio-devido-covid-19 Praveen, S. (2020, June 3). MST mantém ações de solidariedade na África e na América Latina em meio à pandemia. Brasil de Fato. https://www.brasildefato.com.br/2020/06/03/mst-mantemacoes-de-solidariedade-na-africa-e-na-america-latina-em-meio-a-pandemia Presidência da República. (2020). Constituição da República Federativa do Brasil de 1988. República Federativa do Brasil. http://www.planalto.gov.br/ccivil_03/constituicao/ constituicao.htm Ramos, M. (2020). Doações do MST e do MPA chegam a 3.300 toneladas, mas não aparecem no Jornal Nacional. Observatório do Agronegócio no Brasil. https://deolhonosruralistas.com. br/2020/08/26/doacoes-do-mst-e-do-mpa-chegam-a-3-300-toneladas-mas-nao-aparecem-nojornal-nacional/ Reis, G. (2020, July 20). Ao alcançar os R$ 6 bilhões, doações desaceleram em meio a novas emergências. Folha de São Paulo. https://www1.folha.uol.com.br/empreendedorsocial/2020/07/ ao-alcancar-os-r-6-bilhoes-doacoes-desaceleram-em-meio-a-novas-emergencias.shtml Rodrigues, E. (2020, March 24). Política de home office e álcool gel não funcionam em favelas, diz líder comunitário. Cantarino Brasileiro. https://cantarinobrasileiro.com.br/blog/politica-dehome-office-e-alcool-gel-nao-funcionam-em-favelas-diz-lider-comunitario/ Sakamoto, L. (2020, July 8). Mais pobres têm o dobro do risco de se infectarem com coronavírus no Brasil. UOL. https://noticias.uol.com.br/colunas/leonardo-sakamoto/2020/07/08/maispobres-tem-o-dobro-do-risco-de-se-infectarem-com-coronavirus-no-brasil.htm Sampaio, C. (2020, September 17). Fome atinge 10,3 milhões e 44% das familias rurais sofrem com insegurança alimentar. Brasil de Fato. https://www.brasildefato.com.br/2020/09/17/fomeatinge-10-3-milhoes-e-44-das-familias-rurais-sofrem-com-inseguranca-alimentar#:~:text¼A% 20fome%20no%20Brasil%20chegou,Geografia%20e%20Estat%C3%ADstica%20 Samuel, F. (2020, October 21). Ex-ministro da saúde critica "lockdown" e defende conceito de imunidade de rebanho para Covid-19. Correio do Povo. https://www.correiodopovo.com.br/not %C3%ADcias/geral/ex-ministro-da-sa%C3%BAde-critica-lockdown-e-defende-conceito-deimunidade-de-rebanho-para-covid-19-1.503408 Sanar Saúde. (2020). Linha do tempo do Coronavírus no Brasil. Sanar Saúde. https://www. sanarmed.com/linha-do-tempo-do-coronavirus-no-brasil Shapiro, S., Tadajewski, M., & Shultz, C. (2009). Interpreting Macromarketing: The construction of a major macromarketing research collection. Journal of Macromarketing, 29(3), 325–334. https://doi.org/10.1177/0276146709338706 Shultz, C., Rahtz, D., & Sirgy, J. (2017). Distinguishing flourishing from distressed communities: Vulnerabilities, resilience and a systematic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), The handbook of community well-being (pp. 403–422). Springer. Soares, M. (2020a, July 3). Dados do sus revelam vítima-padrão de covid-19 no brasil: homem, pobre e negro. Época. https://epoca.globo.com/sociedade/dados-do-sus-revelam-vitimapadrao-de-covid-19-no-brasil-homem-pobre-negro-24513414 Soares, I. (2020b, April 20). "Não sou coveiro", diz Bolsonaro ao ser questionado sobre mortes por Covid. Correio Braziliense. https://www.correiobraziliense.com.br/app/noticia/ politica/2020/04/20/interna_politica,846638/nao-sou-coveiro-diz-bolsonaro-ao-serquestionado-sobre-mortes-por-c.shtml Stedile, J., & Fernandes, B. (2005). Brava gente: a trajetória do MST e a luta pela terra no Brasil. Fundação Perseu Abramo Stropasolas, P. (2020, June 5). MST apresenta plano de Reforma Agrária Popular para superar crise social e econômica. Brasil de Fato. https://www.brasildefato.com.br/2020/06/05/mstapresenta-plano-de-reforma-agraria-popular-para-superar-crise-social-e-economica#:~: text¼Para%20o%20Movimento%20dos%20Trabalhadores,constru%C3%A7%C3%A3o%20 da%20Reforma%20Agr%C3%A1ria%20Popular

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Sutto, G. (2020, April 13). Itaú explica doação de R$ 1 bilhão para a Fundação Itaú contra Coronavírus. InfoMoney. https://www.infomoney.com.br/negocios/itau-doa-r-1-bilhao-para-afundacao-itau-contra-coronavirus-e-explica-movimento/ Tajra, A. (2020, May 1). Todos nós vamos morrer um dia: veja falas de Bolsonaro sobre o coronavírus. UOL. https://noticias.uol.com.br/saude/ultimas-noticias/redacao/2020/05/01/ todos-nos-vamos-morrer-um-dia-as-frases-de-bolsonaro-durante-a-pandemia.htm Tarlau, R. (2020, May 7). Enquanto Bolsonaro minimiza COVID-19, assentados alimentam pobres e ajudam doentes. MST. https://mst.org.br/2020/05/07/enquanto-bolsonaro-minimiza-covid-1 9-assentados-alimentam-pobres-e-ajudam-doentes/ Todos pela Saúde. (2020a). Informar. https://www.todospelasaude.org/blog/informar/ Todos pela Saúde. (2020b). Proteger. https://www.todospelasaude.org/blog/proteger/ Todos pela Saúde. (2020c, April 13). Coletiva Itaú Unibanco - Todos pela Saúde [Video]. YouTube. https://www.youtube.com/watch?v¼baU-vo7KWbw Trisotto, F. (2020, May 25). Décadas de retrocesso: como a Covid-19 vai ampliar a pobreza e a desigualdade no país. Gazeta do Povo. https://www.gazetadopovo.com.br/republica/pobrezadesigualdade-social-brasil-covid-19/ United Nations. (2020). World social report 2020 - Inequality in a rapidly changing world. Department of Economic Social Affairs, United Nations. https://www.un.org/development/ desa/dspd/wp-content/uploads/sites/22/2020/01/World-Social-Report-2020-FullReport.pdf Vatican News. (2020, July 28. Pope Francis lauds solidarity initiative in Brazil. Vatican News. https://www.vaticannews.va/en/pope/news/2020-07/pope-francis-message-supporting-brazilsolidarity-initiative.html Veiga, I. (2020, April 2). Governo compra 8.000 respiradores da China, mas prazo para entrega é de 30 dias. O Tempo. https://www.otempo.com.br/coronavirus/governo-compra-8-000respiradores-da-china-mas-prazo-para-entrega-e-de-30-dias-1.2320169 Verdélio, A. (2021, March 23). Marcelo Queiroga é nomeado Ministro da Saúde. Agência Brasil.. https://agenciabrasil.ebc.com.br/saude/noticia/2021-03/marcelo-queiroga-e-nomeado-ministroda-saude Wooliscroft, B. (2020). Macromarketing and the systems imperative. Journal of Macromarketing. Advanced online publication. https://doi.org/10.1177/0276146720980521

Marcus Wilcox Hemais , Ph.D. in Business Management obtained at Coppead/UFRJ (Coppead Graduate School of Business of the Federal University of Rio de Janeiro), is Associate Professor of Marketing at IAG/PUC-Rio (IAG Business School Graduate Program at the Pontifical Catholic University of Rio de Janeiro). Research interests are in decolonialism, postcolonialism, consumerism, and bottom of the pyramid theorizations, having published articles related to these themes in journals such as Marketing Theory, Journal of Business Ethics, and Journal of Macromarketing. [email protected]. João Felipe R. Sauerbronn is Associate Professor at the Universidade do Grande Rio. He earned a Ph.D. in Administration and an M.A. in Public Administration from Fundação Getulio Vargas (EBAPE/FGV) and a B.A. in Economics from the Universidade Federal do Rio de Janeiro (UFRJ). He was visiting scholar at the College of Media in the University of Illinois at Urbana-Champaign. His eclectic research interests include macromarketing, constructivist market studies, consumer culture, food studies, and qualitative research. [email protected]. Ronan Torres Quintão is Associate Professor at the Federal Institute of São Paulo and Collaborating Professor of the Business Administration Graduate Program at the Centro Federal de Educação Tecnológica de Minas Gerais. He did his post-doc course in Anthropology at Universidad Complutense de Madrid and holds a doctoral degree in marketing from the Escola de Administração de Empresas de São Paulo da Fundação Getulio Vargas, with a year of international exchange at York University, Toronto. Ronan Quintão has published and also reviewed national and

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international academic papers. His interests lie in critical marketing, decoloniality, consumer behavior, markets, and social movements. Eduardo Teixeira Ayrosa holds a Ph.D. from London Business School (2001). He is a Professor of Consumer Studies, Qualitative Research Methods, and Epistemology at the PPGA- Universidade Positivo. His interests include the impact(s) of consumer culture on societies and subjectivities in consumer cultures. He is currently working on the interplay between violence and consumption and the articulations between work and consumption in organizations. [email protected].

Chapter 5

Canada After COVID-19: A Flourishing Community for Everyone? Stanley J. Shapiro and Julie Stanton

Abstract Just how flourishing a nation was Canada, even before Covid-19? Despite its overall high quality of life (QOL), there were serious shortcomings in both the healthcare system and the social safety network. Also, only limited progress had been made in making the Canadian economy a more environmentally sound one. The arrival of Covid-19 led to even more serious challenges in areas such as seniors care, childcare, paid sick leave, and poverty alleviation. However, it also resulted in a number of organizations spelling out in detail how, by “Building Back Better,” Canada could deal with long existing quality of life inequities. Whether and to what extent Canada has both the political and economic will to better serve its remaining “distressed” segments within an otherwise “flourishing” society remains to be determined. Keywords “Building Canada Back Better” · Sustainable economic development · Healthcare reform · Guaranteed minimum income · Post-pandemic quality of life

5.1

Introduction

As of early May 2021, Canada has logged more than 1.25 million cases of COVID19 infections, and nearly 25,000 deaths, from a population of just under 38 million (Public Health Agency of Canada, 2021a). Indications are that the third wave may have peaked in April, although the uncertainty of that continues to suggest that Canada must focus its energies on both preventing the spread of Covid and on vaccination efforts. Currently, four vaccines are actively being administered, and over 35% of the population has received at least one dose (Public Health Agency of

S. J. Shapiro (*) Beedie School of Business, Simon Fraser University, Burnaby, BC, Canada e-mail: [email protected] J. Stanton The Pennsylvania State University, Media, PA, USA e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_5

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Canada, 2021b). Most of these vaccinations occurred in April 2021 due, in large part, to no vaccine being produced in Canada. These figures suggest that how well or poorly Canada has dealt with the Covid challenge, especially as compared with other developed nations, cannot yet be determined. Unquestionably, however, and using the terminology introduced by Shultz et al. (2017), Canada during the Covid epidemic has very definitely been a “distressed” nation. Prior to Covid, it would have to be considered one of the world’s more “flourishing” nations, although not equally for all Canadians. In this chapter, we illustrate the pre-Covid forces that shaped individual well-being for most Canadians and how they influenced Canada’s Covid experience. As some Canadians seek to Build Back Better through a variety of fresh policies, this understanding of what supports its level of flourishing and what resulted instead in distressed conditions for the less privileged offers important foundational insight.

5.2

The Canadian Context

Most governments, particularly those with democratically chosen leaders, aim to develop and support an economic, social, and regulatory system that provides prosperity and an acceptable quality of life (QOL) to all its citizens. In the ideal version, the system is resilient, built to withstand both anticipated and unanticipated changes in its underlying parameters. Of course, what prosperity and quality of life means will differ from country to country. Prior to COVID-19, Canada, for most people at least and compared to other nations, was indeed a good place to live. According to the 2019 Human Development Index (HDI), Canada had a Global Ranking of 13th but with a numerical value just marginally behind many of the nations ahead of it (UNDP, 2019). Meanwhile, according to the US News and World Report Ranking, Canada was judged the second-best nation in the world in which to live and it ranked number one for quality of life (US News & World Report, 2021). However, Canada was not without its problems, a fact reflected in the significant drop (from 0.922 to 0.841) (UNDP, 2019) when its HDI score is adjusted for inequality, an adjustment which recognizes inequality both of opportunities and of outcomes in more material-related human well-being (UNDESA, 2015). Indeed, both types of inequality were to be found in pre-Covid Canada, suggesting that the system was neither fully able to address all constituents’ needs nor fully resilient in the face of circumstances that less fortunate individuals face. Eventually, Canada will enter either a post-Covid or “Covid under Control” world. To that end, a number of Canadian organizations have already developed Build Back Better plans, many of which have as their intended purpose both improving Canada’s overall quality of life (QOL) and, at the same time, reducing social and economic inequality within Canada. Though the coronavirus has called increased public attention to many of the issues addressed in these plans, both the problems themselves and the solutions being advocated had been discussed long

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before the COVID-19 pandemic. A wide range of different “betters” have been advocated with much of the best work aimed towards helping Canada become a healthier, more economically equitable and much “greener” economy. Both what is being proposed in these three important dimensions of well-being and how they will impact Canada’s QOL are discussed in the following sections.

5.3

Healthcare System

One of the most fundamental aspects of QOL is personal health. Its attainment includes both prevention measures for improving one’s overall health and treatment measures for addressing problems. Being healthy includes physical and mental health, the latter often underestimated in importance and inadequately addressed. As personal health contributes to overall QOL, the system that supports healthy living should be built to address all the various circumstances of life. Indeed, we would argue that the role of the government as a catalytic institution (Shultz et al., 2017) supporting the overall marketing system, including healthcare delivery, requires more attention in this regard. A temporal shock such as COVID-19 reveals new structural gaps and highlights others that have long needed to be addressed.

5.3.1

Healthcare in Canada: Before Covid

Canada, like many European countries, has a single-payer (government) healthcare system. When compared recently with the healthcare systems in other developed countries, the comparison was not a favorable one. Canada has been ranked third-to-last in a detailed international study comparing health-care systems in 11 developed nations, managing to beat out only France and the bottom-ranked United States. According to the study, . . . weaknesses include Canada’s comparatively higher infant mortality rate, the prevalence of chronic conditions, long wait times in emergency rooms and to see specialists, poor availability of after-hours care, and a lack of reliable coverage for things like dental work and many prescription drugs. (Scotti, 2020)

Such weaknesses, particularly the long time required to see a specialist and, even more so, the failure of the system to expand coverage by including coverage for prescriptions (Pharmacare) and dental care (Dentacare), have long been criticized. Pre-Covid, however, political decision makers had been unwilling to add the cost of these additional services to the already ever-increasing healthcare costs associated with a steadily aging population. It has also long been argued that mental health, an important component of wellbeing, has received far less attention in Canada than it deserves. Other noted shortcomings in the Canadian system include poor service to its indigenous population, an increasingly serious drug overdose crisis, and the relative neglect of people with disabilities. Numerous reports documenting the shortcomings of Canada’s

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existing elder care facilities (nursing homes) were also on record. These and other deficiencies of the Canadian system (Martin et al., 2018) suggest that many determinants of how citizen-consumers engage with the Canadian system (Shultz et al., 2017) are underperforming; cultural, location-related, or situational factors in particular created “distressed” as well as “flourishing” sub-communities in pre-Covid Canada.

5.3.2

Healthcare in Canada: During Covid

The healthcare issues mentioned above came into more glaring focus during Canada’s first months of Covid exposure. For example, hospital capacity issues were immediately apparent. There was a concern, both during the first Spring 2020 Covid wave and during the second and third waves, that the number of Covid cases, especially critical care cases, would be too much for hospitals to handle. This indeed proved to be the case. In response, first long-scheduled but less critical surgeries (hip and knee operations for example) were deferred and then in some cases even cancer and heart surgeries. This has already caused serious problems and will continue causing them for years to come. As a result, a number of groups have been laying out plans for Building Back Better the Canadian healthcare system. In April 2020, the Royal Society of Canada (RSC), the country’s most prestigious academic honor society, established a Task Force “mandated to provide evidence-informed perspectives on major societal challenges in response to and recovery from COVID-19” (Royal Society of Canada, 2020a). As an example of the task force’s findings, the Working Group on Long Term Care (LTC) concluded: (I)f we do nothing else right now, we must solve the workforce crisis in LTC. It is the pivotal challenge. Workforce reform and redesign will result in immediate benefit to older Canadians living in nursing homes and is necessary for sustained change. It will also improve, at a minimum, quality of care so that nursing homes are able to reduce unnecessary transfers to hospitals, reduce workforce injury claims, and interface more effectively with home and community care. Solving the LTC workforce crisis is intimately linked with securing robust and sustainable funding and strong governance for LTC going forward. New federal and provincial dollars are urgently needed to tackle the LTC workforce crisis so that we can face and manage COVID-19 pandemic conditions and improve quality of care, quality of life and quality of end of life for people living in nursing homes. (Royal Society of Canada, 2020b)

This specific focus on long-term care facilities highlights deficits in Canada’s healthcare system. Macro factors such as weak economic and budgetary conditions, underdeveloped healthcare infrastructure, and limited educational opportunities influence how the government, as catalytic institution, could better serve the healthcare needs, and hence the overall well-being, of its citizens (Shultz et al., 2017). In the case of Covid, this is particularly problematic. Daily reports of the large number of Covid cases linked to LTC homes, the high percentage of Canada’s early Covid deaths (about 75% as of Nov 24, 2020) accounted for by nursing home

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residents (Canada’s Library of Parliament, 2020), and, above all else, the repeated complaints by the children of those residents during the first two Covid waves as regards patient neglect and even ill treatment have refocused attention on the failures of Canada’s senior care system. A second Royal Society of Canada healthcare-related report dealt with mental health. This document argues that, before Covid, mental health had not received anywhere near the attention it merited and, further, Covid-related mental health issues were now disproportionately impacting the already socially and economically disadvantaged. The COVID-19 pandemic has had a detrimental effect on mental health of people in Canada but the impact has been variable, impacting those facing pre-existing structural inequities hardest. Those living in poverty, and in some socially stratified groups facing greater economic and social disadvantage, such as some racialized, and some Indigenous groups and those with preexisting mental health problems, have suffered the most. (Royal Society of Canada, 2020c)

The report presents 21 recommendations for dealing with Canada’s considerably Covid-worsened mental health crisis, including increasing federal funding, improving coordination with provinces, addressing indigenous and elder needs, and attending to school-age children’s mental health. Each speaks to governance as a catalytic institution and cultural factors as contributors to effect prioritization of QOL. Separately, attention is also being paid to how a healthcare system, one that has already put ever-increasing pressure on Canada’s provincial budgets as the population ages, is going to be able, post-Covid, to deal both with Canada’s already existing capacity, coverage, and performance shortcomings and all of the Covid-delayed medical procedures. A report prepared for the C.D. Howe Institute, a well-respected economic think tank, outlines the near economic impossibility of Canada meeting its future healthcare challenges without a fundamental rethinking of what that system should emphasize (health rather than healthcare), how medical care is provided (with an increased reliance on multidisciplinary teams), and how medical service providers are compensated. A blueprint for making all the necessary changes is provided by the report’s authors (Drummond & Sinclair, 2020). The three reports discussed above reinforce and update familiar themes as do recent arguments in favor of expanding the Canadian healthcare system to include both Pharmacare and Dentacare. Further, systemic racism long known to exist within the healthcare system has also been further highlighted by the Covid crisis and is long overdue for corrective action. In addition, Canada has not had enough beds in intensive care units throughout the country to deal with both successive Covid challenges and normal demand. As well, Canada continues to grapple with the long-running national health crisis that is opioid addiction, with its own alarming death rate from COVID-19. These challenges speak directly to Canada’s crisis in meeting expectations of human well-being prior to and during COVID-19, and how recovering from the pandemic is thus additionally challenged. While a public healthcare system as exists in Canada places much of the burden of improving the system on the government as a catalytic institution, there is little question that

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achieving that improvement is dependent on the cultural, economic, and infrastructure forces that currently define Canada.

5.4

Economic Equity

Similar to health and wellness, economic security is another major determinant of both national and personal QOL. The ideal economic system would be one that provided everyone with a minimum acceptable standard of living while at the same time rewarding outstanding effort and innovation by individuals and corporations. It would be free of inequities based on race, gender, or other individual traits. However, as with healthcare, the shock that COVID-19 brought to the Canadian economy both revealed and contributed further to the already existing weaknesses of Canada’s economic model.

5.4.1

Poverty and Income Inequality in Canada

Despite its relatively high international QOL rankings, Canada had 3.2 million residents (8.7% in 2018) living below its official poverty line even before COVID-19. Although that percentage has been declining (the lowest ever was 2018), the poor population included 566,000 children (Press, 2020). While there had been considerable advocacy over the preceding half century to introduce a form of Guaranteed Annual Income (GAI) to deal with recurrent poverty, other measures to (at least partially) solve the poverty problem had proven more politically feasible. Indeed, the “guaranteed income” concept was so politically charged that a smallscale trial already underway in Ontario, Canada’s largest province, was cancelled in 2018, very shortly after a liberal (center-left) government was replaced by a conservative (right wing) government (Aivalis, 2018). The problems already associated with poverty in Canada were further impacted by the COVID-19 pandemic. In the eyes of GAI advocates, both the epidemic itself and the Canadian government’s mix of programs that had temporarily provided GAI-like funding to millions of Canadians demonstrated both the necessity and the feasibility of a permanent program. This was the position argued in the Royal Society of Canada’s (RSC) Policy Briefing entitled A Federal Basic Income within the Post-Covid Economic Recovery Plan. Just a few years earlier, two of the three authors, Segal (2019) and Forget (2018), had separately advocated at length for a GAI program in pre-Covid Canada. The RSC proposal for a Basic Income Guarantee was described thusly: In particular, we propose that the federal government introduce a Basic Income guarantee for all residents of Canada as part of a comprehensive social safety net that includes access to housing, child care, mental and physical healthcare, disability supports, education, internet access, and the many other public services essential to life in a high-income country.

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Residents with no other income would receive the full benefit which would be sufficient to ensure that no one lives in poverty, while those with low incomes would receive a reduced amount. (Segal et al., 2020)

It seems unlikely, even now, that this ambitious plan has any prospect of adoption, despite the legacy impact of Covid-related economic conditions. However, it illustrates the desire, at least by some, to transform the current economic system to one that addresses its economic and social inequities. Rather than limiting itself to an already ambitious GAI program, the RSC report argues for an even broader social safety net. These views, while not shared by all, speak to the underlying social and access factors—poor access to housing, physical disabilities, unequal access to the internet, etc.—that influence citizen-consumer involvement in the marketing system (Shultz et al., 2017).

5.4.2

Childcare

As with the GAI, support had also previously been expressed for a comprehensive, nationally available, government and/or non-profit run, and highly subsidized day care system that would support the full integration of parents into the economic workforce. Prior to Covid, the Province of Quebec already had a blend of such systems in place (The Canadian Press, 2018). British Columbia was also already moving in this direction (Government of British Columbia, n.d.) and the federal government had committed itself to taking the first steps necessary to facilitating the establishment of a national system (Wright, 2019). More recently, the announced 2021 federal budget supports expansion of childcare options (Aiello, 2021). The COVID-19 pandemic elevated attention to this issue. Covid-related business shutdowns, public schools going online, and the marked increase in parents working from home collectively impacted family life in ways previously unimaginable. Further, when employment figures began to recover after the initial wave, the percentage of reemployed males was significantly greater than the percentage of females returning to work, a development described by some as a “she-cession” (Yahnizyan, 2020). Women’s labour force participation has plummeted to levels not seen in 30 years. And it could get even worse. Some child care centres have been permanently closed, and the cost of delivery has increased, making child care harder to find and even more expensive than it was before the pandemic. Statistics Canada found that more than one-third of parents who have been working from home are concerned that child care challenges will limit their ability to keep working. It’s worse for women with a child younger than six, 56 per cent of whom share this concern. (CUPE, 2020)

Armed with these statistics, advocates of highly subsidized childcare have argued that such a system both is essential to Canada’s economic recovery and will, in time, more than pay for itself given the extra taxes working mothers will contribute. Children benefit educationally as well. This, in essence, is the argument advanced both by groups focused on day care (ChildCareCanada.org) and those, like the

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Canadian YWCA, with more all-encompassing feminist interests (Sultana & Ravenara, 2020). The recent federal budget suggests that the oft-recommended $10 per day cost for childcare may indeed be finally realized (Aiello, 2021).

5.4.3

Paid Sick Leave

Another example of the social conditions that contribute to economic health is paid sick leave. Lack of paid sick leave became a mainstream Canadian issue as soon as the pandemic required workers known to have COVID-19 as well as others who had associated with them to self-isolate. Fewer than 40% of Canadian employees prior to Covid received sick leave benefits (Macdonald, 2020). Thus, staying at home because of Covid would cause the remaining majority considerable financial hardship. In fact, a variety of income replacement programs introduced by the Canadian government provided such individuals, along with millions of others who lost their jobs, with the bridge financing they required (Department of Finance, 2020b). When those initial programs came to an end, the New Democratic Party of Canada (NDP) made a further temporary extension of 2 weeks of government paid sick leave a condition of its continued support for a minority liberal government, support which it needed to stay in power (Tunney & Hall, 2020). The NDP is committed to making paid sick leave for all a permanent feature of the Canadian employment scene but whether or to what extent that will happen remains to be determined. In sum, these examples of poverty, childcare needs, and paid sick leave illustrate the variety of structural issues that keep the Canadian economic system from meeting true QOL standards for all its citizens. There is little question that addressing economic inequities can improve QOL, as argued by Shultz et al. in (2017). Consumers’ access to jobs, housing, childcare, sick leave, etc. all serve as important determinants of their successful participation in the market and hence the overall ability of that system to flourish. The systemic shock that is COVID-19 has highlighted the extent to which Canadians already straddle the divide between distressed and flourishing.

5.5

Environmental (“Green”) Factors

Without doubt, the connections between the objectives of QOL and prosperity and the health of the natural environment are strong. An economic system, while often reflective of its natural resource base, is only as healthy as the natural environment, with damage to the latter invariably harming the former. Canada’s economic system, heavily reliant on natural resources, is one of many where the pressures to reduce negative impacts on nature have risen dramatically. Both how “green” the Canadian system should become and how quickly it should become that green have been controversial issues. Fossil fuels have long been the

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lubricants of economic growth in the Provinces of Alberta and Saskatchewan and more recently in Newfoundland as well. For decades, environmental advocates have been opposed to the construction of new oil and gas pipelines and the further drilling of dirty “oil sands” bitumen, advocating instead for electric vehicle subsidies and carbon taxes. Both the oil industry and its work force have argued in response that the need for oil and gas will continue for many years and that the Canadian industry, which currently employs over 800,000 workers, operates in a much more environmentally responsible manner than its rivals elsewhere. That industry has been both directly and indirectly affected by the pandemic. Global demand for oil fell sharply during the opening months of the pandemic as fewer automobiles were on the road, and lower consumption of oil and gas led to a marked decline in the price paid for Canadian oil. That, in turn, led to lower tax revenues, particularly in oil-rich provinces, with corollary impacts on the economic resources available for healthcare and economic support systems. More recently, both global and Canadian oil prices have risen substantially. More indirectly, the pandemic also shifted consumer attention in terms of products, delivery schedules, and overall consumption levels. Products more useful in the home surged in importance compared to those that support office-based work or school building use. Delays in deliveries that resulted from supply chain disruptions and Covid-impaired labor pools have changed consumer perceptions of immediate gratification. Economic struggles, including lost jobs, have greatly reduced consumption levels of many households. All of these factors illustrate the manner in which a systemic shock has the potential to change micro-level decision-making, particularly those which impact our use of natural resources. In reaction, numerous advocates for a “greener” Canadian economy rapidly developed plans for a post-Covid “Green Recovery.” The nature, the scope, and the cost of one of the most ambitious of these plans are spelled out by the Task Force for a Resilient Recovery (2020). Proposed changes include newly emphasizing zero emission activities and products, $7B; promotion of clean energy, $11.5B; and encouraging Green competition and jobs, $5B. Especially noteworthy in this plan is the very significant emphasis on energy efficient retrofitting, this accounting for $27.25B, just over half, of the required total investment. Much of this total would be “upfront” and all of it, its proponents argued, would more than pay for itself. To no small extent, this road map towards a “greener” Canada would shift the overall system, challenging existing investments, norms, and even power relationships. Because of its transformative intentions, it would provide a “reset” to the roles of the major catalytic institutions, rewarding businesses that innovate, nongovernmental organizations which provide knowledge and guidance towards “green” outcomes, and also enhance the ability of the government to contribute to QOL and prosperity. A green economy’s ability to enhance labor opportunities and shift industry towards less polluting activities also supports other economic and healthcare priorities for Canada.

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Putting It All Together

The focus on healthcare, economic equity, and a green economy is by no means the only way that Canada could be Built Back Better (policyresponse.ca). However, the overarching threads of commentary on Canada’s experience with COVID-19 are these: (1) the Canadian health and social service networks must be greatly strengthened, (2) a bold new approach is required to provide all Canadians with a measure of income security and equitable access to opportunities, and (3) the Canadian economy must be built back “greener.”

5.6.1

Paying the Bills

Achieving these goals will not be cheap. The full impact of COVID-19 on the Canadian economy is expected to be quite substantial. Prior to Covid, Canada’s national debt-to-GDP ratio of 31% was the lowest of the G7 nations (Department of Finance, 2020a). Because of emergency deficit spending, that ratio is expected to exceed 51% by the end of Canada’s 2020–2021 fiscal year (Department of Finance, 2021). Expenditures by provincial governments to deal with Covid’s economic impact have also greatly increased their debt burdens. Substantial government spending to assist both businesses and individuals economically impacted by Covid is certain to continue until the pandemic has run its course. However, the low interest rates expected to continue for the foreseeable future and the Bank of Canada’s adoption of Quantitative Easing (Lee, 2020) are believed by many to suggest this increased debt burden will still be a manageable one. That said, there remains the problem of paying the costs of Building Back Better. A systemic transformation as described above will undoubtedly require both substantial additional funding and the human and institutional drive to change current norms. But how will the necessary social and economic programs being proposed be paid for? The recently announced 2021 budget suggests new taxes on vacant properties and luxury products (Aiello, 2021), but others are needed as well including redirecting subsidies received by polluting industries and closing the tax avoidance loopholes from which corporations benefit. Further, as was argued earlier, Build Back Better advocates believe many of the admittedly very significant expenditures would, over time, more than pay for themselves. In addition, although it has just recently become widely discussed in a Canadian post-Covid context, Modern Monetary Theory (MMT) suggests that budgetary deficits and debt-to-GDP ratios are not nearly as important a problem as conventional economic thinking suggests. The central proposition of MMT is that a state controlling its own currency can readily finance fiscal deficits (resulting from spending increases or tax cuts) at low or no cost through money creation and direct funding of government spending by the central bank. Unlike households or businesses, governments with their own currency and their own

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central bank can never go broke because they can always create money to fund deficits or to pay off debts. The only real constraint on public spending for countries with monetary sovereignty is real productive capacity. Too much additional deficit financing of public spending or tax cuts in an economy with full employment will push up inflation. (Jackson, 2020)

Of course, many economists, policy analysts, and, most importantly, conservative politicians question the desirability of some of the policies being advocated for post-Covid Canada, with Guaranteed Annual Income programs generating especially heated critical responses. Also, proponents of MMT are still greatly outnumbered by those who believe that the spending taps turned on to deal with the COVID-19 pandemic should be turned off as quickly as possible. It thus remains to be determined how many of the programs advocated by those who wish to Build Back Better will become public policy in post-Covid Canada.

5.6.2

A Mandate for Change

In spite of these financial considerations, or perhaps more accurately because of them, it is in Canada’s interest to Build Back Better with a more holistic and systemic mindset. It is tempting to address individual problems as they come up—stockpiling PPE for healthcare workers, legislating up to 2 weeks of paid sick leave, and subsidizing green initiatives. We believe, however, that the change needed is one that questions the current model in its entirety. In terms of healthcare, the goal should be to systematically refocus on health rather than healthcare. The single-payer healthcare system in Canada has many desirable features but remains characterized by long surgical delays in rural areas, in indigenous communities, and even in some of Canada’s less populated provinces. The spiralling costs of serving a steadily aging population raise further problems. With a refocusing, including expanding virtual medicine, Pharmacare and Dentacare are more likely to be provided. A public health service should address all health and wellness needs, whether with regard to medical emergencies, chronic conditions, age, low income, ethnic status, rural residence, or mental health concerns. Within the Canadian context, such a rethinking must consider both provincial and national interests while providing truly universal coverage. In terms of economic equity, the Canadian system needs changes that provide opportunities for all. Its structural weaknesses have left parents out of the workforce, individuals and families devastated economically by emergencies, and many unable to participate due to other disadvantages. Rebuilding systemically to support parents’ work, providing temporary income support in emergencies, and strengthening the existing social safety net can improve both QOL and prosperity. In addition, the economic multiplier value of such actions should be calculated and incorporated into decision making. In terms of environmental concerns, the goal should be to give a healthy natural environment at least equal weight in the economic activities that are supported by the

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government. Ways must be found to convert Canada’s vast natural resources from being a “sink” for its outputs—industrial waste, household trash, etc.—to become instead the source of new opportunities, both socially and economically. Innovation brings about new job types, while moving away from polluting activities reducing negative health impacts. Rather than see environmental protection as a cost to those who undertake it, rebuilding a system to incorporate a healthy natural environment would catalyze other positive economic and human outcomes.

5.7

Lessons Learned

To better illustrate the changes needed to reach these goals, we consider Canadaspecific aspects of the model by Shultz et al. (2017).

5.7.1

Macro Factors

Any marketing system is only as healthy as macro conditions allow, and COVID-19 is almost certain to have a significant and lasting macro-level impact. As a key recommendation, we argue that Canada’s experience with the COVID-19 pandemic makes a case for “public health” being added to the list of “Macro” factors in the conceptual frame of Shutlz et al. (2017). In contrast to seeing public health as the result of other factors, we suggest that viewing it more broadly—to encompass both provision of healthcare by qualified experts and a broadly agreed-upon community prioritization of protecting everyone’s health—would allow its comprehensive impact on marketing activities and QOL to be more clearly articulated. Without purposeful and clear attention to the state of public health, a marketing system cannot adequately aim for or be “flourishing.” Beyond this addition to the model, we see a consistent reflection of the model by Shultz et al. in the Canadian context. Economic forces are seen through Canada’s system emphasizing high levels of consumption and relatively high incomes. Relatively advanced technology fosters economic activity and high-end healthcare. While not available to all citizens uniformly, these factors contribute to overall QOL and well-being. Geographically, Canada’s abundance of natural resources also provides it with materials and tax revenue to support a wide array of both private and public endeavors. Politically, Canada’s provincial system and its relative strength vis-à-vis the federal government is a weakness when it comes to addressing nationwide problems. Leaving so much discretion to provinces with different tax bases and individualized cultures means that Canadians have unequal access to important underpinnings of their well-being. Geographically, the physical size of provinces, the distance between population centers, and their overall population densities also generate different outcomes for provincial residents. Structurally, a change that either

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transfers more responsibility for fundamental aspects of well-being to the federal government or that at least improves federal-provincial cooperation has the potential to lead to a system that is both good for all Canadians and broadly empowered to weather shocks. Whether either change will take place remains to be seen.

5.7.2

Catalytic Institutions

All the above documents the need for change in Canada’s major catalytic institutions—government, business, and nongovernmental organizations. When decisions about factors that are central to well-being are subject to the political winds inherent to a democratic system, the most vulnerable people are the ongoing pawns. While the impact of COVID-19 illustrates what hopefully is a “worst case” scenario, there is no question that poverty, uneven access to healthcare, environmental degradation, and racial and gender discrimination have long existed. The pandemic provided a clearer view of how those factors worsen the position of the already most vulnerable. Governance in Canada needs a clearer mandate to focus on well-being if the needs of the entire population are to be addressed. However, industry also has an important role to play. Best practices by private economic agents should include more attention to wage levels, paid sick leave, the needs of working parents, and racial discrimination if the impacts of shocks such as COVID-19 are to be reduced. There is ample evidence, as discussed earlier, of why attention to such changes should be viewed not as an expense but instead as an investment. Productivity gains at both micro and macro levels would result. While it may be necessary to catalyze the change through public policy, it will still be necessary for businesses and some nongovernmental organizations to adequately respond.

5.7.3

Towards a Canada Where Every One Flourishes

Of course, broader movements to address the needs of society’s most vulnerable, the conditions which lead to vulnerability, and barriers to change do exist. However, the degree to which a community is distressed or flourishing influences the degree to which progress can be made. (A) flourishing community is a recognizable assembly of people with shared values, cooperating to ensure clear evidence of positive physical, economic, environmental, and social well-being, which empower constituent members in their efforts to affect further prosocial outcomes for stakeholders of the community. To be considered flourishing, it must also have demonstrated a temporal sustainability of these domains and a capacity for continued growth and resiliency in these domains. (Shultz et al., 2017, p. 10)

It is clear from its experience with COVID-19 that Canada’s status as a “flourishing” community needs reinforcement. Not only have poverty and

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discrimination shown themselves to be (admittedly not uniquely) a Canadian reality, but also the impacts of COVID-19—a temporal shock—illustrate that the already poor and disadvantaged are not all that well protected by the broader system even in the face of such a monstrous challenge. At best, pre-Covid Canada can claim some level of “flourishing” for many but by no means all. Issues with environmental impacts, disease incidence, and unemployment suggest that many lower-order needs were not being addressed. A truly flourishing community is able to both address such lower-order needs and then focus on higher-order needs (Shultz et al., 2017). Indeed, how Canada chooses to Build Back Better will determine how well it fits the description of a “flourishing” community. While communities may share common values and governance, if their citizens are not empowered to improve their own circumstances and those of others, they are less likely to exhibit resilience to negative shocks. Will Canada’s immediate and long-term futures reflect a common desire for all to seek well-being or will it ingrain the current practices which leave many Canadians vulnerable? COVID-19 emerged as a threat to human health; other threats come from nature (hurricanes, earthquakes, intense weather events) and from our own actions (political change, social factors, and population growth). To flourish, a community—large or small—needs to be prepared for the unexpected, such that its resilience is ultimately a part of the system itself. How well Canada will, in fact, rise to the Covid challenge in a way that improves the QOL for all its citizens still remains to be determined.

References Aiello, R.. (2021, April 19). Budget 2021: Government unveils $101.4B in new spending, with deficit declining. CTVnews. https://www.ctvnews.ca/politics/budget-2021-governmentunveils-101-4b-in-new-spending-with-deficit-declining-1.5393525 Aivalis, C. (2018, August 13). Conservatives end 'basic income' program in Ontario, afraid to be proved wrong. Washington Post. Canada’s Library of Parliament. (2020). Long term care homes in Canada: The impact of Covid-19, Hill Notes, Nov. 24. Retrieved 26, November, 2020, from HillNotes.ca. CUPE Canadian Union of Public Employees. (2020, Sept 15). The gendered impact of the Covid-19 pandemic. Retrieved November 28, 2020, from cupe.ca/gendered-impact-covid-19-pandemic. Department of Finance, Government of Canada. (2020a). Debt Management Strategy for 2020-21. https://www.budget.gc.ca/2021/report-rapport/anx2-en.html Department of Finance, Government of Canada. (2020b, March 25). Government introduces Canada emergency response benefit to help workers and businesses. Retrieved November 29, 2020, from Canada.ca/en/department-finance/news2020/03 introduces-canada-emergencyresponse-benefit-to-help-workers-and-businesses. Department of Finance, Government of Canada. (2021). Our shared economic and social foundations—Challenges and opportunities ahead. https://www.budget.gc.ca/2021/report-rapport/ overview-apercu-en.html. Drummond, D., & Sinclair, D. (2020, October 15). Covid-19 - A catalyst for change in health and health care. Verbatim. Retrieved November 22, 2020, from cdhowe.org/publicpolicyresearch/ covid-19-catalyst-change-health-and-healthcare

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Forget, E. L. (2018). Basic income for Canadians: The key to a healthier, happier, more secure life for all. Lorimer. Government of British Columbia. (n.d.). Childcare BC. Retrieved November 27, 2020, from www2.gov.bc.ca/gov/content/family-social-supports/caring-for-young-children Jackson, A. (2020, November–December). The fiscal deficit, modern monetary theory and progressive economic policy. Monitor, p. 32. Retrieved November 30, 2020, from policyalternatives.ca/publications/monitor. Lee, M. (2020). Now is not the time to get hysterical about the federal debt, Behind the numbers: we did the math, Canadian Centre for Policy Alternatives. Retrieved November 21, 2020, from behindthenumbers.ca/2020/09/22. Macdonald, D. (2020, March). Covid-19 and the Canadian work force. Canadian Centre for Policy Alternatives, p. 4. https://www.policyalternatives.ca/publications/reports/covid-19-and-cana dian-workforce Martin, D., Miller, A. P., Quesnel-Valles, A., Caron, N. R., Vissandjee, B., & Marchildon, G. P. (2018). Canada’s universal health-care system. The Lancet, 391(10131), 1718–1735. Press, J. (2020, February 24). 3.2 million Canadians including over 560,000 children living in poverty: Stats Canada. The Canadian Press. Retrieved November 27, 2020, from globalnews. ca/news/6590431. Public Health Agency of Canada. (2021a, May 4). COVID-19 daily epidemiology update. https:// health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html Public Health Agency of Canada. (2021b, April 30). Canadian COVID-19 vaccination coverage report. https://health-infobase.canada.ca/covid-19/vaccination-coverage/ Royal Society of Canada. (2020a). Covid-19 resources. Retrieved November 20, 2020, from rsc-sec.ca/en/covid-19. Royal Society of Canada. (2020b). Restoring trust: Covid-19 and the future of long term care: Executive summary. https://rsc-src.ca/en/research-and-reports/covid-19-policy-briefing/longterm-care/restoring-trust-covid-19-and-future Royal Society of Canada. (2020c). Easing the disruption of Covid-19: Supporting the mental health of the people of Canada: Executive summary. https://rsc-src.ca/en/research-and-reports/easingdisruption-covid-19-supporting-mental-health-people Scotti, M. (2020). Canada’s health-care system is third last in new ranking of developed countries. Global News, July 14, 2017. Retrieved November 25, 2020, from globalnews.ca/news/ 3599458. Segal, H. (2019). Boot straps need boots: One Tory’s lonely fight to end poverty in Canada. UBC Press. Segal, H., Forget, E. L., & Banting, K. (2020). A federal basic income within the post Covid-19 economic recovery plan: Executive summary. Royal Society of Canada. Retrieved November 24, 2020, from rsc.src.ca/en/researchandreports/covid-19-policy-briefing/federal-basic-incomewithin-post-covid-19-economic. Shultz, C., Rahtz, D., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), The handbook of community well-being. Springer. Sultana, A., & Ravenara, C. (2020). A feminist economic recovery plan for Canada. YWCA Canada. Retrieved November 24, 2020, from feministrecovery.ca/theplan. Task Force for a Resilient Recovery. (2020, September). Bridge to the future: Executive summary. https://www.recoverytaskforce.ca/wp-content/uploads/2020/09/TFRR-Final-Report_EN.pdf The Canadian Press. (2018, May 29). Quebec’s daycare system at a glance. Retrieved November 27, 2020, from financialpost.com/pmn/Canada-news-pmn/quebecs-daycare-system-at-a-glance Tunney, C., & Hall, C. (2020, September 25). Liberals, NDP reach deal on sick leave, avoiding immediate election, CBC News. Retrieved November 29, 2020, from cbc.ca/news/politics/ndpliberals-deal-sick-leave-15739658. U.S. News & World Report. (2021). Best countries overall rankings. https://www.usnews.com/ news/best-countries/overall-rankings

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UNDESA United Nations Department of Economic & Social Affairs. (2015). Concepts of inequality, development issues #1. https://www.un.org/development/desa/dpad/publication/no-1concepts-of-inequality/ UNDP United Nations Development Program. (2019). Human development ranking. http://hdr. undp.org/sites/default/files/hdr2019.pdf Wright, T. (2019, September 16). Trudeau pledges $535 million yearly for childcare spaces outside school hours. The Canadian Press. Retrieved November 27, 2020, from globalnews.ca/news/ 5907861. Yahnizyan, A. (2020, October 25). Opinion: The she-cession is real and a problem for everyone, Financial Post. Retrieved November 27, 2020, from financialpost.com/opinion/the-she-cessionis-real Stanley J. Shapiro , a former marketing professor first at the Wharton School, then at McGill University and Simon Fraser University, also served as Dean of Business at McGill (1973-1978) and SFU (1987-1997). He has authored sixty academic papers, edited 13 books or monographs, served on a dozen editorial review boards—including the Journal of Marketing for over thirty years—and, over 25 years, Canadianized nine successive editions of McCarthy & Perreault’s Basic Marketing, A former Editor of the Journal of Macromarketing and a Distinguished Fellow of the Academy of Marketing Science, he more recently was an Associate Editor both of the Journal of Historical Research in Marketing and of Social Business: an Interdisciplinary Journal. His emeritus research focus has been on marketing history, marketing thought, and teaching approaches relevant to macromarketing. Julie Stanton , a marketing professor at the Pennsylvania State University, researches small farmer challenges in developing countries; organic and alternative food labels in the United States; and business pedagogy. She teaches Marketing Research, Sustainable Marketing, Intro to the US Food System, and International Business, among other courses. Dr. Stanton received the 2020 award for best reviewer from the Journal of Macromarketing and has been a reviewer for more than two dozen journals and numerous international conferences. Her research has been published in the Journal of Macromarketing, Journal of Consumer Marketing, Journal of Consumer Behaviour, Journal of Consumer Affairs, Journal of Promotion Management, Journal of Agribusiness, and Supply Chain Management, among others. Her co-authored book Role Play Simulations was published in 2020.

Chapter 6

Catalytic Institutions and Community Resilience: COVID-19, Obstacles, and Adaptive Mechanisms in Wuhan, China Jie G. Fowler, James Gentry, and Rongwei Chu

Abstract Communities can be placed on a distressed to flourishing continuum. Behavior patterns, traditions, culture, and political/economic systems may enable a community to thrive. This chapter describes the factors that may have contributed to community resilience in the case of Wuhan, China. The chapter highlights the importance of catalytic institutions and their role in mitigating the adverse public health and economic outcomes of the COVID-19 pandemic. Keywords COVID-19 · Institutions · Resilience · Social capital · Economic capitals

6.1

Introduction

The first confirmed case of COVID-19 was reported in Wuhan, China, in December 2019. In response to COVID-19, the Chinese government announced a lockdown on January 23, 2020. All transportation was banned, and residents were not allowed to leave their residential compound without authorization. The lockdown lasted 76 days and severely impacted families, communities, and the global economy (Xiang et al., 2020). Yet, Wuhan has bounced back from a distressed community to a flourishing one within a year. As Norris et al. (2008) have asserted, “communities have the potential to function effectively and adapt successfully in the aftermath of disasters” (p. 127). According to Shultz et al. (2017), community well-being can be categorized as distressed or flourishing. It can also be viewed as a continuum, anchored on one end J. G. Fowler (*) Valdosta State University, Valdosta, GA, USA e-mail: [email protected] J. Gentry University of Nebraska-Lincoln, Lincoln, NE, USA e-mail: [email protected] R. Chu Fudan University, Shanghai, China e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_6

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as “distressed” and the other as “flourishing.” The basic premise is there is movement and no stasis. It is crucial to understand the temporal, transitory, and spatial nature of distressed and flourishing communities. To be considered flourishing, a community must demonstrate the capacity for growth and resiliency (Norris et al., 2008). Community resilience refers to a process linking a network of adaptive capacities (Norris et al., 2008). The capacities can be seen as resources. For example, Bruneau et al. (2003) identified attributes that resources must have to engender resilience. “Robustness” is the ability to withstand stress without suffering degradation. “Redundancy” is the extent to which elements are substitutable in the event of disruption. The third attribute is rapidity which refers to the capacity to achieve its goals in a timely matter. The final attribute is the capacity to identify problems and mobilize resources. By utilizing the community well-being framework (Shultz et al., 2017), this chapter investigates how a community slides on a distressed/flourishing continuum. It identifies possible adaptive capacities that had allowed Wuhan, as a community, to cope with the distress. We also use institutional theory to interpret the case findings. Institutions are defined as “humanly devised constraints that structure human interaction, and can be seen regulative, normative, and cognitive structures and activities that provide stability and meaning to social behavior” (North, 1990; Scott, 2013). In doing so, we relied on secondary data to examine the relevant issues. The findings demonstrate how formal and informal institutions act as resources to cope with stress. Family, community structure, and government are three primary institutions that play a key role in community resilience. Additionally, social, cultural, and economic capital were found to be both facilitators and/or obstacles in community resilience. We also found evidence of collaboration among government, nongovernmental organizations (NGOs), and citizens (consumers) in the market system, which played another key role in community resilience. The chapter begins with a brief narrative of the outbreak in Wuhan. Then, we review two major consequences of the pandemic: the rise of nationalism and the impact on the economy. Data collected are reported from secondary sources. Finally, we propose implications for both marketers and policymakers.

6.2

Inside Wuhan During the Pandemic

Wuhan is the capital of Hubei province. It is considered a major industrial and economic hub of central China. On December 31, 2019, the Wuhan Municipal Health Communication reported 27 patients with viral pneumonia, and 7 patients were critically ill. Most of these cases were epidemiologically linked to the Huanan Seafood Wholesale Market. As a result, the Huanan Seafood Wholesale Market was shut down. A preliminary investigation conducted by the Chinese authorities reported no clear evidence of human-to-human transmission of the novel coronavirus (WHO, 2020).

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The source of the coronavirus had yet to be identified. The most commonly expressed supposition was that it was transmitted from an animal (possibly a bat or rat) to a human. An alternative supposition was that it was developed in one of the many labs in Wuhan and somehow broke out of the lab (Economist, 2021). Former US President Trump implied the latter supposition once he started paying attention to the virus, and current President Biden has started an investigation of its origin. Yet, China has not responded to the allegation; instead, it insisted it has been transparent with the World Health Organization (WHO) (BBC, 2021). The WHO has concluded it was unlikely that the virus leaked out from the lab in Wuhan and dismissed the allegation (BBC, 2021). In late January, infectious disease expert Dr. Zhong NanShan visited Wuhan. Four days later, on January 24, 2020, the city of Wuhan was locked down. The announcement was made the day before the Chinese New Year to demobilize the population. All transportation, including private transportation, was barred. Schools and shops were closed. Residents were not allowed to leave the city. Buildings had security guards monitoring temperature of anyone entering. Residential compounds were closed to all but their inhabitants. The lockdown of Wuhan lasted 76 days. The hashtag “Wuhan is sealed off” was trending on Chinese social media, Weibo. The New York Times reported that the scale of China’s Wuhan lockdown is believed to be without precedent in modern history (Levenson, 2020). As residents were not allowed to leave their homes (and supermarkets were no longer open to individuals), government officials, property management companies, and volunteers delivered food and supplies to households. Shequ,1 which refers to a “socialized governance,” served as a means through which the state responded to citizens’ needs (Qian & Hanser, 2020). Shequ was effective at recruiting and mobilizing community volunteers (Woodman, 2016). During the lockdown, the digital communication platform WeChat became central to Wuhan residents’ experience of daily life (Qian & Hanser, 2020). This social media platform enabled users to chat with family or friends, order food delivery, book a doctor’s appointment, pay bills, and read the news (Chan, 2015). WeChat became integrated into daily life. China lifted the lockdown of Wuhan on April 8, 2020. Residents with a government-issued green Q. R. code on their mobile devices were allowed to go back to work (Gan, 2020). By June of 2020, Wuhan had screened the entire city for COVID-19 and completed 9.89 million nucleic acid tests. The entire city of Wuhan became COVID-free. Four domestic brands of vaccinations became available for the residents (BBC, 2020).

1

Shequ is a form of urban governance in China. It is located hierarchically below district and/or street governments. It is not considered a formal part of government but rather as a self-governing community organization.

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Political Sphere

In December 2019, eight physicians used Chinese social media to warn peer doctors and friends that seven people had contracted a virus similar to SARs. In the following days, the Wuhan municipal government announced that the eight individuals were spreading rumors (untruths). During that period, the Wuhan municipal government was responsible for disease control (Liu & Saltman, 2020). While the local government routinely made attempts to mute anti-government communication, there was still a large amount of information about this outbreak that persisted on social media—this may have been due to the slow reaction of Chinese censors (BBC, 2020). Messages on media blamed Wuhan’s leadership. For example, Beijing News wrote critical commentaries, asking “Why did not Wuhan let the public know sooner?” (BBC, 2020). The central government began warning Wuhan officials they would “forever be nailed to the pillar of historical shame” (BBC, 2020). Consequently, the central government fired several high-ranking officials in Wuhan. There are 337 officials who were “penalized.” Officials from the Red Cross Society in the Hubei province were removed (XinHuaNet, 2020). The communist party chief of the Health Commission was dismissed. The deputy director of China’s National Health Commission was replaced. Li Wenliang, a 34-year-old ophthalmologist from Wuhan, had posted a message on WeChat group alerting fellow doctors to a new disease in December 2019. Li later contracted COVID-19 and died in February 2020. China’s anti-corruption agency was sent to Hubei to investigate Li’s death. Meanwhile, during and after the pandemic break, especially since Wuhan reopening, the Chinese government implemented a series of policies to stimulate the economy. The Chinese Central Bank announced a reduction in the bank’s mandatory reserve ratio, freeing up 550 billion yuan (86 billion US dollars) to support the economy (KPMG, 2020). The central government also announced a package to support the digitalization of small- and medium-sized enterprises (SMEs) (KPMG, 2020). In addition, the stimulus package included deferred tax payments, reduction of rent, research and development (R & D) subsidies, lowered lending rates, etc. The Finance ministry also reduced social insurance payments by one trillion yuan (157 billion US dollars) to incentivize firms to retain employees. Firms that were in financial jeopardy (as a function of the pandemic but managed not to lay off employees) were provided with refunds of unemployment insurance premiums.

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Adverse Effect: Economic Loss and the Rise of Nationalism

Wuhan serves as home to more than 300 factories of the world’s top 500 companies, including Microsoft, German software company SAP, and French carmaker PSA (Ayittey et al., 2020). During the lockdown, numerous firms evacuated their ex-pat workers from the city and temporarily halted business activities. According to You et al. (2020), the estimated monthly economic losses in Wuhan during the lockdown reached 177 billion yuan (19 billion US dollars). Wuhan is also a hub for the production of automobiles and automotive parts. In 2018, the Hubei province produced 2.24 million vehicles, accounting for 10% of China’s total auto output (Malden & Stephens, 2020). Chinese factories heavily depend on the flow of rural migrants for labor. The substantial worker flow disruption has led to a significant labor shortage, with workers stranded inside their homes for weeks. During the lockdown, the production loss reached about 350,000 units. Automakers outside China were concerned about the shortage of auto parts. For example, Hyundai reported the shutdown of its domestic factories after running out of auto parts from China. Besides the automobile industry, the outbreak had an adverse impact on tourism and retail. The Wuhan quarantine order was placed a day before the Lunar New Year’s Eve. In the previous year, approximately three billion trips were made as people journeyed back to their hometowns from the urban metropolises where they worked (Wernau, 2020). This is commonly described as the largest annual migration in the world. Furthermore, Chinese tourists spent about 254.6 billion U.S. dollars while traveling abroad in 2019 (Statista, 2022).But these figures were reduced drastically in 2020. For instance, Vietnam’s tourist industry was expected to lose up to 7.7 billion US dollars due to a lack of Chinese tourists. Furthermore, US restaurant chains, including McDonald’s and KFC, announced partial closure and reduced operating hours in China. Starbucks closed more than half of its 4292 cafes (Malden & Stephens, 2020). Nearly all movie theaters were closed. Total mobile phone sales dropped from 14 million devices to 6.34 million. While most industries in China experienced major disruptions due to the pandemic, communication providers and technology sectors saw an uptick in usage. For instance, between January 22 and February 20, 2020, application downloads increased over 1000 times (Malden & Stephens, 2020). Consumers switched their online shopping from nonessential goods to essential goods. Online sales of food, for example, increased 26.4% in January and February 2020, while purchases of clothing fell 18.1% in the same period. The outbreak also had a profound social impact globally. It has long been hypothesized that nationalism thrives in times of crisis. Disease, like other disasters, can trigger cooperation (Kelman, 2011), as well as it can cause a rise in tension and conflict. According to Su and Shen (2021), fear of death during health crises tend to trigger a rise in nationalism. In other words, the growth of nationalism is typically a response mechanism that serves to alleviate anxiety.

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China was also exposed to friction due to the increase in nationalism in the USA. One iconic image of the global pandemic was a close-up of the daily press briefing of former US president, Donald Trump, captured by The Washington Post. It showed the statement to be read by the president with the word “corona” crossed out and replaced with Chinese (Gan & Culver, 2020). The Trump administration adopted the term “Chinese virus” to associate the pandemic to China, thus deflecting responsibility for the spread of the virus in the USA. Racism and discrimination against Chinese and other Asian Americans increased with the spread of COVID-19 (Bieber, 2020). According to an online reporting platform, there were 1135 COVID-19-related discrimination cases reported between March 19 and April 1, 2020 (Bieber, 2020). While anti-Asian or anti-Chinese bias has been pronounced in the USA, it has also been noted globally.

6.5

Resilience as Metaphor and Adaptive Mechanism

Resilience is fundamentally a metaphor. With roots in physics and mathematics, the term was originally used to describe the capacity of a material or system to return to equilibrium after a displacement (Norris et al., 2008). A resilient material, for instance, bends and bounces back, rather than break, when stressed. Research on resilience emphasizes a capacity for adaptation in the face of disturbance, stress, and adversity (Norris et al., 2008). The concept of resilience has been used to describe individuals, human communities, and larger societies. Community resilience is a process linking a set of adaptive capacities to a positive trajectory of functioning and adaptation after disturbance. The concept of “community resilience” raises the same concerns as the concept of resilience per se, but it is further complicated by variation in the meaning of “community” (Norris et al., 2008). Communities are composed of a built, natural, social, and economic environment that influences one another in complex ways. Past literature on community resilience has described the dynamics from grassroots groups and neighborhoods to complex amalgams of formal institutions. The discussion of community resilience often notes that the “whole is more than the sum of its parts” (Pfefferbaum et al., 2005). This section describes how communities usually cope with distress during a disaster such as a pandemic. We borrowed the community well-being framework (Shultz et al., 2017) to examine the adaptive capacities allowing the community to thrive. We collected data from secondary sources and interpreted the results using institutional theory. According to Scott (2001), institutions are social structures characterized by resilience. They involve cultural-cognitive, normative, and regulative elements that, together with associated activities and resources, provide stability and meaning to social life. Secondary data were drawn from popular sources such as published diaries and documentaries that originated in Wuhan during lockdown. Wuhan Diary: Dispatches from a Quarantined City was the primary data source for our case study.

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The log was initially released in daily installments that were uploaded to Chinese social media like Weibo and WeChat. The log offered real-time responses to and reflections on events that had transpired just hours earlier and provided a platform to understand what was happening on the ground in Wuhan. The daily entry had 3.8 million online followers when it was first published in China. We also drew additional data from Persistence and Antivirus Journey, which were books written by Wuhan residents. Additionally, the documentary “76 Days” provided us with a visual appreciation of the context. This documentary captured the struggles of patients and frontline medical professionals battling the COVID-19 pandemic at the beginning of the outbreak. The focus of our analysis was community resilience and transitory capacities as applied to natural disasters. The findings indicate that transition from a distressed to a flourishing community requires adaptive mechanisms provided by catalytic institutions. The capacities can be formal (e.g., government policies) and informal (e.g., grid governance, family ties, culture). As such, the findings were organized by institutionalized resources that served the community to adapt and evolve.

6.5.1

“Grid” Governance as an Institution

The achievement of COVID-19 control in Wuhan can be attributed to a “grid” management system (Zheng, 2020). In each community, grid coordinators recruit resident volunteers as representatives for their apartment buildings and incorporate them into management, leadership, and community decision-making (Tang, 2020). The grid governance scheme reflects the State’s desire for better penetration into the new private managed housing estates. The “grid governance” system was incorporated into the “so-called” shequ in urban China. Shequ is urban governance commonly regarded as “below district and street-level government” (Tang, 2020). It is usually not considered a formal part of the government but rather as a self-governing community organization. The roots of shequ can be found in Mao-era residents’ committees, which were primarily responsible for overseeing residents who did not belong to State work units (Ngeow, 2017). Due to the economic reform in China, the form of urban governance was redesigned. As a result, shequ serves to provide services ranging from registering residents for social welfare to community policing to organizing political education campaigns. Shequ in “grid governance” is particularly relevant to our case study as it is an essential means through which the state can respond to citizen needs. For instance, During the early stage of quarantine, the challenge of taking care of the daily need of nine million people was taken care of by neighborhood groups that self-organized and used online services to make group purchases in order to provide daily necessities. Later the government mobilized all its civil servants to each and every community to help serve the needs of local residents . . . .. they are deserving of whatever recognition we can muster to acknowledge their collective sacrifice. Spending a full 76 days in quarantine was not an easy

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thing for people to do. But the amount of energy the government later put into the quarantine and various other measures was indeed extremely effective. (Wuhan Diary)

Many volunteers went above and beyond delivering essential goods. As one person wrote in the Wuhan Diary, It has been 21 days now since the city went on lockdown. It’s almost as if I’m living in a daze . . . .. My brother said that there is a delivery boy in his neighborhood who runs around every day to deliver food to everyone. Every family writes up its own shopping list and hands it off to him, and he takes care of the rest. . .There are always a lot of kindhearted people who do incredible things during difficult times. To be fair, those community workers who volunteer to go out to these smaller communities really have a tough job; they basically end up doing all kinds of odd jobs; they have to do a little bit of everything. This is especially the case in the traditional old neighborhoods where the buildings have no elevators; they ended up lugging groceries up many flights of stairs, teaching elderly residents how to use cell phones, and in some cases helping residents who don’t have cell phones make phone calls. There are tens of thousands of young volunteers working on the front lines to battle this outbreak. They are all doing this completely of their own volition. They use social media platforms like WeChat chat groups to organize, and they do virtually everything under the sun. They are truly amazing! People of my generation used to always worry about this younger generation’s becoming increasingly self-centered, but now that I see them springing into action, I realize that old farts like me were worried about nothing! People of each generation are actually all the same in some way, and the older generation shouldn’t worry too much about the younger generation’s not finding their way. The videos of those volunteers are so moving. I’m told that besides the volunteers coming to Hubei, they are also bringing all kinds of medical supplies and protective gear with them. They are even bringing their own supplies of salt, cooking oil, soy sauce, vinegar, and other basic supplies like that so as not to add to the burden of these already-stressed cities. Their selflessness has really brought so many people here in Hubei to tears. More than 20,000 medical workers have volunteered to come to Hubei. You can only imagine the dedication and solidarity behind their sacrifice.

As residents were not allowed to leave their residential compound, group purchasing was the dominant way to obtain goods. Through the WeChat (online) system, residents were able to place orders within the neighborhood group. For instance, in each apartment building, one person had set up the WeChat group (typically organized by shequ volunteers), which in turn was then transmitted to the suppliers. Volunteers were also responsible for delivering the goods. Many volunteers were reported to belong to Generation Y (or the millennial generation). The news media has named the Chinese Generation Y as the “Little Emperors” (Erickson, 2009). China’s one-child policy, introduced in 1979, means that most members of this generation are, in many instances, only children, reared as the sole focus of two parents and four doting grandparents. They are reported to have high self-esteem and a level of confidence that positions them for leadership roles in China and globally. As many in the Y generation around the world, these young Chinese have advanced solid technological skills. These skills have allowed this generation better assist the residents.

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The citizens (consumers) also acted as part of supply chain, consistent with the concepts of “co-creation” or “customer citizenship” that have proliferated the marketing literature during the last two decades. In addition, the findings reveal collaboration among government, NGOs, and citizens (consumers). The government-issued proclamation assuring citizens that “supermarkets would stay open” reflects the key role of how a political entity in market dynamics. Consider the following pronouncement from the Wuhan Diary: This afternoon I heard about another person going into panic mode while at the supermarket picking up a few things; this man said he was afraid that the store would shut down and there would be no new supplies of food coming in. I felt like that was an unrealistic fear. The municipal government already issued a proclamation assuring citizens that supermarkets would stay open. Just to think through this logically: Right now, the entire country is standing behind Wuhan, and China isn’t the kind of nation facing any true shortages of material goods, so I’m sure it won’t be too difficult for the country to ensure that the people of Wuhan have enough food and supplies.

6.5.2

Collectivism as an Institution

Family is regarded as an institution (Laslett, 1973). Traditional Chinese cultural values related to Confucian, Buddhist, and Taoist thoughts constitute the fundamental influence of Chinese families (Shek, 2006). Traditionally, children are expected to take care of their aging parents. The cultural norm has been that family members of different generations live together. Sons are expected to bring honor to the family. Children are expected to be obedient. Yet, Shek (2006) reports that Chinese parents had over time lowered their expectation that children should take care of their aging parents and socialization practices have changed to become more child centered (Shek, 2000). These changes in cultural norms seem to be reflected in our study findings. For instance, consider this entry in the Wuhan Diary: Back on the first day of the Lunar New Year, when I first heard that the downtown district was shutting down the traffic, I immediately went over and brought her (daughter) enough supplies to get her through at least 10 days. I suspect she was just too lazy to cook and that is why she wanted to go out. A good thing my daughter has a good fear of death ingrained in her! The second she heard what I had to say, she agreed to stay at home. She called me back a bit later to ask how to cook cabbage (can you believe that she actually put a head of cabbage in the freezer?). I don’t think my daughter has ever cooked a proper meal in her apartment. Usually she finds a way to get herself invited to other people’s houses for dinner, or just orders takeout. Perhaps this was a good way to get her to finally start using her kitchen. But I’m not sure if my daughter’s finally forcing herself to learn how to cook should be considered the silver lining in this situation. I have been rushing around the kitchen all morning cooking for my daughter; I plan to take some food over to her tonight . . . .. I delivered some food to her just before the Lunar New Year and again on the first day of the New Year. That lasted her a few days, but now she is running out and was talking about ordering some takeout.

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As indicated in the narrative, that the mother cooked for a grown-up daughter seems to be the new “norm,” and the traditional view of the hierarchical order of the family is diminishing. Consistent with the literature, parents have changed their expectations for grown-up children. In addition, we found that social capital has played a key role in helping residents cope in distressed situations in extended families. For instance, another entry in the Wuhan Diary described the following: When my niece received the notification yesterday, it read: “The flight to Singapore will depart at 3:00 a.m.; please arrive early to the airport.” But my brother (in his 70s) doesn’t drive, and with public transportation shut down, they had absolutely no way to get to the airport . . . .. I checked with the Hongshan District Traffic Office to see if I would be allowed to drive there. There are quite a few officers who work at the station there that are actually my readers. They insisted that I just stay home and focus on my writing; they told me that they would take care of the rest.

Social capital is the sum of the actual and potential resources that can be used through membership in social networks (Anheier et al., 1995). As indicated above, family ties and social membership collectively helped to cope with the individual’s difficulties in such an adverse event. The author further addressed sharing “scarcity” resources, such as masks, among family members, neighbors, and colleagues. I found some N95 masks for sale at one store; they were gray Yimeng Mountain brand masks, each individually packaged. 10 yuan each. I bought four. Only then could I finally have a small sigh of relief. Since I had heard that my big brother didn’t have any masks for his family, I also decided to save two for him. Yesterday my old schoolmate Xia Chunping, who is now deputy chief editor of the China News Agency, did an interview with me over WeChat, and today he came over with a photographer to take a few photos for the story. The big surprise was that he brought me 20 N95 masks! It was like receiving a bag of coal on a cold winter’s day; I was ecstatic. Xiao Yuan had edited some of my early books . . . ., he read my post about the scarcity of face masks and delivered three packages of masks right to my doorstep! I was so moved. It is good to have old friends you can count on. All of a sudden, I have found myself with an overabundance of face masks. I’ve made sure to share them with my colleague who only yesterday was complaining about the scarcity of masks. Just now she came to pick them up and brought along some fresh vegetables for me. It really does feel like we are a little community working together to get through these difficult times.

Culture is institutionalized (Bourdieu, 1986). According to Hofstede (1980), culture is the aggregate of common characteristics that influence a group’s response to its environment. Chinese culture is identified as collective. In the case of Wuhan, collectivism served as an institution that helped provide Wuhan residents with tangible and intangible resources. Hofstede (1980) divided culture into multiple dimensions, such as power, gender, and uncertainty. Due to uncertainty at the early stage of the outbreak, few individuals were outspoken. Chinese philosopher Lao Tzu once claimed that “Silence is a source of great strength.” “Silence is golden” is a Chinese cultural value. That is, it is considered polite to pause for a few seconds before answering a question to show that you have reflected upon the question, and your response thus demonstrates

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sufficient gravitas (Shearer, 2020). However, this may not be the case in distressed situations because silence may hinder information flow. As one entry in Wuhan diary expressed, I realized that this was precisely why we were all so angry about the death of Li Wenliang. After all, he was the first to speak out, even if all he did was warn his own friends, but by doing that he revealed the truth. . .People like to say “silence is golden” as a way of showing how deep and profound you are. But what was the cost of silence in this case? Will we again be in a place where we need someone to speak out, but all we hear is silence?

6.5.3

The Interface of Policies and Economic Capital as an Institution

In response to COVID-19, the central government has launched various policies. The policies range from lockdown measures to financial support. For instance, the opening scene of the documentary “76 Days” portrayed the chaos in a hospital that could not admit most of the patients due to lack of medical resources and the ban of. public transportation After the quarantine was imposed, all public transit in the city shut down, and since most residents in Wuhan don’t have their own automobiles, they had to walk from one hospital to another in search of a place that might admit them. It is hard to describe how difficult that must have been for those poor patients. That is also about the time that short videos of patients appealing for help began to appear online; there were also videos of people lining up all night long outside hospitals, hoping to get admitted, and clips of doctors on the brink of exhaustion. We all felt completely helpless in the face of these patients crying out, desperate for help. Those were also the most difficult days for me to get through. All I could do was write, and so I just kept writing and writing; it became my only form of psychological release.

As shown above, individuals without sufficient economic means had difficulty in obtaining resources to cope with the pandemic. Many infected residents, who did not have economic means (e.g., private vehicles) were not able to commute to a hospital to receive treatment and those were who were separated suffered the most. That being said, economic capital also played a key role in the mitigation of the adverse effects of the pandemic. In theory, economic capital refers to household income as well as other financial means (Bourdieu, 1986). Although the vast majority of consumer goods and services tend to be available using one’s economic capital, many consumer items became unavailable during the pandemic. The dual (central versus local) political system further complicated the health and economic impact of the lockdown. The following narrative shows the faith in central government but distrust of local officials. As Wuhan Diary stated, This is because everybody knows that once something in China is taken up at the national level, everyone will step up and do what needs to be done. From that day and forward, the frantic and confused people of Wuhan could dispel all their fears.

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Yesterday’s press conference in Hubei about the coronavirus has become a trending topic on the internet. There are a lot of people roasting those officials online. The three representatives from the government all looked utterly exhausted and depressed, and they kept making mistakes during their presentations; but this shows just how chaotic things are for them. Actually, I kind of feel bad for them. I’m sure they have family members here in Wuhan, and when they attempted to take the blame for what was happening I really felt like they were speaking from the heart.

As stated above, the government as a regulative institution typically plays an important role in helping residents cope with adverse events. During the lockdown, the central government mobilized both financial and human resources to support Wuhan. In addition, the Chinese government had invested in digital tracking systems. One example was the creation of mobile application that categorizes individuals into three groups based on their health status and travel history. Another device that helped in disease surveillance and controlling was the street camera system that served to identify and fine individuals walking publicly without a mask and those showing COVID-19 symptoms.

6.6

Application of the Community Well-Being Framework

Shultz et al. (2017) proposed a framework of community well-being. Communities are broadly placed on a distressed to flourishing continuum. A flourishing community requires an abundance of resources such as water and food. Behavior patterns, traditions, society/culture, and political/economic systems also enable a community to thrive. This framework allowed us to identify the factors that facilitated and/or hindered resilience in Wuhan. That being said, community resilience is an adaptive mechanism that fluctuates on a continuum of availability and abundance of institutional resources (see Fig. 6.1). According to the study findings, institutions (e.g., shequ, collectivism, political system) have contributed to the thriving of the Wuhan community (see Fig. 6.1). Shequ, an unofficial governmental management system, in particular, ensured that community residents were not deprived of daily necessities. For instance, online group purchases of groceries were organized within the neighborhood and delivered by local volunteers. The collaboration between the “grid” system/shequ, the digital platform (WeChat), and marketing entities (e.g., supermarkets) contributed to community resilience. The market system thus became political. As Shultz et al. (2017) state, most governments help business deliver consumer goods and services to help the community prosper. Family, as the fundamental institutional unit, plays an essential role in coping with the adverse events. Economic and social capital of families helped with resource access (e.g., using individuals’ social networks to find transportation to the airport when transportation was banned). Our study findings also point that traditional Chinese values may have changed due to the one-child policy (Fowler et al., 2010). For instance, parents cooking for adult children became the “new

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Flourishing

Fig. 6.1 Adaptive mechanism and community resilience

norm.” The case also revealed a certain degree of “selflessness” among the one-child generation. COVID-19 was (and still is) an adverse event that has impacted Wuhan and the rest of the world. At a global level, it caused the rise of nationalism and economic loss (see Fig. 6.1). At the local level, grid management, collectivism, and the centralized political system have contributed to community resilience. Collectivism served to mobilize social capital to obtain scarce resources in hard times. This finding is consistent with the research on the collective identity and disaster recovery (e.g., Baker & Hill, 2013). Community residents felt a sense of community cohesion (Baker & Hill, 2013). We also found that culture served as a facilitator as well as an obstacle in community response to the pandemic. Although collectivism served as an adaptive mechanism, we found that “silence is golden” hindered information flow. Although the regulative system facilitates means for disease control, it may discriminate against economically deprived households. As previously mentioned, some residents suffered most by failing to obtain transportation to the hospitals when

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public transportation was banned. Lack of economic capital prevented many economically vulnerable residents obtain essential consumer goods and services.

6.7

Policy Implications and Lessons Learned

Governmental policy is key to deal with adverse events within a community and the nation at large. The shequ microsystem served as the key to mitigate the health and economic adverse impact of COVID-19 in Wuhan. The shequ served to control population flow and recruit volunteers to organize consumer purchases of goods and services. Although shequ is considered a nongovernmental organization, Wuhan proved that it may be possible to incentivize community organizations to provide public service. Wuhan residents were recognized for their volunteer work by non-monetary means (e.g., using social media [WeChat] in the community to recognize individual achievements). Further, a digital platform seemed essential for residents to obtain consumer goods and services. The WeChat, a privately owned mobile application, served residents to socialize with friends, book doctor’s appointments, order groceries, track delivery, make digital payments, and even make group purchases. Such a digital platform played an important role in community recovery. In essence, digitalization embedded in everyday consumption was a big plus. Policymakers should incorporate such digital platforms for public services such as monitoring social welfare (e.g., the pension system, taxes, healthcare records). The platform should also allow community residents to communicate with public service officials. That being said, additional R & D seems necessary to support and incentivize community organizations to adopt digital technologies to contribute to community resilience. These organizations should be encouraged to apply for government grants for digital development and adoption. Trust allowed citizens to work with the government to prevent the further spread of the virus. In the case of the Wuhan lockdown, tension between local and central government emerged. Wuhan and Hubei officials were much focused on economic development and social stability, which may have led them to underestimate the potential hazard of the epidemic (Liu & Saltman, 2020). That said, for future reference, policymakers should consider bridging the communication between professionals in the field (e.g., healthcare professionals), local officials, and central government. This move requires greater transparency (i.e., by “breaking the silence”). Incentives should be in place to encourage experts to express their knowledge and opinions about matters of great importance such as pandemics. The impact of the Wuhan outbreak has had a profound impact globally. Travel restrictions had an adverse impact on international trade. Public policymakers should find alternative ways to deal with the problems associated with international logistics. For instance, there may be policies that can be implemented to enhance global B-to-B online transactions (e.g., Alibaba). Additional governmental funds could be used to innovate digital platforms that may allow spontaneous and accurate

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translation for trade purposes. Translation services should be available for buyers and sellers globally. Such policies may serve to incentivize firms to network globally. Other recommendations may include hosting trade shows and exhibitions virtually, providing global firms with tax credits.

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Zheng, W. (2020, March 17). Grass-roots officials take lead role on the front line of Wuhan’s gridby-grid battle against coronavirus. South China Morning Post. https://www.scmp.com/news/ china/society/article/3075453/grass-roots-officials-take-lead-role-front-line-wuhans-grid-grid

Jie G. Fowler is an associate professor of Marketing at Valdosta State University. She graduated from the University of Nebraska-Lincoln with a Ph.D. in Marketing. Before that, she earned her master’s with a concentration in Finance from the University of Nebraska-Lincoln and her bachelor’s in Accounting and Finance. Her research has been published in variety of journals, including Journal of Macromarketing, Journal of Advertising Research, Journal of Business Strategies, Global Business Review, Qualitative Marketing Research, International Journal of Consumer Studies, Journal and Current Issues and Research in Advertising, among others. James Gentry is an Emeritus Professor of Marketing, the University of Nebraska, where he taught for 32 years. Prior to Nebraska, he served on the faculties of Kansas State University, Oklahoma State University, and the University of Wisconsin-Madison (as a visitor). He published widely in the area of Consumer Behavior. Rongwei Chu is an associate professor of marketing at the School of Management at Fudan University, China. He is the secretary-general of the China Marketing Research Center at Fudan University. His research interests include the Chinese marketplace, consumer culture, emerging markets, and consumer well-being. His research appears in the international journals such as Marketing Letters, Journal of Public Policy & Marketing, Journal of Consumer Affairs, Journal of Macromarketing, Journal of Service Marketing, Social Indicators Research, etc. He is the visiting scholar at MIT Sloan School of Management and Long scholar at the University of California, Irvine.

Chapter 7

Colombia: Resilience and Well-Being in Response to COVID-19 Andrés Barrios, Marcos Ferreira Santos, and Héctor Erlendi Godoy Hernández

Abstract Colombia—a medium-size country in northern South America with a population of over 50 million people and a GDP of USD 324 billion—was hit by the COVID-19 pandemic in March 2020. The government rapidly declared a State of National Emergency, closing the country’s borders and imposing a 5-month and strict lockdown limiting people from leaving their houses while preparing the health and economic system for the upcoming difficulties. Despite these actions, the country has been profoundly and negatively affected by SARS-CoV-2, but some initiatives are worth highlighting as good practices intended to protect the population’s well-being. In this chapter, the authors apply the quality-of-life (QOL) framework of Shultz et al. (The handbook of community well-being, 2017) to analyze how Colombia has been affected by the COVID-19 pandemic. Within this framework, Colombia is considered a country and community that has adapted, over time, as a result of the interaction of endogenous and exogenous forces. The pandemic is viewed as a disastrous exogenous force that shifted Colombia from its balanced path to an unbalanced one. Special emphasis is placed on understanding the factors that made the country both vulnerable to and resilient against the virus, as well as the country’s institutional responses—e.g., government, private sector, and citizens—to mitigate it. Keywords Colombia · COVID-19 · Health care · Emergency response · Subsistence market dynamics · Resilience · Well-being

A. Barrios (*) · H. E. G. Hernández Universidad de Los Andes, Management School, Bogotá, Colombia e-mail: [email protected]; [email protected] M. F. Santos Universidad de La Sabana, EICEA, Chía, Colombia e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_7

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Introduction

Colombia is a medium-size country of 440,831 square miles, located in the northern portion South America, and bordered by Venezuela, Ecuador, Peru, Panama, and the Pacific and Atlantic Oceans. Colombia is the third-most populous country in Latin America, after Brazil and Mexico, with over 50 million inhabitants (75% of whom are located in urban areas). The country’s GDP was USD 323,804 billion in 2019, positioning the country as an upper middle-income economy by the World Bank (World Bank, 2020). Its Gini index (2021) has been around 0.5 for the last 10 years (0.57, 2002, to 0.52, 2019), meaning 10% of the population has 40% of the national income, while the other 90% receives the remaining 60%. This situation puts Colombia among the most unequal countries in Latin America (UNDP, 2021). Over the last 20 years, Colombia has been a protagonist for South American political and economic change. Politically, the country experienced the de-escalation of the longest internal armed conflict in the world, which lasted over 50 years, and directly victimized 8,792,781 people, which equals 22% of the country’s population (Unidad para la Atención y la Reparación Integral a las Víctimas, 2019). Economically, the country was experiencing a steady growth and reduction of poverty. Estimates indicate that by 2002, the proportion of the population living below the monetary poverty line was 49.7%, and by 2018, it had been reduced to 27%. During the same period, the middle-income population increased from 49% to 70% (DANE, 2020a, 2020b). In general, the country was on a flourishing path. The COVID-19 crisis hit Colombia in March 2020, with devastating effects. Fifteen months after the initial contagious disease was identified, more than 4.2 million people were diagnosed with the virus and over 100,000 people have died, resulting in a rate of 2095 per million of inhabitants (Worldometer, 2021). As of December 2020, Colombia had occupied the tenth position globally in the number of cases, and the fifteenth position in the number of deaths per million inhabitants (WHO, 2020). The government policies to slow the infection rate while preparing the health system for the upcoming situation, including a 5-month strict lockdown, deeply affected the country’s economy. The economy shrank by
8.2%, causing a rapid increase in the unemployment rate that reached around 20% (DANE, 2020a, 2020b). Despite these negative indicators, institutions such as the World Health Organization (WHO) have highlighted the measures taken by the Colombian government institutions to provide a quick unifying response to control the spread of the virus (Ministerio de Salud, 2020). At the same time, the International Monetary Fund (IMF) has recognized the dynamism of the Colombian economy and the rapid governmental policy responses to the pandemic that made it possible to forecast a smaller decline in economic activity than that of other Latin American and Caribbean countries, which together are expected to have an average GDP reduction of
9.4% in 2020 (IMF, 2020a, 2020b, 2020c). Like any other community, Colombia adapts and transforms over time as a result of an interactive process between the endogenous and exogenous forces that shape citizens’ actions. Such forces can affect the country, disrupting its balanced system,

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which is responsive to its participants’ needs, establishing one that is unbalanced and unable to provide for them and vice versa (Shultz et al., 2017). This chapter uses the systemic framework proffered by Shultz et al. (2017) to analyze the COVID-19 pandemic as an exogenous force that affected Colombia’s positive path and the country’s response against it. To do so, we first present the framework and then establish the pandemic as a disastrous exogenous force, identifying the endogenous forces that made the country both vulnerable and resilient to the pandemic’s consequences. Finally, the chapter describes how different Colombian catalytic institutions (government, NGOs, and private sector) developed joint initiatives aiming to resume the country’s positive path. Our findings extend previous understandings of the analysis of the dynamic effects of policy interventions, involving security improvement, market inclusion, and community-infrastructure development, for marketing systems in selected Colombian communities.

7.2

Community Well-Being, a Systemic Framework

A community involves a group of people delimited by similarities to others in the group and differences from others outside the group (Cohen, 1985). Community boundaries are set by geographical location, collective culture, and shared relational characteristics (Molinari et al., 1998). Throughout history, communities have been able to overcome different external and internal problems. For example, anthropological studies confirm that the ability to coordinate activities beyond the family group allowed human beings to survive the Ice Age, some 30,000 years ago (Dunbar, 1996). More recently, in Sri Lanka and New Orleans, community work proved to be a determining factor of inhabitants’ ability to overcome catastrophe (Gilchrist, 2009). These examples, among others, have prompted analyses from different disciplines (including marketing) of communities as a collective resource via which to face adversity. Community well-being is growing in importance as a goal for policy makers and academics and, of course, individual members of communities. Shultz et al. (2017) describe community well-being as a continuum ranging from flourishing to distressed, where the former pertains to communities whose members work together to satisfy their developmental needs and the latter pertains to communities unable to meet those needs (Sirgy, 2011). This approach involves the dynamic nature of community well-being, as any given community is constantly moving along this continuum; thus, a community cannot be assessed only within the context of its current state of “what is”; it must also be measured within the broader normative context of “what is, if...”. That is, community well-being is in constant flux between positive and negative states responding to an interactive process between endogenous and exogenous forces that disrupt the community’s equilibrium (Hounhouigan et al., 2014). Such forces can transform a balanced system responsive to its participants’ needs into an unbalanced one unable to provide for them and vice versa. Endogenous factors include elements embedded in the community’s social matrix.

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For example, the social matrix of developing countries has been characterized as deeply rooted in resource scarcity, insufficient infrastructures, lower levels of education, and weaker regulatory institutions (e.g., Burgess & Steenkamp, 2006; Sheth, 2011). Exogenous factors include shocks outside the community’s social matrix. For example, natural disasters and war have been identified as exogenous factors affecting a societal system (e.g., Barrios et al., 2016; Iacobucci, 2019; Shultz, 2016). The potential effect of such endogenous and exogenous factors on well-being is driven by a set of community characteristics, which render the community as vulnerable or resilient (Shultz et al., 2017). Community vulnerability is associated to, or emerges from, the pre-event group characteristics or qualities that create a potential for harm (Cutter et al., 2008). Vulnerability depends on the community’s exposure to risk and the sensitivity of its members to that risk (Adger, 2006). “The sensitivity and susceptibility to a negative event/shock(s), such that a community’s capacities to contribute positively to a sustainable and desirable state of flourishing are prevented, limited or compromised” (Shultz et al., 2017, p. 409). Community resilience relates to the collective ability to deal with stressors and efficiently resume the rhythms of daily life following a shock (Aldrich, 2012). Such ability in turn relates to a possession of, access to, or development of resources that allow the community to absorb impacts and cope with an event, as well as post-event, adaptive processes (Cutter et al., 2008). Resilience facilitates the timely restoration of community capacities “to contribute positively to a sustainable and desirable state of flourishing” (Shultz et al., 2017, p. 411). Next, we analyze the different characteristics related to Colombia’s vulnerability and resilience to the COVID-19 pandemic.

7.3

Colombian Vulnerability and Resilience Factors

Although communities’ vulnerability and resilience characteristics are dynamic and transform in time, for the purposes of analysis in this chapter we analyzed them at a single point in time, just before the COVID-19 pandemic hit Colombia.

7.3.1

Vulnerability Factors

Two interrelated characteristics that put Colombia in a vulnerable situation in terms of the COVID-19 pandemic were the subsistence marketplace dynamics and the Venezuelan migration crisis.

7.3.1.1

Subsistence Marketplace Dynamics

A high percentage of Colombians lives in subsistence marketplaces, characterized by deeply rooted resource insufficiencies and weak regulation that led individuals to

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develop informal commerce (Viswanathan et al., 2010). These subsistence marketplaces operate within the informal economy through microlevel enterprises (Mair and Marti, 2009). Such conditions make it impossible for people to find work or earn enough money to survive; they therefore may start an informal venture with their scarce resources (Viswanathan et al., 2014). Given the informality of these businesses, whose activities are not monitored (or are weakly monitored), regulated, or registered by the government, they tend to have limited or no access to public support. Sixty percent of the economic activity in Latin America stems from subsistencelevel exchange and comprises one-third of the region’s gross domestic product (OECD, 2020a). The informality rate in Colombia is 47%, which means that 5.7 million of its inhabitants survive in such an environment. This is particularly worrisome in cities such as Cúcuta, which is located on the border with Venezuela, where informality reaches 73% (Observatorio Laboral, 2018). The most common informal economic activities in the country are construction, retail trade, and domestic service, which, coincidentally, present higher risks of contagion, given their particular characteristics. The most visible informal activity is street vending, where subsistence entrepreneurs sell their goods on the street. This type of work is prevalent in an urban economy and includes individuals and entrepreneurs that might undertake piecework in their own premises, street vendors, and most domestic workers. They lack protection for nonpayment of wages and retrenchment without notice and often work under limited occupational safety conditions with no sick pay and health insurance. In addition to the lack of protection, these individuals have low daily income, which limits their saving capacity (an informal worker earns between 10% and 50% of the monthly minimum wage of a formal worker of USD 236). The characteristics of subsistence markets increased community vulnerability to COVID-19 for the following reasons: • Informal employees were considered most expendable during the economic uncertainty brought by the pandemic. Job loss reduced income and thus the purchasing power for goods and services. In subsistence businesses, individuals survive on typically spending daily income and therefore have a low saving capacity. • The government’s lockdowns and social distancing regulations imposed to limit the spread of the virus has had a severe impact on these subsistence businesses, as workers usually have to leave their homes to sell their products and to earn economic resources for everyday survival. The reduced number of people in the streets has obviously reduced their capacity to sell products. • Commercial exchange with these entrepreneurs is transacted in person, in a market system among trusted friends and family; such conditions often are not compatible with health measures implemented during the pandemic. • Due to their informality, these businesses are excluded from mainstream marketinstitutional support (e.g., credit, insurance, worker/customer safety). The government provides support only to incumbent formal actors; as described by Stiglitz et al. (2019), “Anything unmeasured is invisible to policymakers.”

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Venezuelan Migration Crisis

Venezuela, which for decades was regarded to be a socially stable and democratic country, with significant economic assets in the forms of oil and gas reserves, has suffered major disruptions. By most accounts, a downward spiral began in 1998 when the former army lieutenant, Hugo Chavez, won the presidential election. During his presidency, Chavez changed the constitution and the legislature to centralize power in the presidency and to allow indefinite reelection (Romero & Mijares, 2016). The government, which at the time enjoyed a period of economic prosperity due to high oil prices, expanded state control over the economy by seizing more than a thousand Venezuelan international companies and Petróleos de Venezuela (PDVSA), arguably the country’s most important company (Millard et al., 2019). Capitalizing on high oil prices, the government expanded welfare programs that cemented Chavez’s political power and created a loyal base. The government also began to promote a socialist ideological agenda in Latin America by using the oil revenue to gain influence and clout with countries such as Cuba, Ecuador, Bolivia and Argentina. After three presidential reelections and 14 years in power, Hugo Chavez died. His vice president Nicolas Maduro assumed his mandate. Maduro has continued in this role up to the time of this writing. Chavez’s death resulted in social conflict between those who want political change and those who do not. The country’s concomitant institutional uncertainty and economic deterioration exacerbated by declining oil prices in 2014 have led to the departure of myriad companies and the decline or absence of basic products and public services such as water, light, and transportation. The country’s poor living conditions have become so intolerable that many Venezuelans have left the country, looking for a better life elsewhere. Almost 5.5 million Venezuelans have fled since 2014. Of these people, only 2.48 million possess legal migrant permits; the other 3.02 million have migrated and lived “informally” (UNHCR, 2020a). The UNHCR (2020b) describes this situation as a migration crisis, affecting only Venezuela and other South American countries, including Colombia. Indeed, with a 2219-km border and a Border Integration Area with Venezuela that permits free mobility between the two countries, Colombia has the greatest influx of legal and illegal Venezuelan migrants (UNHCR, 2020a): by 2020, 1.5 million Venezuelans had taken refuge in Colombia. The effects of the Venezuelan migration into Colombia started to be felt in 2014. At the time, the lack of social support in Venezuela drove migrants to Colombia, to receive economic, social, or health support. However, these people were largely visitors who returned to their county. Over time, these migrants started to remain on the country borders. Despite the increasing number of Venezuelan migrants to/in Colombia, the country did not allow the establishment of refugee camps, a frequent response to hosting displaced people until the cause of their displacement is resolved. One of the reasons for this policy was that provisions intended for temporary safety often become conduits for lengthy stays of 20 years or more; for some refugees, this represents their whole life (Milner & Loescher, 2011). As a

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result, migrants began to walk across the country looking to settle in different regions, forming informal concentrations in cities where they put up improvised tents in which to live while obtaining resources to pay rent and to survive. Given their increased need and lack of resources, some of these migrants have been subject to labor—and in some cases sexual—exploitation. In view of the text above, Colombia’s large refugee population was highly vulnerable to COVID-19 due to the following: • Venezuela’s lack of sufficient health infrastructure led to an increase in infected refugees trying to enter the country to obtain medical support. • Migrating through informal pathways (“trochas”) made refugees subject to and vectors of contamination to COVID-19. • Refugees continually move across the country trying to reach a city in which to settle. This limits their possibilities of being tested or treated, increasing their risk of serving as vectors of transmission. • This population’s subsistence is based on informality, humanitarian aid, or other people’s good will. The latter is obviously limited given the current conditions of confinement and economic crisis triggered by COVID-19.

7.3.2

Resilience Factors: Universal Health System

Colombia has universal health coverage, provided under the General System of Health and Social Security (SGSSS). This is a mixed system, between public and private institutions, whose management is centralized by the Ministry of Health and Social Protection (Minsalud) (Ministerio de Salud y Protección Social – Minsalud, 2020a, 2020b). The SGSSS is responsible for the development of strategies that guarantee the coverage, accessibility, quality, and regulation of the health system. Colombians can access the systems through either a contributive or subsidized regime. The contributive regime is for people with a formal job and their beneficiaries. Organizations are obliged to affiliate their workers to the health system through Health Promotion Entities (EPS). The contributions made to the health system are proportional (12.5%) to the income of each worker. The worker contributes 4% and the remaining 8.5% is contributed by the contracting organization. The subsidized regime is for people without a formal job and their beneficiaries. People need to be registered in the Selection System of Beneficiaries for Social Programs (SISBEN) to receive free medical care. For self-employed workers and pensioners, if their job income is higher than the minimum monthly legal wage of USD 256, they enter the contributive regime paying 12.5% of their declared income; otherwise, they enter into the subsidized program (Ministerio del Trabajo, 2020). All contributions go to the SGSS that pays the EPS (clinics and hospitals). The economic resources of the contributing regimes are not usually enough to subsidize the EPS, and thus, the government provides the funds required.

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These two regimes guarantee Colombians’ accessibility to a Basic Health Plan (PSB) that covers medical care, treatment, surgery, and medicines according to the needs of the population (PAHO, 2020). This plan is updated every year to review the relevance of the set of services offered to the population as a basic need. The National Health Superintendence (SNS) is the organization in charge of coordinating and executing the policies for SGSSS inspection, surveillance, and control. In case of emergencies, people are treated in the nearest health institutions, regardless of the regime. The universal health system became a source of resilience against COVID-19 for the following three reasons: • Every Colombian will have access to medical treatment through the system. • The system can monitor and manage hospital and ICU occupation. • The system can monitor the number of people who have contracted the virus or died from it.

7.4

COVID-19 as a Disastrous Exogenous Force

The UN defines disaster as “A serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources.” As pointed out by Shultz (2005), disasters can be natural, usually weather related (e.g., tornados, hurricanes, tsunamis), or humanmade, whether intentional (e.g., violence, terrorism) or accidental (e.g., nuclear). But their effects are experienced collectively by a community in relation to the surprise factor, the disaster’s severity, and duration (McFarlane & Norris, 2006). For example, natural disasters such as floods or earthquakes are usually unexpected, severe events with a short duration. Human-made disasters such as the Chernobyl plant explosion are usually unexpected, severe events with long periods in which threat is present (Marples, 1988). Although disasters are not generally part of everyday life, their frequency leads to communities’ learning how to deal with them (e.g., Drabek, 1986: response to disaster process). The COVID-19 pandemic in Colombia could be described as a disaster that has overwhelmed the country’s resources and exceeds its ability to cope with the damage caused for the whole population. The pandemic was not a sudden event (there was a month between the time the WHO declared it as a Public Health Emergency of International Concern—January 30—to the first infection), but its severity in terms of the loss of human lives (32,000 and counting) and duration (1 year so far) has been tremendous. The virus arrived in the country on March 6, 2020, through one of the country’s 12 international airports (IMF, 2020c). As the number of cases started to grow and given the impossibility for the government to establish a quick diagnosis and isolate individuals with the disease, on March 17, President Ivan Duque, following the

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advice of the WHO and PAHO, declared a State of National Emergency and implemented different policies to avoid the spread of the disease. Some of the measures imposed were the closing of international borders, limiting people’s mobility with a nationwide strict lockdown in which people could leave their houses only if they were working in basic need industries, and providing biosecurity guidelines to different economic sectors and citizens. These measures were intended to instruct the population in terms of following safety measures to prevent being infected and to prepare the country’s health system to receive the high number of people infected with the disease. The National Health Institute (INS) is a governmental body in charge of closely monitoring the expansion of COVID-19. Figure 7.1 presents the number of people dying from the disease over time. The figure starts with the first case of COVID-19 which appeared on March 21, 2020. The strict lockdown measures had a positive effect on flattening the death curve between March and June. In May, two economic sectors—construction and manufacturing—were allowed to reopen under special prior compliance of biosafety standards. In June, another two economic sectors— commerce and air travel—were authorized to reopen. As expected, the number of death cases increased from June to September reaching a first peak in August with 400 people dying from the disease in 1 day. Therefore, a 2-week total lockdown was implemented. In September, following evidence of a decrease in the number of active cases, the government decided to reopen the remaining productive sectors, except for bars and entertainment. People were also allowed to leave their homes for leisure purposes. Despite the reopening, the number of deaths between September and December remained stable at between 160 and 220 cases per day. Cases increased among Colombia’s—mainly Roman Catholic—population between December and February, primarily due to the Christmas and end-of-year holidays,

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with a second peak in January reaching 395 deaths per day. At this point, the vaccination campaign started using an age-related scheme and vaccinated the elderly first. The campaign included the migrant population that entered the country by legal means. In addition, a second total 2-week lockdown was implemented reducing the number of deaths to a stable 50–100 per day. In April, already with a vaccination plan running, a third and most deadly peak started. Between April and July, the number of deaths increased due to several factors including 2-month citizen’s mobilizations and protests against the government economic reforms and the virus’ Delta variance reaching the highest number in June with 722 per day. A snapshot of the cumulative health consequences of COVID-19 by July 7 of 2021 provided by the INS shows that the total number of confirmed cases in Colombia reached 4,375,861 with 109,466 (2%) deaths. Of the total cases reported, 52.33% have been women, however, with 61.39% of the deaths being men. As for age groups, although most infected people (43.6%) are aged between 20 and 40, most deaths (49.09%) have occurred among the 60- to 80-year-old population. Finally, those with the highest infection rates and that comprise the biggest percentage of deaths in the country are people in the low socioeconomic brackets (69%). This group includes individuals with subsistence marketplace dynamics. The number of Venezuelan migrants infected in Colombia is 43,416, which amounts to 90.8% of the total cases involving foreigners. By July 7, 2021, seven million citizens (mostly aged 60 years or older) were fully vaccinated. The speed of the vaccination rollout has depended on the supply of vaccines arriving in the country (INS, 2021). Despite these negative indicators, institutions such as the WHO have highlighted the measures taken by the Colombian government entities as successful at preventing a high infection curve (Presidencia de la República, 2020). As mentioned by Gina Tambini, a representative of the World Health Organization (PAHO/WHO) analyzing the Colombian situation, states: “If we had not taken the pertinent measures, it would be worse.” Different economic authorities have highlighted that although the strict lockdown was successful at preventing the spread of the virus, it also had a high negative impact on the country’s economy (OECD, 2020b). The longer the confinement period, the greater the drop in production and income and the demand for goods. This vicious circle led to a significant decrease in investment, the destruction of firms, and an unprecedented increase in the country’s unemployment affecting many people, especially the vulnerable population that lost their jobs. From March to October 2020, the country’s economy shrank by 10% and the unemployment rate increased from 10% to 20% (OECD, 2020a, 2020b). Despite these negative indicators, institutions such as the IMF recognized the dynamism of the Colombian economy and the rapid governmental policy responses to the pandemic that made it possible to forecast a smaller drop in economic activity than that of other Latin American and Caribbean countries, which together were expected to have an average GDP reduction of
9.4% in 2020 (IMF, 2020a, 2020b). Since the beginning of the pandemic, the Colombian government has faced the gauntlet of trying to achieve an equilibrium between health by resuming short lockdowns to prevent contagion and economic development by keeping the

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economy open to ensure the sustainability of the most vulnerable and avoid repercussions that destroy the well-being acquired during the last decades. However, social tensions and mobilizations have arisen against the distancing measures and demanding the government for extra economic support. Between April and June 2021, the country has been hosting numerous mobilizations with thousands of participants. These manifestations of social discontent extended over 50 days and ended in violent confrontations resulting in 1113 people injured and 21 deaths. The demonstrations also became a source of infection, as people agglomerated in the streets, contributing to a new peak in the number of deaths. These recent developments highlight the fact that the government alone cannot solve the problem generated or aggravated by the COVID-19 pandemic, furthering the proposition that a solution can only be reached through a social pact and government collaboration with NGOs and business associations.

7.5

Colombian Catalytic Institutions: Good Practices

According to Shultz et al. (2017), taking a community from distress to a flourishing state requires the collaboration of catalytic institutions (government, NGOs, and business) enabling communities to create marketing systems capable of delivering a wide assortment of quality goods and services in amounts that both satisfy community members’ needs and result in long-term success. Sometimes, these collaborations can be social traps, whereby some practices yield short-term benefits and happiness for citizen consumers and entire communities but generate long-term costs and suffering. The assessments of these collaborations are determined by how they influence each community’s vulnerability and resilience. According to the UNDP, two factors considered to have an important impact on a country’s ability to respond to the COVID-19 crisis are human development and its health care system’s capacity (Kovacevic & Jahic, 2020). This section describes initiatives that catalytic institutions have jointly developed to tackle the pandemic in terms of the above two factors.

7.5.1

Maintaining Citizen Subsistence Means

In terms of human development, catalytic institutions developed different joint initiatives to provide the necessary resources to maintain people’s means of subsistence during the strict confinement period. Containment measures to prevent the spread of COVID-19 have been particularly hard for low-income consumers who follow subsistence marketplace dynamics, as their absence of safety nets puts them at greater risk (OECD, 2020b). Some thought leaders recommended that workers should be kept in jobs with a paycheck and that broader-based liquidity and debt

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relief should be provided for individuals and households as a way to counter the consequences of the pandemic on society and the economy (e.g., Stiglitz, 2020). A first initiative was to ensure workers continued to receive their paychecks. In Colombia, 90% of the companies are small- or medium-sized enterprises (SMEs); these companies lack the resources to deal with the pandemic’s economic consequences and are at risk of closure, which would entail the loss of many jobs (OECD, 2020b). Losing jobs would push people into poverty and into subsistence markets for survival, thus increasing the possibilities of infection. The government agreed with the private sector to provide businesses with a payroll subsidy equivalent to 50% of the minimum wage per worker during the strict confinement period (Presidencia de la República, 2020). To access such benefits, companies had to commit to retaining employees and demonstrate their need for the state contribution by certifying a decrease of 20% or more in their income in the previous 3 months. A second initiative was to support people without a job by ensuring biosafe subsistence marketplace dynamics. As mentioned before, people in poverty often live on their daily income; if they are not allowed to work 1 day, they do not have the means to satisfy their basic needs the following day. For individuals in this situation, in addition to the traditional programs established for people in poverty, the government provided a monthly stipend of USD 42, which represents 18% of the country’s minimum wage, during the strict confinement period (Presidencia de la República, 2020). Furthermore, utility companies were banned from cutting-off home service provisions due to no payment and to reconnect those who had their services cut off. Finally, no one could be evicted from a house due to nonpayment during strict confinement. A third initiative was to implement different programs to provide basic needs supplies for individuals in need. These campaigns were usually led by NGOs— which hold the relevant information regarding those in need—supported by retail companies, which provided supplies at no extra cost and citizens who provided the funding. The following are some examples of these campaigns: (a) “Ayudar nos hace bien,” a campaign led by the national government that collected and transferred one million food baskets (Presidencia de la República, 2020); (b) “Donatón,” a campaign led by the local government that collected an estimated USD $13,000,000 destined to vulnerable families (Alcaldía Mayor de Bogotá, 2020); and (c) “Colombia Cuida Colombia,” a national-level campaign promoted by different NGOs and private companies that collected and transferred USD 39,000,000 destined to vulnerable families (Colombia Cuida a Colombia, 2021). Given that the pandemic pushed many people into poverty, individuals who were not supported by the programs mentioned above, hung red rags from their windows or doors to communicate that they have urgent basic needs. This has allowed support organizations and neighbors to identify the most vulnerable families and to deliver basic aid quickly (BBC News, 2021). However, as the COVID-19 crisis went on and lockdowns in some regions continued into 2021, this symbol was also used as one of protest against the government’s measures. Some of these initiatives reached Venezuelan migrants. The government’s business payroll support included migrants with formal jobs, NGOs’ basic needs supply

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included migrants in need, and the no eviction rule during the strict confinement included hotels that house migrants, thus providing them with shelter during the strict confinement. Additionally, a new migrant status—Permiso Especial de Permanencia (PEP) or special permanence permit—was implemented to grant migrants shelters with basic conditions for short-term stay, access to the country’s free health services, education, legal, and childcare systems. To obtain PEP, migrants need to have accessed the country legally and prior to August 2020 and not to have a criminal record or an open deportation or expulsion order (Migración Ministerio de Relaciones Exteriores, 2020). For those migrants that accessed the country illegally, an alliance between different NGOs supported by international aid was formed to provide basic support across the country. The impact of migration on Colombia’s economy is estimated at 0.25% of the GDP in 2019 and will represent a 0.1–0.3% increase from 2020 to 2030. These figures have to be compared to the budgetary pressure of the migrants on the Colombian budget, which will account for 0.7% of the GDP in 2023 (IMF, 2019; Semana, 2021). These figures highlight the need for international funding to help alleviate the economic impact of migration and smooth the transition in host countries such as Colombia. Moreover, the education level of the migrating workforce suggests that there is potential for an increase in the size of the skilled labor force (IMF, 2020a), if policies are implemented to encourage that investment. However, as of 2021, there is no indication the Colombian government will propose such policies.

7.5.2

Broadening the Health Care System

Concerning the capacity of the health care system, catalytic institutions have developed different joint initiatives to improve their response rate and broaden their capacity to attend to patients. COVID-19 is a disease the Colombian health care system was not prepared for, meaning there was an urgent need for new infrastructure to diagnose and treat the infected. One possible remedy is better support for the health care and social insurance systems, as a way to counter the pandemic’s consequences on society and the economy (Stiglitz, 2020). A first initiative was designed to provide health care for everyone in the country. The government has instructed hospitals to treat any emergency patient, Colombian or migrant, regardless of the system they belong to. The management of both public and private intensive care unit systems was transferred from hospitals to the local governments. A second initiative was intended to guarantee the health care network’s economic sustainability. The government urged public and private institutions to pay any debts they had with hospitals; an extra funding of 8% was provided for the health care system; and any tax on medical equipment, supplies, medicines, and cleaning material was eliminated (Cámara de Comercio de Bogotá, 2020; Ernst and Young Global Limited, 2020).

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A third initiative was intended to increase the equipment and staff training required for COVID-19 diagnosis. The government and universities worked together to train and certify laboratories to diagnose the virus infection. The country started in March 2020 with seven laboratories having the capacity for 2000 tests a day, to 149 laboratories with the capacity for 150,000 tests a day in June 2021. An example is the program implemented by Universidad de Los Andes (Universidad de Los Andes, 2020), which raised USD 3.2 million from private donors to take one million free tests of people in conditions that made them vulnerable to the virus (e.g., cab drivers, street vendors, delivery people). A fourth initiative was designed to improve hospital infrastructure to treat the sick. COVID-19 has severe health consequences for those infected and requires quick treatment in ICUs. Colombia started the pandemic with 5363 intensive care units; by October, the number of beds rose to 10,693 (Ministerio de Salud y Protección Social – Minsalud, 2020a, 2020b). In addition, telemedicine and home care systems were implemented to help decongest the medical units allowing for greater efficiency in health centers. Between March and April, the number of teleconsultations increased from 337,415 to 2,803,229, and home care went from 171,538 to 940,925 cases (EPS reports—resolution 521). Cross-sector partnerships with the government, private institutions, and universities were developed to build mechanical ventilators. For example, a program from the Universidad de La Sabana (2020) designed and produced 6000 low-cost mechanical ventilators (approximately USD 1000 each).

7.6

Lessons Learned

As the COVID-19 pandemic continues, academics and policy makers continue to explore its impact and assess the government’s response. The purpose of this chapter was to use the framework provided by Shultz et al. (2017) to understand the effects of the pandemic on Colombian communities’ well-being. Following this framework, the pandemic is considered a disastrous exogenous force that shifted Colombia from its path towards progress to one that is in distress. The country’s subsistence marketplace dynamics and the Venezuelan refugee crisis were identified as factors of vulnerability, while the country’s unifying health care system has been identified as a factor of resilience against the spread of the virus and its consequences. We then provided a description of the effects of the virus on the citizens’ health and the economy. Finally, we analyzed the joint efforts made by catalytic institutions to both countervail the vulnerabilities via maintaining citizens’ subsistence means and leveraging resilience via strengthening the health response capacity. Guthey et al. (2014) ask, “are some places better suited for framing messy problems. . .?” (p. 9). Colombia seems to be an interesting location in which to analyze the role of catalytic institutions in these types of problems. Previous research has analyzed the positive effect of catalytic institutions’ policy interventions in restoring a community following a disaster such as a hurricane in the United States

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(Guion et al., 2007) or war in Colombia (Barrios et al., 2016). The crisis caused by COVID-19 in Colombia reveals how cross-sector partnerships are requisite to counteract the factors that cause vulnerability while leveraging factors to enhance resilience. The nature of this study is exploratory, which limits the generalizability of its findings, but it reveals the importance of systemic analysis and the importance of catalytic institutions to mitigate/end the crisis and highlights particularly salient/ unique factors that must be addressed to enhance well-being in a Colombian context. Moreover, this research lays a foundation for many future studies. As just a few examples, researchers could assess the impact or effects of other factors, independently or as they interact with factors examined here; they can apply concepts and insights from this study to explore how similar countries are addressing the COVID19 pandemic and other crises, and/or they can develop longitudinal designs and measures to assess the long-term impact of the actions taken by the catalytic institutions in Colombia—all of which may enhance well-being and resilience.

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UNHCR. (2020b, December). Venezuela situation. https://data2.unhcr.org/es/situations/vensit Unidad para la Atención y la Reparación Integral a las Víctimas. (2019). Registro Único de Víctimas (RUV). https://www.unidadvictimas.gov.co/es/registro-unico-de-victimas-ruv/37394 Universidad de la Sabana, Media coverage. (2020). Retrieved from. https://www.unisabana.edu.co/ we-want-to-save-lives/media-coverage/ Universidad de los Andes. (2020). Proyecto Covida. [online]. https://uniandes.edu.co/es/covida Viswanathan, M., Echambadi, R., Venugopal, S., & Sridharan, S. (2014). Subsistence entrepreneurship, value creation, and community exchange systems: A social capital explanation. Journal of Macromarketing, 34(2), 213–226. Viswanathan, M., Rosa, J. A., & Ruth, J. A. (2010). Exchanges in marketing systems: The case of subsistence consumer–merchants in Chennai, India. Journal of Marketing, 74(3), 1–17. World Bank. (2020). Colombia | Data. Retrieved December 18, 2020, from https://data.worldbank. org/country/colombia World Health Organization. (2020, December 12). WHO coronavirus disease (COVID-19) dashboard. https://covid19.who.int/ Worldometer. COVID Live update: Worldometer. Worldometers.info. (2021). Retrieved June 26, 2021, from https://www.worldometers.info/coronavirus/?utm_campaign¼homeAdvegas1

Andrés Barrios is an Associate Professor at Universidad de Los Andes Management School. He received his Ph.D. at Lancaster University. Andrés’s research spans marketing, entrepreneurship, and strategy. His interest focuses on the way in which business initiatives can promote social inclusion. Andrés’s research has appeared in a wide range of international marketing journals across disciplines, such as Journal of Service Research, Journal of Business Research, Journal of Public Policy & Marketing, Journal of Macromarketing, International Journal of Advertising, among others. Andrés’s research has been funded through a variety of international and local grants, including RCUK, Colciencias, USAID, and World Women Bank Foundation. Marcos Ferreira Santos is MsC and Ph.D. in Management. Professor at Universidad de La Sabana, Colombia, he has more than 30 articles published in journals and conferences. His main areas of research are Macromarketing, Transformative Consumer Research and Branding. Héctor Erlendi Godoy Hernández is MsC and Ph.D. student in Management at Universidad de Los Andes. His main areas of research are Higher Education Institutions and Regional Development.

Chapter 8

Croatia: Assessing Resilience and Responses of Firms and Consumers During COVID-19 Pandemic Dario Miočević, Ivana Kursan Milaković, Biljana Crnjak-Karanović, Mirela Mihić, and Antonija Kvasina

Abstract This study builds on the concept of resilience and investigates the responses undertaken by Croatian consumers and firms during the COVID-19 pandemic. The main aim of this research is to explore how resilience drives behavioral intentions of consumers and SMEs within the context of the “new normal.” Through secondary data analysis, the impact of pandemic on Croatian lives, policy reactions, consumers, and firms was observed. Additionally, primary research was conducted to (1) explore the impact of consumer resilience on online buying shifts and (2) investigate the influence of SME’s resilience, actualized through top managers’ self-efficacy, on investment intentions. The findings indicate that Croatian consumers feel of themselves as being quite resilient while Croatian SMEs increase the resilience by relying on the self-efficacy of top managers who are prone to engage in investment during pandemic. Our study contributes to literature by revealing the profile of resilient consumers and firms and how it affects their behavioral intentions during pandemic. The authors conclude with some discussion of lessons from key findings and implications for crisis-management, business, governance, marketing, and well-being. Keywords COVID-19 pandemic · Resilience · Consumers · Firms · Responses

8.1

Introduction

From late February 2020, the SARS-CoV-2 virus started spreading around the globe, with exponential growth of new COVID-19 cases reported daily. To this day, this novel coronavirus has infected more than 130 million people (Worldometer, 2021) causing severe economic and social disruption. To deal with these threats, countries enforced strict restrictions on the movement and initiated countrywide economic D. Miočević (*) · I. K. Milaković · B. Crnjak-Karanović · M. Mihić · A. Kvasina Faculty of Economics, Business and Tourism, University of Split, Split, Republic of Croatia e-mail: [email protected]; [email protected]; [email protected]; [email protected]; [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_8

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lockdowns with a goal of slowing this alarming trend. From the perspectives of health and well-being, the COVID-19 pandemic has forced tremendous shifts in people’s everyday living. From the economic perspective, the COVID-19 pandemic has brought severe negative impacts on the world economy. According to the World Bank (2020) report, the expected decline in global GDP in 2020 is around 5.2% while IMF (2020) report suggests that world economy will witness cumulative loss of more than 12 trillion US dollars in the next 2 years. By fundamentally impacting business sectors, these GDP contractions will be driven by lower investment activity, which will further initiate declines in employment, per capita income, human capital, and disruption of global supply chains. As a response to the pandemic, consumers around the globe continue adjusting to “the new normal” conditions, and insights from investigation of consumer sentiment across the globe show that consumers have engaged in novel shopping behaviors but also increase their spending in the category of essentials and decrease their spending in nonessential product and service categories (McKinsey & Firm, 2020). The consumer-oriented business sector has largely changed, given the COVID-19 crisis, to consider the adaptive consumer lifestyles and technology (Deloitte, 2020). The pandemic has disrupted seemingly all aspects of consumer behavior, forcing consumers toward adoption of newer technologies that are likely to modify existing buying and consumption habits (Sheth, 2020). As a new field of research, consumer resilience becomes a dynamic area for academic exploration, especially now, when the COVID-19 crisis reveals it as a worthy research opportunity (Sheth, 2020). The framework of our research builds on the concept of resilience which is a central building block in assessing the ability of society to navigate through events that cause distress (Shultz et al., 2017). Resilience is multidimensional concept encompassing economic development, social capital, information and communication, as well as community competence (Sherrieb et al., 2010). Considering community and disaster response context and acknowledging the interplay of natural, technological, and human causes over a period of time, Shultz et al. (2017, p. 18) define resilience as “an adaptive process driven by the possession of, or access to, resources that allow a timely restoration of its capacities to contribute positively to a sustainable and desirable state of flourishing.” The current COVID-19 pandemic fits this profile very well, and the aim of our study is to investigate how resilience drives behavioral intentions of both consumers and small- and medium-size enterprises (SMEs) in the context of “the new normal,” which the pandemic has caused. Currently there is very limited knowledge on the role of resilience on behavioral shifts and intentions of both consumers and firms during pandemic. Hence, our research aims to fill these gaps in the literature. This paper is organized as follows. First, we review the extant literature and focus on the concepts. Next, we utilize secondary data sources to examine how the COVID-19 pandemic impacted general life, policy reactions, consumers, and firms in the Republic of Croatia. We then proceed with primary research to reveal whether resilience is a significant factor that explains the behavioral shifts of both consumers and SMEs. We conclude with implications and limitations, as well as suggestions for future research.

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Literature Overview and Conceptual Development Consumer Resilience During Crises

One’s resilience can be defined as a process of recovering from difficult experiences and adapting well to trauma, tragedy, stress, or threat (American Psychological Association, 2012). Resilience can emerge from different factors, such as psychological (Campbell-Sills et al., 2006), biological (Morgan et al., 2002), and environmental (Haskett et al., 2006), whereas all individuals can be more or less vulnerable given the situation (Jourova, 2016). Resilience historically was studied primarily from the perspectives of children, natural disasters, and wars, in ways or for purposes highly reliant on the context (Ungar, 2008). Here, we focus on the resilience that addresses the perceptions and attitudes of individuals/consumers faced with the current pandemic. Compared to the global financial crisis in 2008, which had dramatic impact on industry, in the past several months of the COVID-19 crisis, purchase/consumption of nonfood products greatly decreased—unlike the food products, which can be attached to “panic buying.” In addition, COVID-19 effects on retail vary across countries, due to the different measures applied in different countries (Eurostat, 2020). The necessity for acquiring the needed goods, given the available buying channels, stresses the importance of exploring the relationship between consumer’s resilience and behavior/buying shifts in terms of online channels. We are witnessing huge changes in consumers’ shopping habits via these channels, which are generally interpreted as a method for reducing virus transmission and coping with health threats more generally. Moreover, the importance of resilience resides in its relevance for one’s psychological well-being and connection to the cultural and religious values (Souri & Hasanirad, 2011). This suggests that different nations cope differently with adverse situations, which draws attention to the Croatian context and scholarly explorations of resilience during the current crisis. Our research aims to add new contextual insights to this literature (see also Maurer, 2016; Mayntz, 2016). New shifts in consumer behavior and business operations encourage firms and consumers to reinforce one another for the purpose of creating and stimulating the “new normal progress” (Deloitte, 2020). Businesses need to understand consumer changes and think how to reach consumers through a variety of channels; by doing so, businesses will enhance strategies to build resilience for the firm/organization and their consumers. In our research, we will focus on determining the level of consumer resilience and its relevance for shifts in consumer behavior. Hence, our aim is to investigate how is consumer resilience connected to online buying, perception of pandemic as a good opportunity for acquiring the new buying skill, and online (re)purchase intention. We believe that such an approach will determine or at least predict future consumer buying patterns important for the business response strategies.

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Firm Resilience During Crises

The essence of economic crises is that they affect the economy as a whole initiating shrinkage in customer demand (Lim et al., 2020). Many studies on firms’ responses to economic crises have emerged since the last global financial crisis, in 2007–2008. Findings indicate differences between large firms and SMEs, indicating larger firms are able to recover more quickly from declining demand brought by crisis (Peric & Vitezic, 2016). Generally, studies show that economic crises push SMEs to reduce the number of employees (Cowling et al., 2015), and that SMEs have more cautious aspirations toward growth (Varum & Rocha, 2013). SMEs however are not a homogenous group; studies have shown that there are significant differences between SMEs and entrepreneurial firms on how they approach the crisis. Smallbone et al. (2012) found that economic crisis has not adversely impacted all small businesses. To the contrary, a significant number of SMEs performed well; thus, the types or forms of resilience might vary among SMEs during economic crises. Resilience entails how firms can utilize resources to create effective responses to crisis, which make them less vulnerable to its consequences (Williams et al., 2017). The academic research into firm resilience is evolving and there are many issues that require further exploration (Duchek, 2018). For example, resilience has been tightly related to a firm’s ability to adapt to challenging landscapes and contexts (Powell & Baker, 2012). As a basis for resilience, some authors identify self-efficacy (Bullough & Renko, 2013), which is defined as the set of abilities that enable the manager to enact appropriate responses during crisis. Self-efficacy, considered to be an important coping mechanism, enables top managers and CEOs to weigh whether a specific course of action will be effective. Therefore, the top managers with high self-efficacy are expected to be reassured when navigating the stormy landscape of economic crisis and as a result to perceive the increased likelihood of success of their actions (Bandura, 1997). Also, strong self-efficacy might manifest as higher attentiveness to potential threats from external environments (Nag et al., 2020) as well as ability of managers to shape effective coping responses to unexpected events (Duchek, 2018). Therefore, the resilience of SMEs resides in self-efficacy of its top managers who are able to effectively cope with economic crisis. In the context of our study, we will examine whether resilient SMEs are prone to invest in specific areas of their business model, specifically employment, expansion of capacities, development and launch of new products and services, and human capital.

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Fig. 8.1 Evolution of active cases in Croatia (Source: Worldometer)

8.3 8.3.1

COVID-19 Pandemic in Croatia: Origins and Developments Health Situation and Policy Reactions

The first COVID-19 case in the Republic of Croatia was reported in Zagreb (the capital of Croatia) on 25 February, when a patient who had come from Italy tested positive. Since the outbreak of the pandemic in Croatia in early 2020 (11 March), the Croatian government has responded with a wide range of measures to limit the spread of SARS-CoV-2 virus and to mitigate the economic impact of it (Vlade Republike Hrvatske, 2020). COVID-19 Health Situation After the period of countrywide lockdown during March and April 2020, the country was mostly reopened during the 2020 summer tourist season. Overall, the situation was satisfactory with almost no cases reported for weeks. The situation progressively worsened over the summer, and several countries issued travel warnings on nonessential travel to all or part of Croatia. Throughout September and early October, the number of new cases steadily grew, with 200–350 new cases per day (OECD, 2020a, 2020b). After a dramatic increase in late October, the number of new cases grew rapidly through November and eventually slowed during December (Worldometer, 2020). Currently (April 2021), there are more than 2000 cases per day, with total of more than 270,000 active cases. The evolution of active cases in Croatia can be seen in Fig. 8.1.

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Measures to Slow the Spread of the Virus and Support the Health System Several measures were introduced to break the possible chain of infection and to manage the broader impacts of the disease. School closure was introduced on 16 March, and educational institutions were closed. Distance learning was delivered through public service broadcast (primary education) and via different educational platforms (high schools and universities) (OECD, 2020c, 2020d). Schools were able to choose between model A (fully in-person learning), B (mixed model), or C (distance learning). However, on 7 December, the Government announced that all high schools were obliged to switch to distance learning, as of 14 December (OECD, 2020e). Restrictions on activity and movements were introduced on 16 March. As of 27 of April, businesses selling goods and services were permitted to reopen following the prescribed epidemiological/safety measures. New restrictions as of 28 November were introduced: the organization of public events and funerals gathering more than 25 participants and private gatherings with more than ten participants were prohibited, weddings remain forbidden, while all stores are obliged to respect the limits with regard to the maximum allowed number of customers on site (OECD, 2020f). In addition, working hours of bars and restaurants as well as public events were first limited and then forbidden, along with sport practice and competitions, except for professionals. The extension of the existing measures (from December 21 to January 10) includes a provision that a maximum of ten people from two different households are allowed at private gatherings, whereby the restrictions on internal movement forbid people to leave the county without obtaining a pass (Vlada Republike Hrvatske, Sredisnji drzavni portal, 2020). Lastly, wearing of facemasks is mandatory indoors and in open spaces in cases where adequate physical distance cannot be assured. Economic Support Measures On 17 March, the Government announced a set of 63 measures of a possible combined impact of over HRK 30 billion (approximately EUR 3.9 billion) to support the economy in coping with the effects of the pandemic (Vlada Republike Hrvatske, Sredisnji drzavni portal, 2020). These included interventional procurement of critically important sanitary equipment (disinfection equipment, soap, masks, etc.), authorized delays in tax payments, purchase of surpluses of potentially threatened businesses (agricultural or industrial goods), measures to support the tourism industry, and aid for preserving jobs in affected sectors. Fiscal measures to support firms—cash support—from 23 March, the employment agency has made available special subsidies to employers to cover salaries of full-time and part-time workers in accommodation, food and beverage, transportation, and other sectors in which workers are prevented from attending work due to confinement measures. Fiscal measures to support firms—liquidity and guarantees—were announced; within the April package, the Government announced an exemption on payment of income tax and contributions for entrepreneurs with an annual income of less than HRK 7.5 million (representing 93% of firms), whose revenue declined by more than 50%. Firms with an annual income above the threshold would be partially exempted. The Government also announced a deferral on VAT payments until the collection of invoices or payments, applying both to

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SMEs and large businesses. The Croatian Small Business Agency (HAMAGBICRO) has given loans totaling 343 million (around EUR 93 million) to support liquidity of small businesses, benefitting around 900 businesses so far (OECD, 2020f). According to the Ministry of Finance (2020), by the end of September, HRK 6.9 billion (around EUR 913 million) had been invested to support businesses and employment, of which HRK 5.4 billion (EUR 714 million) came from the state budget. An additional HRK 1.2 billion (around EUR 159 million) was planned to be invested by the end of year 2020, while in 2021, COVID measures are planned to be financed from EU funds (React EU) in an amount of HRK 2.1 billion (EUR 280 million) (Ministry of Finance, 2020).

8.3.2

Consumer Behavior During COVID-19

Personal consumption represents compound economic and social aspect, whereby in Croatia it contributes to GDP for 60%, mainly due to an increase in disposable income and tourist visits and consumption (Čipčić, 2020). Croatian citizens base their purchasing decisions on the permanent income while forecasting their future earnings; thus the increased consumption depends on the economic growth that relies on institutional reforms, employment rate, and SMEs empowerment (Čipčić, 2020). In Croatia, the pandemic brought increased growth in online shopping, especially in terms of groceries, whereby the consumers put an emphasis on the price and quality of products (Herceg, 2021). A great number of consumers bought groceries online for the first time, and many consumers plan to continue to buy products that way (Herceg, 2021). Nevertheless, it can be said that coronavirus pandemic, and the experience of lockdown, inevitably changed and affected consumer habits in Croatia. These changes are reflected in changes in demand for individual products, price sensitivity, less frequent and “rational” shopping, orientation toward healthier lifestyles, and preferences for online shopping and payment methods. Change in Demand for Individual Product Categories (and Within Certain Types of Products) and Services Besides the increase of the demand for certain types of food products (e.g., flour, rice, powdery products for cake preparation, and pasta (Nielsen, 2020a and fresh meat, meat products, milk, cheeses, canned vegetables, oil, and coffee (Nielsen, 2020b)),1 especially at the beginning of the pandemic, there was also an increase in the demand for products related to hygiene, cleaning, and health (Nielsen, 2020a, 2020b), while the demand for clothing and cars2 1

This was expected because these products are necessary for home food preparation and can be stored 2 Croatia ranks first in the EU, given the new vehicle sales drop in the first half of 2020, which decreased by 54.4% (Croatian Chamber of Commerce, 2020a)

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recorded a smaller or greater decline. Categories of products that have also experienced growth in demand during the epidemic are (Dujić, 2020a, 2020b) computer equipment (i.e., equipment for distance working and learning), some household appliances (e.g., for baking bread), socialization products (e.g., board games, toys for kindergarten age), etc. During this period, platforms for communication and distance learning, food-ordering applications, and medical services, i.e., contacting doctors via e-mail and m-banking, have also greatly increased (Starman Frančić, 2020). In addition, restaurants’ visits (while they were open) decreased significantly (Masterindex research, 2020b). Namely, almost 65% of respondents stated that they went to restaurants less frequently due to the pandemic. Hence, it can be concluded that, within this period, Croatian consumers increased their buying of necessities, such as products they needed for the household functioning, as well as those products/services that allowed them to connect, socialize, and communicate with others, while the purchase of other products (primarily more expensive and/or luxurious ones) was largely delayed. Price Sensitivity, Switch to Cheaper Product Alternatives in Certain Product Categories, and Buying Discounted or Sale Items Already price sensitive, Croatian consumers have shown a tendency to buy cheaper and private brands in some product categories, such as beauty and personal hygiene products, especially in terms of premium products. On the other hand, consumers generally buy the same brands, as before the pandemic, but they are especially attentive to affordable prices (52%) and quality (38%). Although 59% of respondents prefer the well-known brands, the same number of respondents buy them only when on sale, while 14% of respondents do not care for brands but only for the price (Hendal, 2020). Less Frequent but Larger Individual Purchases According to results from several surveys (e.g., Equestris, 2020a; Gfk, 2020; Ja Trgovac & Hendal, 2020), customers buy less often in shopping centers (this applies to small and large purchases), but they buy larger quantities. For example, small purchases (up to 200 HRK), associated with daily shopping as well as the one 2–3 times a week, decreased significantly while weekly purchases increased. Sensible, Rational, and Planned Shopping Behavior Now, consumers spend less on “unnecessary” products that they previously bought unplanned on their way to the checkout (Ipsos, 2020a). This trend is also supported by the Croatian Bureau of Statistics’ data (2020a): in the first 10 months of 2020, retail trade turnover decreased by 6.5%, compared to the same period of the previous year. Moreover, Black Friday consumption fell by 7.75%, that is, from Thursday to Sunday by 22% (Croatian Chamber of Commerce, 2020a). Furthermore, a greater online shopping orientation may contribute to a more “rational” purchase, which seems to be supported by the finding that 37% of consumers spend more within physical stores at the point of sale, while 29% spend more when shopping online (Equestris, 2020a). Moving Toward a Healthier Lifestyle Consumers show a greater interest in organic and sustainably produced products (Euromonitor International, 2020), as well as dietary supplements, such as vitamins, minerals, probiotics, etc. For instance,

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now 32% of shoppers consume more of these products, compared to 26% of them before the pandemic. In addition, consumers who were already prone to exercise and eat healthy now have increased such habits (Improve, 2020). Greater Consumer Tendency Toward Online Shopping, Ordering, and Delivery Services From March to October 2020, online shopping increased by 55% in general compared to the same period of the previous year (Croatian Bureau of Statistics, 2020b). Furthermore, a survey conducted by Equestris in April (2020b) shows that during the coronavirus pandemic more than 2.1 million of Croatian citizens (approximately 52% of the population) have turned to online shopping; at least 130,000 of these shoppers previously had not shopped online. The most ordered categories of products and services online were clothing and footwear (39%), home furnishings and equipment (26%), and multimedia (21%) (Croatian Chamber of Commerce, 2020b; MediaNet, 2020). Furthermore, from March to the end of April purchases of fresh food from local producers increased nearly sevenfold. There is also a growth in the number of people ordering/purchasing food online (Masterindex Research, 2020b); in this case, consumers are not motivated by speed of delivery, which is one of the most important criteria in “classic” online purchases, but by the quality of groceries (78% of respondents) and price (54%). As a pickup model for ordered products, 73% of online customers used door delivery, 15% drive-in, and 11% preferred the combination of door delivery and drive-in. Changing Payment Methods Survey data show that people pay less in cash, whereby 30% of consumers paid in cash less than before, with an increase in debit and credit cards or transaction account payments (Masterindex research, 2020a). Given the current situation, these forms of payment are perceived as quick, simple, and healthy and hygienically safer payment methods. In addition to changing consumer habits, the pandemic has also affected consumer sentiments and their expectations toward personal financial situation. Consumers expect that their financial situation will worsen (47%) and think they will not be able to save any money (56.3%) (Mediana, 2020).3 Moreover, 67% of consumers think that the pandemic will negatively affect their financial situation (Ipsos, 2020b). Given the consumer optimism and confidence, it seems that Croatian consumers are more pessimistic than they were before the pandemic, which suggests the lack of trust in government when it comes to both investors and consumers (Ivković, 2021). However, improved governmental measures and job security perceptions might increase consumer optimism and confidence (Ivković, 2021).

It should be noted that despite this finding, there is a significantly higher number of happy citizens and those who are satisfied with their lives compared to those unhappy and/or dissatisfied

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Firm Behavior During COVID-19

The COVID-19 pandemic has largely led to a slowdown in Croatian economy since mid-March 2020; the quarterly GDP decreased in real terms by 10.0% in the third quarter of 2020, as compared to the same quarter of 2019 (Croatian Bureau of Statistics, 2020c). For the Croatian economy, SME sector4 is of great importance—it has by far the largest share in the number of enterprises (99.7%). In 2018, the micro and SME sector accounted for 58% of total income generated at the level of Croatia and employed almost three quarters (72.2%) of all employees in business entities in Croatia (CEPOR - SMEs and Entrepreneurship Policy Center, 2019). Furthermore, the COVID-19 pandemic had a direct impact on the reduction of regular business activities. The introduction of restrictions on the freedom of movement and social activities has caused changes in the operation and sustainability of businesses, which therefore operated with reduced capacity or have suspended their operations for a longer period (Croatian Bureau of Statistics, 2020d). Croatian Chamber of Commerce has been conducting surveys periodically to identify difficulties in business related to COVID-19 pandemic and to track the pandemic’s consequences on business activities. The survey from February 2020 showed that, at the end of February 2020, two thirds (66%) of Croatian firms already felt the negative consequences of COVID-19 in their business, and for more than half of them (53%) turnover had dropped (Croatian Chamber of Commerce, 2020c). The most affected are travel agencies (69%), firms that provide accommodation, food preparation and serving (62%), and transportation and storage businesses (51%). It is important to mention that SMEs are experiencing a greater negative impact of COVID-19 pandemic than larger firms do (Croatian Chamber of Commerce, 2020d). Regarding the specific types of consequences related to COVID-19 pandemic, most firms reported difficulties in concluding new deals (30%), completing existing contracts (29%), and performing existing contracts (28%). In addition, firms had difficulties with the transport of goods; cancellation of participation in international fairs, congresses, and events; and reduction of demand for products and services in the domestic market (Croatian Chamber of Commerce, 2020d). At the beginning of March 2020, three quarters of domestic firms (74%) experienced the effects of COVID-19 on their business, which represents an increase of 8% points compared to results from February 2020. Exporters (65%) and importers (61%) suffered equally, yet micro and SMEs recorded a decline (both imports and exports) to a much greater extent than medium-sized and large firms. The most endangered sectors are tourism, transportation and storage, agriculture, forestry, and fisheries

4

Criteria for classifying entities in the small and medium enterprise sector are defined by the Accounting Act and the Small Business Development Promotion Act. The Accounting Act, which was used in CEPOR report, classifies entrepreneurs into micro, small, medium, and large, based on amount of total assets, amount of income, and average number of employees during business year

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sectors, followed by arts, entertainment and recreation, wholesale and retail, and manufacturing industry (Croatian Chamber of Commerce, 2020e). At this point in time, more than half of the surveyed firms (53%) recorded losses of up to half a million HRK due to the consequences of the COVID-19. After the Government of Croatia issued measures to help the economy fight the COVID-19 consequences in mid-March 2020, new survey results still showed an increasing negative impact on the domestic economy, with micro-firms being the most affected. As many as 95% of firms reported a drop in turnover, with 28% having a drop of 100%. Three quarters (74%) of firms reported a drop in production, of which a fifth (21%) had a 100% drop (Croatian Chamber of Commerce, 2020f). When it comes to the supply of raw materials and supply chains, more than 60% of firms had difficulties in regular ways of doing business. Export decline was recorded by 45% of firms and import decline by 41% of them. Furthermore, 42% of firms considered laying off workers, and 37% considered closing the firm (Croatian Chamber of Commerce, 2020f). As for firms’ interest in Government measures to help the economy, among the 63 measures offered, firms were most interested in payment delays (56%) and supporting job preservation in the affected sectors (50%), followed by the approval of new liquidity loans (35%) and the introduction of a moratorium on existing credit obligations (32%) (Croatian Chamber of Commerce, 2020f). In May 2020, Equestris (2020c) issued a report indicating 61% of firms had requested measures to fight COVID-19 consequences, and those measures were approved for 75% of firms and partially approved for 18% of them. Most firms had requested measures from Croatian Employment Service (75%), where the most used measure was subsidies for employers regarding job preservation (95%). Altogether, 43% of firms applied for measures offered by Ministry of Finance, where the most used measures were payment of VAT upon charged realization (40%), tax exemptions5 (38%), deferred payment of tax liabilities6 (38%), extension of the deadline for submission of annual financial report for 2019 (30%), and partial tax exemption7 (19%) (Equestris, 2020c). To mitigate the impact of the crisis, firms’ responses were cost reductions (30%), application for subsidies, request for deferral tax payments, preservation job measures (21%), protection of employees and teamwork (16%), digitalization (15%), and organization of work from home (12%) (Equestris, 2020c). Many firms are expecting accelerated digitalization, as well as for supply chains to be brought closer to home. Moreover, most of the firms that have applied for measures report

5

Measure for entrepreneurs with an annual income of less than HRK 7.5 million, who record a drop in income of more than 50% 6 Measure for entrepreneurs with an annual income of less than 7.5 million HRK, which recorded a decline in income between 20 and 50% 7 Measure for entrepreneurs with an annual income of more than HRK 7.5 million, in proportion to the decline in income

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satisfaction with the way the measure was implemented (49%) (Kearney & American Chamber of Commerce in Croatia, 2020). Therefore, regarding the resilience of the firms, the analysis shows that more than half of the firms surveyed had a general contingency plan for emergency situations before the pandemic, which in this situation proved to be effective in 90% of the cases. Despite the fact that firms generally expect a negative impact on revenues and investments, a reduction in the workforce, and problems in cash flow (almost 47% of the cases), there are examples where firms are increasing investments in digitalization, mergers, and acquisitions and developing transformation measures to emerge from the crisis as winners. Furthermore, most of the firms surveyed have already started drawing up business transformation plans for the post-crisis period. Almost 43% of them are preparing for internal transformation and market opportunities. As many as 56% of the firms plan to accelerate the digitalization of internal processes and continue work from home, and 30% of firms plan to introduce more automated and robotized processes.

8.4 8.4.1

Primary Research Consumer Resilience and Behavior During COVID-19 Pandemic

To shed more light on consumer behavior during COVID-19 pandemic, we explored the influence of consumer resilience on consumer online buying shifts (online buying, perception of pandemic as an opportunity for acquiring new buying skill, and online (re)purchase intention). For this purpose, the convenience sampling method was used; an online questionnaire was developed and distributed through various social networks and e-mails. The research was conducted at the end of May and beginning of June 2020. A total of 502 respondents was reached. Data were checked for missing values, normality of distribution, skewness, kurtosis, and outliers. Missing values (90) were deleted from a database along with outliers (12); thus the final sample size is n ¼ 400. The sample was 71.5% female and 28.5% male respondents, age 18–84; the majority of respondents were 25–34 (27.7%) and 35–44 (35%); the majority have finished high school (41.2%) and university degree or higher (36%). Seven consumer resilience items were adapted from Connor and Davidson (2003) “Resilience scale” and slightly modified. For this purpose, a Likert scale of 7 (1-completely disagree to 7-completely agree) was employed; Cronbach’s alpha ¼ 0.856. The items included the following: I think I can easily adapt to changes; I can deal with whatever comes; When things look hopeless, I never give up; When under pressure, I can focus and think clearly; I think of myself as strong person., I can handle unpleasant feelings; I think I am in control of my life.

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Croatian consumers think of themselves as being highly resilient (M ¼ 5.37, SD ¼ 0.93). They think they easily adapt to changes, and they can handle all unexpected events and never lose hope. In addition, they feel resilient due to the ability to focus, think clearly, and successfully handle negative emotions. Furthermore, Croatian consumers think of themselves as being strong and having control over their lives. For the purpose of this research, consumer behavior shifts were explored through online buying changes due to the pandemic, such as online buying, perceiving the pandemic as an opportunity for acquiring some new buying means/patterns, and intention to (continue) buy online after the pandemic. When exploring the consumers’ perceptions whether the pandemic forced them to buy products via new (online) channels (This pandemic situation forced me to buy products through new (online) channels), 48.2% of the consumers responded not at all, and 42.4% reported that the pandemic forced them to buy through new online channels to a lesser degree. In addition, 8.3% of respondents stated the pandemic forced them to buy via new online channels to a higher degree and 1% completely. As can be seen, the current crisis forced more than 40% of the consumers to buy online to a lesser degree. Consumers were also surveyed about the pandemic perception in terms of seeing it as an opportunity for acquiring some new buying habits/means (I think that this pandemic can be seen as a good opportunity for acquiring some new buying means). The majority of the respondents (44.8%) sees this pandemic as an opportunity for acquiring new buying ways to a lesser degree, while 38.4% does not perceive in a similar way at all. In addition, 12.3% of consumers think to a greater degree that this pandemic is an opportunity to acquire new buying skills, while 4.5% fully adopt this perspective. This research also explored the consumer intention to continue buying online after the pandemic (I will continue to buy through online channels when this pandemic is over). The results show that 29.2% of the consumer will probably not continue to buy online, while a majority will continue, that is, 35.8% probably will buy online depending on the type of the product, and 35% will definitely continue to buy online. To test the differences in buying shifts with respect to consumer resilience, one-way ANOVA was performed; results with post-hoc tests are shown in Tables 8.1 and 8.2. A one-way between-groups ANOVA was conducted to explore the impact of consumer resilience on buying shifts in terms of online buying, perception of pandemic as acquiring a new buying skill, and online (re)purchase intention. Participants were divided into three groups according to their resilience level (Group 1 ¼ low resilience, Group 2 ¼ medium resilience, and Group 3 ¼ high resilience). A statistically significant difference exists at the p < 0.05 level in online buying scores for resilience groups, unlike the perception of pandemic as an opportunity for acquiring new buying skill and online (re)purchase intention (see Table 8.1). Given the significant relationship between consumer resilience and online buying, post-hoc comparison, using Tukey HSD test (see Table 8.2), indicates that the mean score for Group 1 (M ¼ 1.74, SD ¼ 0.716) is significantly different from Group

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Table 8.1 ANOVA results

3 (M ¼ 1.50, SD ¼ 0.674). Group 2 (M ¼ 1.62, SD ¼ 0.643) did not differ significantly from either Group 1 or 3. These results indicate that, during the pandemic, less resilient consumers were forced to increase online purchases, unlike the highly resilient consumers.

8.4.2

SMEs’ Resilience and Responses to Crisis

To test how SME resilience (actualized through top manager’s self-efficacy) influences strategic investment responses, we focused on SMEs operating in various B2B industries. Since most of the B2C industries were either in lockdown or their operations were significantly restricted by undertaken measures, such a sampling frame is justified. Overall, the sample frame included 2347 SMEs and was drawn from one commercial business database. The data were collected via structured questionnaire disseminated online. We were able to identify the e-mail addresses of top managers. Eventually, we obtained 155 valid responses from top managers resulting in a response rate of 6.3%. Given the conditions of data collection were severely hampered by the pandemic and lockdown, the research team concluded that response rate was satisfactory. In terms of sample demographics, 65.2% of top managers were active owners of the SME. Most, that is, 87.7%, SMEs were at least to some extent active exporters. On average, the SMEs were 19 years old and had 38 employees in average. Our sample firms covered diverse range of industries. The largest number of SMEs

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Table 8.2 Post-hoc analysis (Tukey HSD) Mean difference (I-J) 0.113 0.236a 0.113 0.123 0.236a 0.123

Dependent (I) Consumer (J) Consumer variable resilience resilience This panLow Medium demic situaHigh tion forced Medium Low me to buy High products High Low through Medium online channels I think that Low Medium 0.064 this panHigh 0.027 demic can Medium Low 0.064 be seen as a High 0.091 good opporHigh Low 0.027 tunity for Medium 0.091 acquiring some new (online) buying means I will conLow Medium 0.103 tinue to buy High 0.083 through Medium Low 0.103 online chanHigh 0.019 nels when High Low 0.083 this panMedium 0.019 demic is over a The mean difference is significant at the 0.05 level

Std. error 0.081 0.087 0.081 0.082 0.087 0.082

Sig. 0.349 0.019 0.349 0.291 0.019 0.291

95% Confidence interval Lower Upper bound bound 0.08 0.30 0.03 0.44 0.30 0.08 0.07 0.31 0.44 0.03 0.31 0.07

0.098 0.105 0.098 0.098 0.105 0.098

0.789 0.965 0.789 0.625 0.965 0.625

0.30 0.22 0.17 0.14 0.27 0.32

0.17 0.27 0.30 0.32 0.22 0.14

0.097 0.103 0.097 0.097 0.103 0.097

0.539 0.699 0.539 0.978 0.699 0.978

0.33 0.33 0.12 0.21 0.16 0.25

0.12 0.16 0.33 0.25 0.33 0.21

belonged to the manufacturing sector (23.8%), wholesale (16.1%), ICT (13.5%), professional services (12.6%), construction (9.0%), other business services (13.5%), and other industries (11.0%). The measurement scales for key constructs were derived from existing literature. For each firm, we measured the top manager’s self-efficacy by adapting a scale from Wilson et al. (2007). The scale captures the top manager’s skills in comparison to other managers and was comprised of the following items: “being able to solve problems,” “making decisions,” “managing money,” “being creative,” “getting people to agree with you,” and “being a leader.” Top manager’s self-efficacy was measured on 5-point Likert scale with anchors 1-much worse, 5-much better. To measure the SME’s proclivity for investment response, we used a scale from Zhao and Thompson (2019). The scale asks top managers how likely it is that their firm will implement the following investment responses: (1) development and launch new products/services, (2) new capital investments, (3) increase in the number of employees, (4) increase the skills of the workforce, and (5) increase the leadership

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Mean of Innovation

3,4

3,2

3,0

2,8

1,00

,00

Self_efficacy Fig. 8.2 Self-efficacy and investment in innovation

skills of managers. The first item represents investment in innovation; the second and third items were classified as investment in capacities; the fourth and fifth items were labeled as investment in human capital. The scale items were measured on 5-point Likert scale with anchors 1 as extremely unlikely and 5 as extremely likely. Again, we used the top manager’s self-efficacy as a proxy for SME’s resilience. SMEs with self-efficacious top managers are (1) able to implement vision into practice, (2) highly attentive to threats, and (3) possess skills to achieve desired goals. To make distinction between top managers with high vs. low self-efficacy, we used a median split in our sample. Then after, we analyzed the differences that exist among top managers regarding their investment response to crisis (innovation, capacities, and human capital). We used one-way analysis of variance (ANOVA). The findings suggest statistically significant differences between group means as determined by one-way ANOVA. We find that investment in innovation (F (1153) ¼ 8.780, p ¼ 0.00), capacities (F(1153) ¼ 4.157, p ¼ 0.04), and human capital (F(1153) ¼ 7.250, p ¼ 0.00) show statistically significant differences. To better understand the results, we present ANOVA plots in Figs. 8.2, 8.3, and 8.4. In general, the findings indicate that in Croatian SMEs managed by top managers with high self-efficacy, there is a stronger inclination toward investment response in innovation, capacities, and human capital. This leads us to conclude that resilient

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2,80

Mean of Capacities

2,70

2,60

2,50

2,40 1,00

,00

Self_efficacy Fig. 8.3 Self-efficacy and investment in capacities

SMEs, led by self-efficacious top managers, are able to harness investment opportunities even during COVID-19 pandemic.

8.5

Discussion, Lessons, and Conclusions

The COVID-19 pandemic has brought tremendous changes to Croatian consumers, industry, economy, communities, and society. This crisis necessitates scholarly exploration of consumer and business responses and resilience. Resilience remains a key factor that drives the economic recovery and increases the well-being of society during upheavals, crises, and catastrophes (Shultz et al., 2017). We have offered a review of the extant literature focused on these compelling issues in a Croatian context, utilizing secondary data to examine how the pandemic affected life in the Republic of Croatia generally, and with special focus on consumers and firms. An overview of events related to the COVID-19 pandemic in Croatia reveals that both consumers and firms have been impacted at least to some extent by this crisis. Consumers were shown to increase purchases of essential products, switch to cheaper product alternatives in certain product categories, focus on larger individual purchases, become more price sensitive, switch to healthier products, increase

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3,80

Mean of Human_capital

3,70

3,60

3,50

3,40

3,30 1,00

,00

Self_efficacy Fig. 8.4 Self-efficacy and investment in human capital

contactless purchases, and switch to online buying in many product categories. At the same time, a majority of firms have been forced to retrench by engaging in cost reductions, capacity divestment, and have relied significantly on governmental support measures; however, some firms have cultivated a growth mindset, which has resulted in various investment behaviors during pandemic. What remains less clear are the underlying drivers of such shifts in behavioral intentions among both consumers and firms. Thus, we draw on the concept of resilience and investigate how it shapes response intentions of Croatian consumers and SMEs during the COVID-19 pandemic. Primary research within the pandemic context reveals that Croatian consumers believe they are being quite resilient while Croatian SMEs increase the resilience by relying on the self-efficacy of top managers who are prone to engage in investment response strategies even during pandemic. Particularly noteworthy are the profiles of resilient consumers and firms and how those profiles affect response intentions during pandemic. Our research provides insights regarding consumer resilience and how it drives shifts in consumption. Consider online buying, for example, our findings indicate that less resilient consumers tend to buy online, unlike highly resilient consumers. Furthermore, no relationship was found between consumer resilience and perception of pandemic as opportunity to acquire new buying skill(s). This result suggests that perceiving pandemic as a good opportunity for learning new ways to purchase items

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is not dependent on consumers feeling resilient. In other words, consumer resilience does not impact consumers’ perceptions of a pandemic being an opportunity for learning new ways/skills of buying. Nevertheless, physically visiting a retailer and shopping on site is a ritual of sorts—an important social activity—that people value and are not yet willing to give up. It is also an opportunity to physically experience the products, to assess quality, prior to purchase. Furthermore, it can be assumed that consumers, who are generally cautious—e.g., price sensitive—will still prefer lower priced and private brands and thus will search for sales, discounts, and special offers. Furthermore, the expressed needs for health and safety are likely to hold, including the increased propensity to buy locally sourced groceries and preferences for contactless payments. Our results also have marketing implications. For example, a shift in consumer buying—transitions from offline to online channels for some consumers but also the intention of other consumers to return into physical stores—calls for omnichanneling by the firms and indeed adaptations to the marketing mix more generally. Firms need to be present across a variety of channels (both offline and online) to optimize reach and access. Firms moreover need to align their communication strategies with consumers’ preferences, which can be achieved by appealing to safety, security, and value of the shopping experience within the physical store but also online. Such appeals would address the information needs of consumers to increase consumer confidence and reduce the perceived risks. This approach could build resilience by creating more informed consumers and more marketplace options to ensure access to goods and services during crisis and beyond it, enhancing a sense of control; it might also instil optimism/hope in the moment of crisis and about the future. The findings indicate the resilience of SMEs, actualized through managers’ selfefficacy, is significantly related to strategic investment responses. That is, more resilient firms have managers that tend to invest (more) in innovation, capacities, and human capital during pandemic. Top managers with high self-efficacy are thus fundamental to SMEs during crisis. Such higher resilience is further related to the firms’ strategic investment responses vis-à-vis new product introductions, operations capacity extension, and human capital management. These results have practical implications, namely, to maintain optimal levels of resilience, firms’ top managers need to be actively engaged in and committed to problem-solving and decisionmaking throughout the crisis. In this sense, synergy with governmental institutions needs to be achieved and maintained since SMEs may require support for innovations, capacity enlargement, human capital investments, possibly mergers and acquisitions, and potentially other adaptive practices as effective response strategies. This can be achieved by offering incentives and other forms of support that would help to retain the existing capacities and to stimulate effective crisis responses and future innovations in business processes—not only to satisfy customers but also to enhance the safety, security, and well-being of consumer groups, communities, and the Croatian society. Nevertheless, there are some bright best-practice examples of managing the pandemic in Croatia. For instance, government has financially supported companies

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and launched the campaign to raise the awareness of applying safety and social distancing measures. One unique and interesting example is the development of Andrija application (https://andrija.ai/). Andrija is a digital assistant based on artificial intelligence that helps to record and share data about virus spread. In addition, a new vaccination campaign is launched that promotes a website (https://cijepise. zdravlje.hr/) for citizens’ COVID-19 vaccination registration. Marketers are battling with the pandemic by establishing online shops that were not previously available, including the online orders of fruits and vegetables with door-to-door delivery. Companies that were not delivering before (e.g., restaurants) offered the service of take-out or door delivery. Other companies mostly managed the pandemic via TV advertising (e.g., beer companies, Karlovačko) appealing to humor and social distancing measures, while others opened virtual banking stores (e.g., Addiko Bank), and provided retail click-and-collect (e.g., Pevex) or free delivery supported by free grocery items (e.g., Podravka). Some companies offered free data transfer and educational channels (e.g., A1 telecommunication). Lastly, we recognize research limitations, particularly in the convenience sampling in both consumer and SME surveys. Future research should include a more representative sample of Croatian market agents and explore more personal/consumer characteristics; it should include other business sectors, with some emphasis on the extent to which and how those firms innovate as a response to pandemic and the perception of consumers regarding those innovations and related strategies. These and other research foci can build on this study and further expand our understanding of resilience during pandemics and potentially other crises.

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Dario Miočević (Ph.D.) is Associate Professor of Marketing at Faculty of Economics, Business, and Tourism, University of Split, Croatia. Dr. Miočević’s research focuses on export marketing strategy, strategic marketing issues, international consumer behavior, and industrial marketing. So far, he has published his research in outlets such as Industrial Marketing Management, Journal of International Marketing, International Marketing Review, International Journal of Advertising, Journal of Small Business Management, Journal of Purchasing & Supply Management, Journal of Hospitality & Tourism Research, International Journal of Consumer Studies and Journal of Business & Industrial Marketing among many others. Ivana Kursan Milaković (Ph.D.) is an Assistant professor at the Department of Marketing, at the Faculty of Economics, Business, and Tourism, University of Split, Croatia. Her main research interests encompass consumer behavior, marketing communication, advertising, brand marketing, and e-commerce. She has published in several international and domestic journals, such as International Journal of Advertising, International Journal of Consumer Studies, The Service Industries Journal, Electronic Commerce Research and Applications, Market, Economic Review, and Economic Research. Biljana Crnjak-Karanović (Ph.D.) is a Professor of Marketing at Faculty of Economics, Business, and Tourism, University of Split, Croatia. Her research interests are in international marketing, strategic marketing issues, and business ethics. She has published in the Journal of Business Ethics, Industrial Marketing Management, Journal of Small Business Management, EuroMed Journal of Business, International Journal of Business and Emerging Markets, among others. Mirela Mihić (Ph.D.) is a Full Professor at the Department of Marketing at the University of Split, Faculty of Economics, Business, and Tourism. Her major research interests include consumer behavior, marketing communication, and personal selling. Prof. Mihić is an author of two books and a larger number of scientific papers. She has published in several journals such as Economic Research and The Service Industries Journal. Prof. Mihić has participated in conduction of training programs for entrepreneurs, sales/purchasing personnel as well as tourist guides and representatives. For that purpose, she has created several expert guides. Antonija Kvasina is a Teaching Assistant at the Department of Marketing and a Ph.D. student at the Faculty of Economics, Business, and Tourism, University of Split, Croatia. Her main research interests include international marketing, international consumer behavior, and entrepreneurial marketing strategies. She has published in several international and domestic journals, such as International Journal of Consumer Studies, Management, and Market. She is a co-founder of an entrepreneurial venture Nalivpero d.o.o., owners of brand 757 Natural Cosmetics.

Chapter 9

Finnish Response to the First Wave of COVID-19 Accentuated Persuasion Petteri Repo, Pia Polsa, and Päivi Timonen

Abstract While the first confirmed case of COVID-19 had appeared in Finland at the end of January 2020, the first wave of the pandemic remained less serious in Finland than in other European countries. In this chapter, we look at how Finnish society responded to and acted during the first wave of the pandemic, which lasted until June 2020. We review key societal and political responses within a systemic framework focused on community well-being and individual quality of life (QOL), as proposed by Shultz et al. (The handbook of community well-being, Springer, 2017, pp. 403–422). The government led the Finnish response, and their actions prompted dramatic restrictions on the freedom of personal movement and new labor market arrangements. Additionally, significant financial support was given to businesses. Schools went online, as did many workplaces. While people at times expressed uncertainties about the effects of these responses, the actions resulted in fewer deaths and less of a drop-in economic activity than in other European countries. Persuasion rather than “command” was the central characteristic of the Finnish response. Examining the process and outcomes within the well-being framework highlights the way in which goods and services as well as recreational and cultural opportunities can be provided to citizens and consumers and where the government should focus their attention during this and future pandemics or public health emergencies. Keywords Finland · COVID-19 · Persuasive governance · Citizen engagement · Community well-being

P. Repo (*) · P. Timonen University of Helsinki, Centre for Consumer Society Research, Helsinki, Finland e-mail: petteri.repo@helsinki.fi; paivi.timonen@helsinki.fi P. Polsa Department of Marketing, Hanken School of Economics, Helsinki, Finland e-mail: pia.polsa@hanken.fi © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_9

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Introduction

Finland was among the first European countries hit by the COVID-19 pandemic after a Chinese tourist from Wuhan tested positive on January 29. Finland adopted dramatic policy measures that became common standards throughout Europe, such as closing off the country, shutting down many key activities, and limiting the gathering of people. As in other countries, there was obviously much uncertainty about how to handle the pandemic and how it would impact health, social life, and the economy. In retrospect, the measures taken in Finland during the first stage of the pandemic should be considered successful since the health system did not become overstrained, the death rate remained low, social life found new forms, and the economy suffered less than initially feared. The Finnish response to the pandemic was distinct in at least one respect: it was led by a government characterized by a young generation of female ministers who seemed to be in touch with the everyday lives of the population. Prime Minister Sanna Marin, for instance, became known for her clear and relatable communication style. When the more densely populated and virus struck Uusimaa province was reopened after having been closed off from other parts of Finland due to the rapid spread of the virus, Marin underscored that it still was not a good time to visit cottages (Sutinen et al., 2020). Cottages are characteristic of the Finnish way of life, and Finns travel to their cottages in great numbers especially during spring and summer. Visits to cottages are a seasonal tradition and offer the chance to be close to the nature, even though they in many ways have become modernized second homes. School buildings were shut down entirely, and schooling moved online. Tens of thousands of schoolchildren began attending video classes and conferences almost overnight in what was a gigantic test of the functioning and inclusiveness of the information society. The information society proved successful in this respect, and schooling also became a family matter in new ways as parents of young children became part-time school and computer assistants when working from home or after having been temporarily laid off. Closing schools entirely would have been unheard of in Finland, which is proud of its free schooling system; schools even offer free warm meals to schoolchildren, and Finns generally view education as a way of moving up socially and economically. In this new digital environment, the government held a live children’s press conference, which was broadcast on national television, radio, and the Internet. In the conference, children posed questions to key government ministers. The ministers answered the questions in a factual and appreciative manner. When one schoolchild named Valdemar asked if it was fair that some can sleep longer than others in distance learning, Prime Minister Marin acknowledged that it is not fair and that she sometimes feels the same way when going to early meetings, but she reminded him that it is part of the job and that schoolchildren’s job is to go to school and learn even if over a remote connection (Harjumaa & Björksten, 2020). Fairness and practicality are indeed keyways by which Finns assess changes, however dramatic. Minister of Education Li Andersson further explained that everyone advances in

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school with help from the teacher and that she is pretty sure that everyone needs to wake up early by turns just who must wake up early, and when, would likely even out in the long run. Minister of Science and Culture Hanna Kosonen chimed in that there is no trip to school in distance learning, which probably affords students a little more time for sleep, and she emphatically added that sometimes mornings are difficult also for her. While symbolic and community building efforts certainly are important when supporting the morale of a nation in times of distress, there is much more to such efforts than what meets the eye. Finnish society is arranged institutionally according to a “Nordic” model, which is characterized by the market economy complemented by a welfare state funded through taxation. The model has traditionally aimed to secure individuals’ rights, promote social mobility, and stabilize the economy. Welfare is inclusive in the sense that, for instance, education and health care are free of charge or provided for nominal fees to all citizens. Collective agreements play an important role in the labor market and are accompanied by state welfare policies and arrangements. Further, Finland has not experienced any internal social divisions that would have led to systematic acts of violence or terrorism in the era following the Second World War. This means that no legal framework was in place to limit individual liberties quickly and exhaustively. Accordingly, the Finnish response to the pandemic relied heavily on recommendations, argumentation, and support from governmentally funded systems—persuasion became dogma in governance. In this chapter, we examine the Finnish response to the first stage of the pandemic through the quality of life (QOL) framework proposed by Shultz et al. (2017). This framework is particularly useful for assessing the response from a macro-societal perspective, which extends beyond health matters to consider the societal functioning of catalytic institutions and marketing systems. It also allows for examination of how these institutions and systems optimally can serve citizen-consumers and their quality of life in times of distress. We next describe the QOL framework in relation to Finnish society and discuss how its components can be applied to our analysis of the COVID-19 responses in Finland. We then identify key responses from the perspective of Finnish citizenconsumers and reflect on how they contribute to QOL. In the concluding section of the chapter, we discuss our findings and how they relate to factors contributing to QOL in Finland.

9.2

The QOL Framework and the Finnish Response

The QOL framework (Shultz et al., 2017) is applied to provide a structure for the analysis of community well-being in Finland during the era of COVID-19 (see Fig. 9.1). Finland is a small, western, industrialized country with a population of 5.5 million and a low population density. It is politically and legally organized according to a Nordic social and economic model, which incorporates a comprehensive welfare state, high spending on human capital (i.e., education, childcare, and

Fig. 9.1 The QOL framework (Shultz et al., 2017) applied to the Finnish COVID-19 response

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R & D), and strong labor unions and employer associations (Andersen et al., 2007). Economists have argued that while this model has served Finland well in the past, it is increasingly being strained by economic and social trends such as globalization and an aging population (Andersen et al., 2007). The added burden caused by the international pandemic must now be considered as well. In sociocultural terms, Finland belongs to the northern European cultural cluster, which is characterized by low power distance, high femininity, medium individualism, and high uncertainty avoidance (Hofstede, 2001). Further features include medium performance orientation, low to medium future orientation, medium assertiveness, high societal institutional collectivism, and medium power distance (House et al., 2004). The Lewis model of culture, additionally, highlights pragmatism, characterizing Finns as factual decisive planners who operate discreetly and effectively (Lewis, 2006). The Finnish educational level is high, and students perform well in international comparisons (OECD, 2020a). Education is highly valued in Finland and seen as a way to advance socially. Finland is also one of the most transparent and accountable societies in the world when measured in terms of people’s access to political rights and civil liberties (Freedom House, 2020), governance, personal freedom and social capital (Legatum House, 2020), and perceived lack of public-sector corruption (Transparency International, 2020). Indeed, factors relating to life evaluation, social support, freedom, and lack of corruption make Finland a regular top performer in the World Happiness Report (Helliwell et al., 2020). Curiously, Finns and other Nordics do not rank high in generosity when measured by how much money people donate to charity. It has been proposed that other forms of prosocial behavior, such as volunteering, make up for this (Martela et al., 2020). The Finnish economy and consumer society have advanced rapidly during the postwar period. Economic globalization and European integration have provided lucrative opportunities for its small and open economy. While many types of production have been moved to other countries or abandoned altogether, Finnish companies have become world-class performers especially in information and communication technology, engineering, and forestry industries. Although the Finnish marketplace is small and the country peripherally located in Western Europe, access to services and products is high due to the European Single Market and globalized economy. The choice and variety of brands and goods might be lower than in larger marketplaces, but they are traditionally of high and uniform quality, which has been enhanced by an active consumer policy and protection. Many services offered on the private markets in other countries are provided in Finland publicly in a comprehensive manner. Both health-care and educational services are free or quite affordable for Finnish citizens. There are no tuition fees during primary and secondary school studies, and university studies are free of charge even for citizens from other European Union countries. Health care, on the other hand, is offered on both public and private markets, providing choice for customers. Public transport is frequently used in both urban and rural settings.

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In Finland, per capita gross domestic product was 48,700 USD in 2019 (World Bank, 2020), placing Finland 16th in the world and above the EU and OECD average (OECD, 2020b), yet still behind the other Nordic countries. European integration has challenged market arrangements and how consumers perceive of such arrangements in the Nordic countries (Repo & Timonen, 2017), but access to the European Single Market has standardized market activities and offerings. When coupled with publicly provided, high-quality services, such as education, day care, and health care, the economic position of Finnish consumers is quite good. The strong solvency of domestic financial institutions proved an additional asset when consumers and businesses needed flexibility in managing their finances during the pandemic. In the Finnish market economy, and especially during the COVID-19 pandemic, the government and businesses in particular operate as catalytic institutions. While Finland has numerous NGOs, their focus is more on civil society, and when they do provide services, the services support public services rather than complement them. There is one major exception to the relatively minor role of NGOs as catalytic institutions: the Finnish labor system is corporatist, meaning that labor unions and employee associations determine working conditions to a large degree. During the first wave of the pandemic, catalytic actions connected to these institutions were central when coordinating the Finnish response. The government took the lead in not only safeguarding the public but also in supporting business life and labor market arrangements as well as in securing the continuity of schooling. Correspondingly, businesses focused on securing the provision of services and goods, while labor market NGOs focused on reformulating working conditions during the pandemic. Nevertheless, other NGOs and local businesses were also active catalytic institutions, with varying degrees of success. Local businesses and the NGOs backing them faced various challenges. Restaurants and the tourism industry, for instance, coped better in terms of support than local gyms and the cultural sector. Overall, though, businesses and industries that expressed their viewpoints through NGOs or the media were able to better initiate changes in market systems. Government, in turn, was required to follow up on NGO and business responses when balancing health concerns with societal and business interests. In this respect, governance by persuasion requires being in touch with those being affected. Analysis of the efforts to serve citizen-consumers puts added focus on the activities of catalytic institutions and marketing systems (Layton, 2019; Shultz et al., 2017). It further contrasts notions that citizens or consumers should serve rather than be served by society in times of distress (Lammi et al., 2013). Accordingly, individuals are served by institutions and markets both as citizens and consumers. The COVID-19 pandemic has made it increasingly clear that the analytical traditions of approaching influence and loyalty in the economic and political domains need to be considered in parallel when establishing society-wide responses. Further, a macro-approach, as opposed to one focusing on individual consumers, helps to address major concerns regarding consumption, which often are of a systemic and complex nature (Sandberg & Polsa, 2016).

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Even if an assessment of whether societies are distressed or flourishing is to some degree subjective and premised on certain values (Shultz et al., 2017); the QOL framework and accompanying international indicators (Statistics Finland, 2020a) clearly reveal that Finland has transformed from a distressed society to a flourishing one during the postwar era. The next section provides an analysis of how the Finnish type of flourishing community responded to the COVID-19 pandemic in its early stages.

9.3

A Finnish Perspective on COVID-19

How did Finland perform in its response to the first wave of the pandemic compared to other Nordic and European countries facing a similar situation? It appears that Finland performed quite well in this comparison, although there were acknowledgeable shortcomings in the accuracy and comparability of information, especially during the first wave of the pandemic from January to June 2020. For instance, it was difficult to assess the spread of the pandemic because of limits in the capacity of testing facilities, which also made it troublesome to determine the effects of policy responses to the pandemic. Nevertheless, the number of deaths and developments in gross domestic product (GDP) can be considered comparable, albeit crude, figures from across Europe. The Finnish death rate remained low, as did the decline in GDP. It is noteworthy that Finnish figures were close to those of the other Nordic countries, with the notorious exception for Sweden, which accentuates that national differences do persist between countries adhering to the Nordic social and economic model. Sweden indeed adopted a differing policy response path, which is discussed in another chapter in this book. It quickly became clear that the established procedures for handling pandemics were not sufficient to address the uniqueness of COVID-19. Accordingly, governance needed to adapt, further underscoring its reliance on persuasion. Persuasion not only took the form of suggesting desired behavior for citizen-consumers, civil society, and business life but also helped to alleviate shortcomings in legal arrangements and made it easier for catalytic institutions and markets systems to find consensus-based solutions. Further, opting for persuasion instead of control was less troublesome and burdensome to implement and monitor The Finnish response also evolved dynamically as knowledge about the pandemic grew.

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Fig. 9.2 Deaths caused by COVID-19 in selected countries and regions (cumulative deaths recorded after 100th death per 100,000 citizens) (source: Ala-Risku and Nurmela (2020); data from Finnish Institute of Health and Welfare, Johns Hopkins University, and Helsingin Sanomat)

9.3.1

Deaths and the Economy: It Could Have Been Even Worse

While the pandemic took a serious toll in Finland, the number of deaths remained low in an international comparison during the first wave of the pandemic. Figure 9.2 shows that cumulative deaths caused by COVID-19 grew rapidly at first, but they remained at a lower level than in many countries of reference. At the end of October 2020, the number of deaths caused by COVID-19 was 6.4 per 100,000 persons, which was well below the world average of 15.1, with Finland ranking 98th in global country comparisons and having fewer deaths than all 50 US states (Vermont was lowest with 9.3) (Worldometer, 2020). It needs to be acknowledged that there are differences between countries in how deaths caused by COVID-19 are recorded, but the trends in the country figures are nonetheless comparable. Mortality in Finland remained at a level only slightly above the 5-year average, which indicates that the response to the pandemic did not contribute significantly to deaths for other reasons or to deaths due to, but not recorded as, COVID-19 (Mäkeläinen et al., 2020). Similarly, GDP figures that would have been considered alarming under normal circumstances were low in international comparisons during the first wave of the pandemic. Indeed, Finland experienced the smallest drop in GDP of any country in Europe during the second quarter of 2020 (Eurostat, 2020a). The drop was 4.4%, while the European average was 11.4%, with the most seriously hit large European countries falling well below that number (Table 9.1). In additional international

9 Finnish Response to the First Wave of COVID-19 Accentuated Persuasion Table 9.1 GDP change between first quarter and second quarter of 2020 (sources: Eurostat (2020a) and U.S Bureau of Economic Analysis (BEA, 2020))

Country Finland Denmark Sweden Germany European Union, 27 countries France United Kingdom United States

189 Change, %
4.4
6.8
8.3
9.7
11.4
13.8
19.8
31.4

comparisons, the economy of the United States fell by 31.4% during the same period (BEA, 2020). Although the European economies differ from each other and Finland often tends to be affected by periods of slow growth later than other countries due to its economic structure and reliance on international trade, the figure was better than expected. The mildly positive economic outlook was echoed in the consumer confidence indicator, which experienced a significant drop in March 2020 but returned to levels matching the previous year already in April, and Finns were largely confident about their personal economy (Statistics Finland, 2020b). The gross debt of the Finnish government compared to GDP was projected to rise significantly from 59.3% to 68.7% between the last quarter of 2019 and the second quarter of 2020. These rates still remain below those for the Eurozone, though (84.0% and 95.1%, respectively) (Eurostat, 2020b).

9.3.2

From Disease Control to Macro-Societal Persuasion

The figures on deaths caused by COVID-19 and the rather low drop in GDP indicate that the Finnish response can be considered successful in international comparisons, since “flattening of the curve” occurred not only in terms of the spread of the pandemic but also in its negative economic impacts. The figures, however, provide only a limited view on the response, which was in many respects essentially a social one, with governance aimed primarily at instituting appropriate safety and security measures. Hence, the intrinsic relationship between society and markets merits particular attention. Indeed, the response to the pandemic had far-reaching effects on the everyday lives of individuals as citizens and consumers. In Finland, it became clear quite early on that previously successful procedures and legal frameworks for controlling the adverse impacts of serious global infectious diseases were inadequate as a response to the first wave of COVID-19. Attention then shifted to addressing macro-societal factors in distressed communities, taking into account the everyday behavior of citizen-consumers. At first it was considered particularly important to secure the number of sick beds in intensive care units, but

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very quickly the need to consider macro-societal factors became nearly equally important in the general response to COVID-19. The government took a leading role in responding to the pandemic, and focus shifted from a European approach to a national one. The Finnish government, operating as it does in a democratic and corporatist system, needed to persuade rather than command citizen-consumers, the civil society, and business life regarding ways that would contribute to an efficient response to the pandemic. Governance through persuasion differs from hierarchical top-down leadership and needs to appeal to shared norms, principles and values (Bell et al., 2010; Keohane, 2001). It reflects the notion that the government was not omnipotent, even though it had a pivotal role in the Finnish response to the pandemic. Accordingly, the Finnish government to a large degree issued recommendations and sought responses that civil society and markets were most apt to adhere to. When strictly binding measures were enforced in the early stages of the pandemic, they relied on the Emergency Powers Act and concerned education, health care, social welfare, the labor market, and movement to and from the temporarily closed province of Uusimaa. Further, the Border Act was used to regulate international traffic. Nevertheless, most of the government’s activities relied on restrictive recommendations and were based on the Communicable Diseases Act (Finnish Government, 2020). Governance through persuasion and recommendation is done in a way that acknowledges the quite sovereign roles of both citizens and consumers in contemporary Finland. Alternative responses could have relied on the power and expertise of hierarchies and networks while “nudging” people toward desired behavior, but this would have constituted a more covert approach. In this respect, accentuating persuasion in governance measures highlighted a commitment to people internalizing the new norms and personally committing themselves to behave differently (see Mols et al., 2015). Relying on persuasion also acknowledges people’s civic rights and that their choices as consumers matter. It was precisely these fundamental rights and choices, though, that the Finnish response to the pandemic would restrict. People were to apply social distancing, that is to say, they were expected to work and attend school from home and avoid social gatherings. The elderly especially needed to isolate themselves. As statistics on the restricted development of the pandemic in Finland show, these actions proved in retrospect to be successful, but successfully carrying them out required much persuasion and the reconfiguration of many kinds of social systems. Further, social distancing policies were accompanied by partial and temporary lockdowns, which not only affected how citizen-consumers were served but also had direct negative impacts on them as employees and small business owners. Accordingly, key macro responses to the pandemic in Finland also considered support for businesses as well as novel labor market arrangements.

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Dynamically Evolving Response

Initially, the government assessment was that Finland was well prepared to manage the pandemic and that the Communicable Diseases Act was sufficient for directing and implementing responses. The government devised plans and arranged for materials to address the pandemic, and hospital districts already had SARS and MERS corona-virus guidelines and contingency plans in place. Nevertheless, it quickly became clear that there were serious concerns about health-care capacity, if the COVID-19 outbreak were to escalate similarly as it was progressing in other European countries. Further, supplies of protective equipment were limited and partly outdated, and new supplies were not readily available on the international market. It was also difficult to obtain the substances needed to test for COVID-19. Here, the dual nature of the public-private health-care system also became evident as citizen-consumers used to low-cost health-care services reacted negatively when private health-care providers offered COVID-19 tests at market prices. In the latter stages of the response, a public-private partnership was formed with testing becoming free of charge. The Ministry of Social Affairs and Health began facilitating the efforts of municipalities, hospital districts, the Finnish Institute for Health and Welfare, regional state administrative agencies, and other ministries. Soon, the Prime Minister took a significant lead in operations, and in mid-March, a state of emergency was declared in Finland for a period of 3 months. Declaring a state of emergency is extremely uncommon in Finland and had previously been used as a response only in relation to conditions, namely, those in the 1940s and during the oil crisis in the early 1970s, but not as the result of a pandemic before. Prime Minister Marin opened the government’s press conferences on a regular basis by reporting on progress, proposals to Parliament, and decisions made by the government. The press conferences continued with other ministers and experts letting people know more about the details. A key turn in the Finnish response occurred when medical and health measures were no longer considered sufficient as responses to the pandemic. Focus shifted to keeping the society functional, and the connections between catalytic institutions and marketing systems and the citizen-consumers they serve became increasingly important. Alleviating distress in society, as embraced in the QOL framework, related both to the adverse effects of safe behavior in times of pandemic as well as to coping with a situation caused by a slowing economy. Provisioning consumers and citizens with services and goods became accentuated, while restricting their behavior at the same time was a key concern in the Finnish response to the pandemic. Macro-societal factors characteristic of Finland, such as the Nordic welfare state model, the emphasis on schooling, and the key role of labor unions and employers’ associations in determining working conditions, set the framework by which Finland formulated and implemented its response to the pandemic. This will be presented and discussed in the upcoming section.

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29.1. First observed COVID-19 case

25.6. Government press release: Coronavirus epidemic has calmed down in Finland – infections still possible

First recommendation on restrictions on public gatherings, 12.3 – State of emergency, 16.3 – 15.6 Distance work begins, 16.3 – Schooling switched online, 17.3–14.5 Major temporary changes on labor market, 20.3 – First major economic package, 20.3 – Closing of leisure travel to and from the Uusimaa province, 28.3.–19.4 Closing of restaurants, 4.4.–31.5 Fig. 9.3 Timeline of Finnish responses during the first wave (January–June 2020)

9.3.4

Key Macro-societal Responses in Finland

Much of the focus in the Finnish response was on the health-care system. In Finland, public health care is complemented by private health care, including occupational health care, which required coordination when testing for COVID-19. As the Finnish response to the pandemic expanded beyond health-care to macro-societal activities, other characteristics of the Nordic economic and political model were affected. Provisioning the population with services and utilities was a high priority, while labor market arrangements eased social and economic well-being and distance education was temporarily implemented as well. Other key responses related to the economic and recreational well-being of people, which had been stressed by the pandemic and subsequent restrictions on social and working life. Figure 9.3 provides an illustrated timeline of the Finnish responses during the first wave of the pandemic, which took place in Finland between January and June 2020. The activities listed in the figure are presented and discussed in greater detail in connection to Table 9.2. In Table 9.2 we summarize a review of how the design of the responses in key provisioning systems as well as their determinants of success and shortcomings affected outcomes from the perspectives of community well-being and individual quality of life. Since the Finnish government took a leading role in formulating and

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Table 9.2 Key macro-societal factors and their connections to the Finnish response Provisioning systems 1. Provision of services and utilities

Response to pandemic Business as usual
Extensive public health-care system
Shops, malls, and public transport remained open
No shortages in utilities and health care

2. Labor market arrangements

Flexibility in labor market
Telecommuting
Lay-offs made easier
Annual leaves more flexible
Unemployment benefits extended to entrepreneurs

3. Education in a welfare state

Distance school
Schools and universities closed
Take-away school lunches

Determinants of success
Sufficient capacity of overall healthcare system and intensive care
Long opening hours for shops in the grocery sector
Special shopping hours for risk groups
Relatives, friends, and neighbors helped with shopping
Public transport remained operational
Employees were advised to work remotely by government
Easier and quicker access to unemployment benefits were developed
Entrepreneurs became entitled to unemployment benefits
Special arrangements were made for essential foreign guest workers
Teachers and schoolchildren already used ICT tools
Online teaching systems, broadband connections, home computers prevalent

Shortcomings of responses
Limited capacity for COVID-19 testing
Restaurants and nightclubs were closed
Home care services were potential COVID-19 carriers
Public transport under financial stress

Community wellbeing and individual QOL
Health care remained accessible and affordable
The grocery trade grew as food was prepared at homes
Shifting to takeaway was difficult for restaurants
Shared responsibility for the elderly, home care services under stress


Difficulties in balancing family and working life
Border crossing difficult for guest workers, need to stay in Finland


Better continuity of employment
Financial stability through unemployment benefits
Increasing appreciation for small businesses
Recognition of guest workers improves
Acknowledgment of crossborder workforce


Distance education was particularly difficult for some children
Not all parents could help with distance learning


Children could continue to go to school, see classmates, and have a rhythm to everyday life
Families working and being together increased (continued)

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Table 9.2 (continued) Provisioning systems

Response to pandemic

Determinants of success

4. Financial flexibility

Financial support for people and businesses


Parents helping schoolchildren and serving lunches
Deferrals of mortgage and debt repayments
Interest rate regulation for consumer credit
Subsidies for businesses

5. Recreation and cultural life

Cancelation of public events and cultural activities accompanied with international travel restrictions


Most indoor recreational facilities were temporarily closed
Banning of celebrations and festivals
Expats were asked to return to Finland

Shortcomings of responses


Repayment of loans slowed down
Access to the credit market was blocked for low-income earners
Businesses not always sure of the kind of support they could apply for
Social exclusion of all and especially the elderly
Insufficient capacity of outdoor recreational facilities and services
Lack of COVID-19 control of international arrivals

Community wellbeing and individual QOL


Household consumption levels remained in place
Consumer confidence in one’s own economy returned to the longer term average
Slump in production especially in services


People flocked to outdoor activities and local nature sites became very popular
Enthusiasm for gardening, cottage life, fishing, and hiking in national parks
Leisure time was spent at home and holiday travelling was postponed

achieving responses to the pandemic, we reviewed its official communications, which were frequent and communicated also to the public at large (Appendix 1). Targets and challenges, as well as desired behavioral changes, are well documented in the examined press releases. The assessments of impacts on community wellbeing and individual QOL are our own. While some of the characteristics of the responses are described at a detailed level, our aim was to assess the responses at a macro-societal level. In the early stages of the pandemic, there were concerns about the provision of services and utilities. Much effort was put into securing the capacity of the extensive public health-care system and intensive care units, which managed well despite shortcomings in COVID-19 testing. In general, access to health care remained good and at affordable costs for citizen-consumers.

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In addition to keeping the health-care system fully functional, businesses were expected to serve people without additional interference: shops and malls could remain open and public transport was not cut back. Very early on in the pandemic, the government stressed that there was no need to hoard excessive amounts of food or other products, as the domestic provision of products and services would continue and international goods could enter Finland despite the travel restrictions. The government wanted to ensure access to consumer goods and medicine and prevent economic activities in society from stagnating. Overall, Finland experienced no major shortages in utilities and health care. Many people also postponed their regular health-care visits. Health-care resources were shifted to testing and intensive care facilities to better manage in a difficult situation as well as to prepare for the potential successive waves of the pandemic. The long opening hours for shops in the grocery sector enabled special shopping hours for risk groups and decreased the number of simultaneous shoppers. Neighbors and relatives also helped elderly people isolated at home with their shopping. Key shortcomings related to the limited capacity for COVID-19 testing, the closing of restaurants, significantly reduced revenues for public transport systems, and home care services potentially spreading COVID-19 to risk groups. With respect to community well-being and individual quality of life, it was essential that health care remained accessible and affordable. Preparing meals at home became common after most lunch canteens and restaurants closed their doors and at the same time found it difficult to shift to take-away orders. Home care services worked under stress, and relatives shared greater responsibility for the elderly than before. Significant new labor market arrangements were introduced as a response to the pandemic. First, telecommuting was recommended when possible. Second, greater flexibility in the labor market was successfully negotiated with labor unions and employers’ associations. Layoffs were made easier, annual leaves made more flexible, and unemployment benefits extended to entrepreneurs for a fixed term. A corporatist labor market culture as well as a good infrastructure that facilitated telecommuting were key determinants of success for such arrangements. In sectors considered critical to society, the number of working hours for personnel was not limited, and holidays were postponed. The government made special arrangements for essential foreign guest workers, especially for those in agriculture and construction. As shortcomings, there were difficulties in balancing family and working life, particularly for families with children. In addition, guest workers could not cross the borders and were required to stay in Finland. In terms of community well-being, these responses provided better continuity of employment, with workers being temporarily laid-off instead of made permanently redundant. Businesses in turn could reduce their expenses while waiting for better times. Additionally, the recognition of guest workers and acknowledgment of the importance of a cross-border workforce increased. The accentuated role of education in the Nordic welfare state is a macrosocietal factor that had a key impact on the Finnish response to the pandemic. The Nordic welfare model is characterized by comprehensive, nearly free-of-charge

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education and universal childcare. Education is then a key instrument to achieve social justice and security, and high-quality education is provided to all citizens. Private schools are not allowed to make a profit, and their costs are instead fully tax-subsidized, which is reflected by that Finland performs quite well on the socioeconomic inclusion index for compulsory schooling (Lundahl, 2016). In response to the pandemic, day care centers, schools, and universities were closed in mid-March, and the government recommended that children be cared for at home and that teaching be shifted to digital learning environments. Day care was provided for children whose parents worked in critical sectors of society. Providing education through digital learning environments proved a workable solution because both students and teachers already had quite good IT skills, and broadband connections as well as computers were prevalent in households across the country. Free warm lunches are a key feature in Finnish schools, and municipalities provided schoolchildren with lunches as take-away meals, food bags, and shopping vouchers. Not all was upbeat, though. Distance learning was difficult, in particular for schoolchildren who needed the physical presence of and interaction with teachers and other schoolchildren. Further, not all children had the assistance of parents who could help them with their schooling. Indeed, issues relating to equality in education and concerns about some children falling behind contributed to opening up schools for the final 2 weeks before summer. Financial flexibility was provided to households and businesses both in the form of government support and through the business activities of financial institutions. Government support was provided to businesses for product development in general and to restaurant and tourism businesses specifically. Banks operating in Finland were solvent and were able to give households deferrals on mortgage payments and arrange for corporate loan payments. In addition, a new ten per cent temporary interest rate limit for consumer credit was prepared and introduced. These actions also made the shortcomings of the financial system visible. Businesses were not always sure about what kind of support they could apply for and criticism leveled that the support in any case was insufficient to cover the losses caused by the pandemic and the responses to it. Deferrals on mortgage payments and interest rate caps on consumer credit highlighted household overindebtedness. Nevertheless, securing access to finance had positive impacts for community wellbeing and individual quality of life. Household consumption levels remained in place and consumer confidence in one’s own economy returned to the long-term average, even though there was a slump in production, especially in services. Recreation and cultural life were seriously affected by the pandemic response. The cancelation of many public events and cultural activities, accompanied by travel restrictions, seriously affected the everyday lives of people. Even family parties at people’s homes ended up being canceled, not to mention that indoor recreational events at libraries, theaters, concert halls, and sports facilities were temporarily halted. These restrictions meant social exclusion for all, and especially the elderly felt isolated. Some social activities were postponed or shifted online. Cities had insufficient capacity to accommodate all who wanted to make use of outdoor recreational facilities and services, especially on weekends. As one means of

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enhancing quality of life, local nature sites became quite popular and people flocked to such spots to engage in outdoor activities. Enthusiasm grew for gardening, cottage life, fishing, and hiking in national parks as a result of many people needing to spend more leisure time at home and postpone their holiday travels. Amidst international travel restrictions, the government made the curious effort of asking expats return to Finland, only for them to land at an airport lacking proper COVID-19 controls and the advisory capacity to guide arrivals. The fields of recreation and cultural life offer two contradictory examples of how to induce catalytic change in marketing systems. A successful example can be observed in the activities of the Finnish Hospitality Association (MaRa), which represents a wide range of companies, such as hotels, restaurants, amusement parks, tourism businesses, congress organizations, and wellness service providers. This NGO offered views and suggestions through media and other channels concerning cost support for companies, subsidies for reemployment, compensations for restrictions, bankruptcy prevention, moderating restrictions on gatherings, and providing support for domestic tourism, just to name a few examples. Indeed, the summer season following the first wave of the pandemic turned out quite well for many of the smaller businesses in these industries in Finland. Fields such as event planning and the theater, in contrast, were not as successful in catalyzing change under the same circumstances, and they have consequently suffered in the long term. Overall, the observed key macro-societal responses to the pandemic, as presented in Table 9.2 and discussed above did have negative effects on community well-being and perceptions of individual quality of life. Our assessments of the effects of the responses concern the first wave of the pandemic and indicate that much distress was alleviated in the everyday lives of consumers; the effects of the pandemic on community well-being and individual quality of life in general would have been much more dramatic if the health system and economy had collapsed. The responses arguably also took their tolls on well-being and quality of life, and not all people received equal treatment. People who were laid off and risk groups who were socially isolated suffered especially. Further, large groups of people, such as families with young children, people already underprivileged or in difficult situations, and migrant workers, needed to find new and often strenuous ways to cope in their everyday lives. The pandemic not only created new hardships but also made existing ones more visible. Facing difficulties is also a subjective phenomenon, which is beyond the scope of our analysis.

9.4

Discussion and Conclusions

Finland was among the first countries in Europe affected by the COVID-19 pandemic, but while it dramatically affected human health, economic activity, and social life, Finland somehow managed to cope better than many other European countries in an uncharted situation. Indeed, Finland could arguably have handled the first wave of the COVID-19 pandemic much less successfully, as the health-care system

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remained intact and the economy slowed down less than many feared. International debates on the pandemic were at times polarized between the options of saving lives or saving the economy, and Finnish debates made note of this already because the neighboring country of Sweden took a less restrictive response to the pandemic. Suppressing the pandemic rather than enduring it became a response strategy, and it turned out that “flattening the curve” was achieved both with respect to growth of the pandemic and decline of GDP. The QOL framework proposed by Shultz et al. (2017) has guided us in being systematic and comprehensive in our analysis of the Finnish response to the first wave of the pandemic. In particular, it provided legitimacy for looking beyond health and the economy by giving focus to both society and markets and how they serve citizen-consumers. The latter feature contradicts a top-down governance model in which servitude is expected from citizen-consumers. Overall, the QOL framework aptly highlights that responses take place within societal and marketing systems, thereby implying the complexity of making international comparisons. Nevertheless, any framework or research design retains a scope and may be complemented by additional analysis and reflection. For instance, the social distancing and health conventions adopted in Finland already in the 1920s due to tuberculosis seem eerily familiar in the current situation. The Nordic social and economic model as it is institutionalized in Finland provided the setting that shaped responses to the pandemic. The response by the Finnish government especially prioritized the targets of ensuring that the health-care system society and markets at large continued to function adequately. New arrangements, which in normal times would have been considered extraordinary, were quickly adopted especially with respect to the labor market. Schooling in a sense followed the more conservative idea of resilience, although it became technically extraordinary by shifting temporarily to an online format. Financial support was given to people and businesses, which led to a considerable budget deficit and increasing national debt, but still policy makers generally approved of such support by significant margins in political debates during the first wave of the pandemic. Recreational life and cultural activities suffered and changed because of social distancing. Nevertheless, the pandemic showed that Finland had socially and technologically agile structures capable of adapting to the situation at hand. It must be noted, however, that many adverse effects beyond the scope of this chapter certainly also occurred. In terms of governance (see Bell et al., 2010), persuasion was accentuated in the Finnish response probably due to uncertainty about the pandemic and how effectively measures could be implemented and citizen-consumers engaged in a feasible manner on short notice. The urgency of the situation put governance under great stress, and traditional political negotiation gave way to consensus building in catalytic institutions and marketing systems (as expressed by Shultz et al., 2017). These institutions and systems indeed managed to adapt the Finnish version of the Nordic social and economic model in a remarkably quick way to the crisis at hand. For instance, dramatic changes in the legal basis for lay-offs were presented by the government to the parliament after having been proposed only 8 days before by the

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key employees’ associations and trade unions. Not all was harmonious, though, and smaller NGOs and local businesses experienced varying degrees of success in acting as catalysts for changes in marketing systems. The ability to catch such nuances is an indication of the versatility of the QOL framework. Such versatility is called for when attempting to address complex activities that challenge hierarchical models of governance. The government also focused its efforts at persuasion on directing the behavior of citizen-consumers and in many respects by giving guidance on how to act safely. While it can be argued that an inherent weakness exists in attempting to persuade rather than coerce people to change their behavior due to the lack of serious sanctions, persuasion has the major strengths of causing people to accept new behavior without feeling that they have compromised their civic rights. When successful, it also alleviates needs for a laborious and costly system of penalties. Whether or not the Finnish experiences will prove applicable to and successful in other settings remains an open question. The encountered situations as well as the institutions and market systems arguably both enable and limit the responses that can be achieved in times of pandemic. Nevertheless, we maintain that addressing economic issues quickly after securing a functional health-care system is one type of response that policy makers in other settings could benefit from. Overcoming the polarized and even unsuitable option of choosing between health and the economy is a key priority, one which further directs attention to a wide range of social issues. While there is concern that any upcoming waves of the pandemic might prove us wrong, at the time of writing Finland is still coping well compared to other European countries. Acknowledgments The authors are grateful for the constructive comments provided by professors Elizabeth Shove and Frank Trentmann for this chapter.

Appendix 1: Selection of Government Communications on the Pandemic in Finland Provision of Services and Utilities • Recommendation to the employees and employers of healthcare and social welfare services and educational institutions in the coronavirus situation, 12.3.2020. • Minister of Employment Tuula Haatainen: No disruptions in the supply of daily consumer goods, 13.3.2020. • Restaurants closed to customers, ordering takeaway permitted, 24.3.2020. • Ministry of Social Affairs and Health gives instructions to municipalities on home care services during the coronavirus outbreak, 31.3.2020. • People have equal access to services in the coronavirus situation—everyone has access to the help and care they need, 3.4.2020.

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Arrangements on Labor Market • Employees in sectors critical to the functioning of society, 17.3.2020. • Notice period for temporary lay-offs and the duration of co-operation negotiations will be shortened due to COVID-19, 26.3.2020. • Working group on essential work-related travel and other traffic appointed to assess the need for workers’ entry into country in the state of emergency, 26.3.2020. • Legislative amendment extends employees’ right to unemployment benefit during lay-off and provides easier and quicker access to unemployment benefit, 31.3.2020. • Government wants to speed up processing of unemployment benefit applications, 27.4.2020. • Situation report: lay-offs buffer unemployment growth, financial support for businesses prevents bankruptcies, 28.5.2020.

Education in Welfare State • The dates of the matriculation examination tests in humanities and sciences will be brought forward by 1 week due to the coronavirus situation. 13.3.2020. • Government policy recommendations for providers of early childhood education and care, pre-primary education, primary and lower secondary education, general upper secondary education, vocational education, higher education, liberal education and basic art education in order to slow down the spread of coronavirus infections, 16.3.2020. • Government decides to lift the restrictions on early childhood education and care and on primary and lower secondary education, 29.4.2020.

Flexibility of Finance • Member states urge Nordic Investment Bank to increase lending, 27.3.2020. • EUR 2000 in operating support for sole entrepreneurs in the coronavirus situation—application to open as soon as possible, 31.3.2020. • Government proposes additional funding to address impacts of coronavirus on culture and sport sectors in its second supplementary budget proposal, 8.4.2020. • Finnvera’s financing authorisations increased in response to the coronavirus— additional funding EUR 10 billion, 23.4.2020.

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Recreation and Cultural Life • Prohibiting public events in Finland: Ministry of Social Affairs and Health sent guidelines to the regional state administrative agencies, 12.3.2020. • If you are travelling abroad, return to Finland! 14.3.202. • Advice for the over-70s on protecting themselves from the coronavirus, 19.3.2020. • Movement restrictions to Uusimaa—the Government decided on further measures to prevent the spread of the coronavirus epidemic, 25.3.2020 Minister of the Interior Ohisalo: This year, we will celebrate vappu at home.

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Helliwell J.F., Layard, R., Sachs, J.D. & De Neve, J.-E. (Eds.) (2020). World happiness report. Retrieved October 29, 2020, from https://happiness-report.s3.amazonaws.com/2020/ WHR20.pdf Hofstede, G. (2001). Cultures and consequences, comparing values, institutions and organizations across nations. Thousand Oaks. House, R. J., Hanges, P. J., Javidan, M., Dorfman, P. W., & Gupta, V. (Eds.). (2004). Culture, leadership, and organizations. The GLOBE study of 62 societies. SAGE Publications. Keohane, R. O. (2001). Governance in a partially globalized world" Presidential Address"," American Political Science Association, 2000". American Political Science Review, pp. 1–13 Lammi, M., Repo, P., & Timonen, P. (2013). Consumerism and citizenship in the context of climate change. In R. Worthington, M. Rask, & M. Lammi (Eds.), Citizen participation in global environmental governance (pp. 141–154). London. Layton, R. (2019). Marketing systems - Looking backward, sizing up and thinking ahead. Journal of Macromarketing, 39(2), 208–224. Legatum House. (2020). The legatum prosperity index 2019. Retrieved October29, 2020, from https://www.prosperity.com/globe#FIN Lewis, R. D. (2006). When cultures collide: Leading across cultures (3rd ed.). Nicholas Brealey International. Lundahl, L. (2016). Equality, inclusion and marketization of Nordic education: Introductory notes. Research in Comparative and International Education, 11(1), 3–12. Martela, F., Greve, B., Rothstein, B., & Saari, J. (2020). The Nordic exceptionalism: What explains why the Nordic countries are constantly among the happiest in the world. In J. F. Helliwell, R. Layard, J. D. Sachs, & J.-E. De Neve (Eds.), World happiness report 2020. Sustainable Development Solutions Network, United Nations. Mäkeläinen, M., Martti, E. & Pietarinen, E. (2020, September 12). Koronakuolemia on virallisesti 900 000, mutta totuus on karumpi – Katso, miten kuolleisuus eroaa Suomessa, Ruotsissa, Espanjassa ja muissa maissa (There are officially 900.000 corona deaths, but the truth is more severe – See how mortality varies in Finland, Sweden, Spain and other countries). Yle.fi, Retrieved October 29, 2020, from https://yle.fi/uutiset/3-11516123 Mols, F., Haslam, S. A., Jetten, J., & Steffens, N. K. (2015). Why a nudge is not enough: A social identity critique of governance by stealth. European Journal of Political Research, 54(1), 81–98. OECD. (2020a). PISA 2018 results. Snapshots of students’ performance in reading, mathematics and science. Retrieved October 29, 2020, from https://www.oecd.org/pisa/PISA-results_ ENGLISH.png OECD. (2020b). Gross domestic product (GDP). Retrieved October 29, 2020 https://data.oecd.org/ gdp/gross-domestic-product-gdp.htm Repo, P., & Timonen, P. (2017). Regime market performance analysis: Informing European consumer policy. Journal of Consumer Policy, 40(1), 125–143. Sandberg, M., & Polsa, P. (2016). Macro perspectives on sustainable consumption: A literature review. In N. Campbell, M. Claudy, & A. O’Driscoll (Eds.), Proceedings of the 41st annual macromarketing conference, Dublin. Shultz, C., Rahtz, D., & Sirgy, J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), The handbook of community well-being (pp. 403–422). Springer. Statistics Finland. (2020a). Finland among the best in the world. Retrieved October 29, 2020, from https://www.stat.fi/tup/satavuotias-suomi/suomi-maailman-karjessa_en.html Statistics Finland. (2020b). Consumer confidence exceeded its average - large purchases are tempting. Published July 27, 2020. Retrieved October 29, 2020, from https://www.stat.fi/til/ kbar/2020/07/kbar_2020_07_2020-07-27_tie_001_en.html

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Sutinen, T., Luukka, T. & Nalbantoglu, M. (2020) Uudenmaan raja avattiin – pääministeri Marin: “Nyt ei ole oikea aika lähteä mökeille”. (The border of Uusimaa province was opened – prime minister Marin: ‘Now is not the right time to go to the cottages’. Helsingin Sanomat April 14, 2020. Retrieved October 29, 2020, from https://www.hs.fi/politiikka/art-2000006473946. html Transparency International. (2020). Corruption perceptions index 2019. Retrieved October 29, 2020, from https://images.mutualcdn.com/transparency-org/images/Mapindex.jpg World Bank. (2020). GDP per capita (current US$). Retrieved October 29, 2020, from https://data. worldbank.org/indicator/NY.GDP.PCAP.CD Worldometer. (2020). Covid-19 coronavirus pandemic. Retrieved October 29, 2020, from https:// www.worldometers.info/coronavirus

Petteri Repo is Research Director at the Centre for Consumer Society Research at the University of Helsinki. He holds a Ph.D. from the Hanken School of Economics and is an Adjunct Professor (Docent) at the Aalto University School of Business. His current research interests include novel energy services, circular economy from a consumer perspective, natural language processing methodologies, and data visualization. His recent work has been published in journals such as Environmental Innovation and Societal Transitions, Sustainability: Science, Practice and Policy, Futures: The Journal of Forecasting and Planning and Technological Forecasting and Social Change, reflecting his interests in sustainability transitions and a forward-looking orientation. He consults Finnish policy makers regularly in matters covering consumer interests, market developments, and sustainability concerns. He is also a member of the board of the Consumers’ Union of Finland. Pia Polsa is an Associate Professor of Marketing at the Hanken School of Economics in Helsinki, and has previously worked as a researcher for Fudan University, Nankai University, and as a Dean for Hult International Business School in Shanghai. Her current research interests concern poverty alleviation, multi-dimensional value in cross-sector settings, service and relationship marketing at non-profit settings like health care, and cross-cultural methodology. She has published in journals such as Journal of Business Ethics, Journal of Business Research, Industrial Marketing Management, Journal of Macromarketing, Journal of Services Marketing, Supply Chain Management; International Journal, among others. Her work has also appeared in practitioner-oriented journals like Talouselämä. She is currently working on CORE (www.collaboration.fi) project on environmental issues and has consulted the Ministry of Health and Social Affairs in Finland. She wishes to acknowledge the financial support she received from the CORE (www.collaboration.fi) project (no 313017) funded by the Strategic Research Council at the Academy of Finland. Päivi Timonen (Ph.D. and Adjunct Professor) is Research Director at the Centre for Consumer Society Research at the University of Helsinki. Her work explores sustainable consumption and reconceptualizations of consumption in the realm of the sharing economy and collaborative consumption. Her current research interests relate to the connections between consumption, policy, and climate change. Her work has been published in journals such as Futures, Journal of Consumer Policy, and Journal of Urban Design, among others. She consults consumer policy makers on a regular basis in Finland and in the European Commission. She has been involved in rethinking consumption in a joint effort by scholars and the Consumers’ Union of Finland.

Chapter 10

The COVID-19 Outbreaks in the German Meat Industry: A Culturalistic Explanation Michaela Haase and Anne Schade

Abstract This chapter explains the series of outbreaks of the Corona disease among posted workers that occurred in the German meat industry in 2020. Drawing on Max Weber’s ideal-type methodology, we “rationalized” the historical development leading to the series of outbreaks and, based on this causal rationalization, explain it as multicausal process. By using Karl Polanyi’s and Ferdinand Tönnies’s categories and conceptualizations, we describe the historical development and identify potential causes of the outbreaks. From this, we obtained information about potential causes (or “drivers”) of the historical development in terms of commodification and movement. We match Polanyi’s distinction between movement/countermovement with Tönnies’s distinction between the local and the trans-local dimensions of concepts. In short, the event occurred because the virus found favorable conditions for its dissemination in the tayloristic work organization and working conditions at production sites, because the main actors in the German meat industry and Eastern European subcontracting business organized their business or established marketing systems devoid of ethical reflection, and because posted workers remained without effective legal protection and communal association in Germany. Keywords Corona · German meat industry · Ideal type · Karl Polanyi · Ferdinand Tönnies

10.1

Introduction

The COVID-19 pandemic has hit communities, nation states, and people worldwide. In the last decades, humanity has faced several health crises or pandemics, ecosystem crises, economic and financial crises, not to mention the climate crisis. The pandemic is not a single event disturbing otherwise flourishing communities (Shultz et al., 2017) or states but rather one event within a series of events indicative of a

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more fundamental, all-embracing crisis that has become a permanent constituent of human livelihoods. Among the zoonotic diseases that have appeared since the 1980s, COVID-19 is the most recent one.1 Zoonotic diseases originate from contacts of humans with wildlife. The number of humans-wildlife contacts is on the rise, for several reasons: the destruction of animal habitats, the loss of biodiversity, and the offering of living animals at wild animal markets. Animal farms are catalysts for zoonotic diseases in that they help viruses to adapt to human conditions. The COVID-19 pandemic could not have spread that fast without international trade and travel agreements (Stefanic, 2020); in this sense, the pandemic is (as the others in the last decades) a child of globalization. In the first half of 2020, during the first wave of the COVID-19 pandemic, Corona outbreaks occurred in German slaughterhouses and meat processing facilities with thousands2 infections among posted workers,3 most of them from Eastern Europe, i.e., Poland, Bulgaria, Romania, or Hungary. By the end of October 2020, eight times more posted workers contracted an infection than the rest of the population (Verschwele & Wernicke, 2020). We subsume the series of single Corona outbreaks in the German meat industry under the term “the event.”4 German media has reported precarious working and living conditions of posted workers for years. The event shed light on these socially and ethically untenable circumstances again. These Corona hotspots attracted more attention than all media documentation of the conditions in the German meat industry in the years before, as the local authorities had to quarantine affected companies and lockdown the communities in which they are located. Finally, the event gave rise to a change of labor legislation in Germany that became effective in January 2021 (Table 10.1).5 Our paper aims at an explanation of the event from a socioeconomic or culturalist (Weberian) perspective. As Weber (1973) argued, scholars select their objects of study based on their research interests and values. We expect to gain insights from using a wide lens that connects virologic with socioeconomic and values-based dimensions of the COVID-19 pandemic. For this reason, we draft an argument connecting the virologic causes with causes originating from cultural reality (Weber, 1973) for the causal explanation of the event. Theoretically and

1 Schmidt-Landenberger (2020) lists HIV (since 1981), SARS (since 2002), bird flu H5N1 (2003), swine flu (since 2009), MERS (since 2012), bird flu H7N9 (since 2013), and the EBOLA outbreak in 2014. 2 In 2020, 2117 infections occurred alone at Tönnies, the industry leader (Verschwele & Wernicke, 2020). 3 “A ‘posted worker’ is an employee who is sent by his employer to carry out a service in another EU Member State on a temporary basis, in the context of a contract of services, an intra-group posting or a hiring out through a temporary agency” (European Commission, 2021). 4 We disregard the Corona outbreaks that took place in other branches in Germany as, e.g., among migrant harvesters. 5 The Occupational Safety and Health Act (Arbeitsschutzkontrollgesetz) was approved in December 2020.

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Table 10.1 European Commission and Germany: ideas and rules Year 1987 1990s 1996

Directive, Act, Complaint, or Regulation Single European Market Act (put in place 1993) Bilateral agreements between Germany and prospective EU member states Posted Workers Directive (Directive 96/71/EC)

1996

German Posted Workers Act (Arbeitnehmerentsendegesetz)

2014

Directive 2014/67/EU

2014

2014

Amendment of the German Posted Workers Act (Arbeitnehmerentsendegesetz) Code of Conduct (Germany)

2015

Self-Commitment (Germany)

2017

Act to Secure Employees‘ Rights in the Meat Industry (Gesetz zur Sicherung von Arbeitnehmerrechten in der Fleischindustrie (GSA Fleisch)) Occupational Safety and Health Act of 22. December 2010 (Arbeitsschutzkontrollgesetz)

2020

About, Content, or Purpose Free market ideology (free trade, free movement) Aims at making cheap labor available for German industries Based on the idea of loyal cooperation among EU member states Regarding posted workers, • Social security standards of the home country apply, • Principle of the most advantageous social law and establishment of a hard core of minimum rules, • They continue to be employed by the sending company (Richard, 2014) Different working and renumeration conditions apply to different sectors Meat industry is excluded Objectives and measures (Richard, 2014):
Typifying posting situations,
A host member state can set a precise list of measures being effective on a foreign company that is posting workers on the home country’s territory,
“The company must appoint a representative who is responsible for negotiating with the host country’s social partners on behalf of the employer” (p. 5),
For the building industry only: the contractor can be held responsible for infringements of the subcontractors Inclusion of the meat industry; main contractor liability applies to the meat industry Commitment to comply with social standards, especially with regard to the accommodation of posted workers from other EU-member states The six largest meat producers commit themselves to refrain from posting and oblige their contractual partners to hire workers only according to German law in order to improve the working conditions General contractor liability (main contractors can be held responsible for infringements of all subcontractors) After the event, banning “serious shortcomings . . . in terms of working conditions and accommodation for workers” (Bundesregierung, 2020a)

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methodologically, we draw on Karl Polanyi (1886–1964), an anthropologist, Ferdinand Tönnies6 (1855–1936), the first President of the Deutsche Gesellschaft für Soziologie (1909–1933), and Weber’s ideal-type methodology (Dieckmann, 1967; Gerhardt, 1994). Polanyi’s (2001 [1944]) analysis of the historical development of capitalism and the categories invented or utilized by him are a major source of our analysis. For the explanation of the event, we refer to what Polanyi has called the “double movement” and “commodification.” “Double movement” includes a movement and its countermovement. Commodification is a major catalyst of “movements” (or “marketizations,” Burawoy, 2010); it designates the interplay of policies arising from the idea of the liberal market (movement) on the one hand and of policies reacting to states of affairs or problems resulting from these “liberal policies” (countermovement): Because efforts to disembed the economy from society inevitably encounter resistance, Polanyi argues that market societies are constituted by two opposing movements – the laissez-faire movement to expand the scope of the market, and the protective countermovement that emerges to resist the disembedding of the economy. (Block, 2001 [1944], p. xxviii)

Against this backdrop, we subsume the European legislation that facilitates posted work and the German legislation that, becoming effective in January 2021, forbids subcontracting in this industry under the categories “movement” and “countermovement.” Our analysis of the historical development that has led to the event (abbreviated by “HDE”) refers to these categories. “Commodification” is a concept used by Polanyi (2001 [1944]) to designate the change of entities which are no “genuine” commodities into “fictitious commodities.”7 Polanyi (2001 [1944]) criticized the commodification of labor, land (nature), and money (in the meantime, the list has been extended). We only touch upon commodified nature (in form of animals8) and focus on commodified law and labor—labor in form of posted workers in the German meat industry and law in form of the legislation of the European Union (EU) and Germany between the 1990s and 2021. The several extensions of the EU necessitate the management of posted workers, firstly codified in community law in 1996 (Richard, 2014; see Table 10.1). The extensions of the EU in 2004 and 2007 increased the number of member states by the Eastern European countries, which are the home of the majority of posted workers in the German meat industry. The Directive 96/71/EC on the Posting of Workers faced

6

The Tönnies Holding is one of the main actors in the German meat processing industry. We have no knowledge about a potential relationship of Ferdinand Tönnies’s family and the family behind the Tönnies Holding. 7 The distinction between “genuine” and “fictitious commodities” originates from Ferdinand Tönnies (Langthaler & Schüßler, 2019). 8 The subtitle of a Heinrich Böll Foundation’s publication is telling: Data and Facts about Animals as Food (Daten und Fakten über Tiere als Nahrungsmittel) (Heinrich Böll Stiftung, 2021).

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several amendments and became an important factor of influence on the structure of the German meat industry (Solomon et al., 2021). Eastern European subcontractors became business partners of German companies on a large scale. The remainder of the chapter begins with a brief introduction to our theoretical framework. Block (2003, p. 276) ascribes to Polanyi the “idea of the always embedded market economy”—an idea somewhat confusing given the literature on disembeddedness or re-embedding, as “always embedded markets” imply that there are no disembedded markets or market economies. That, as Block points out, Polanyi has not elaborated on this idea, has given rise to two problems: First, there is no precise concept of the embedded market; second, without a clear reference point (the embedded market), “disembeddedness of markets” can take different meanings. Tönnies (1887) established “community” and “society” as trans-local and genuine sociological concepts which we use to obtain such reference points. Based on our analysis of the HDE and Tönnies’s fundamental sociological categories (“society” and “community”), we distinguish three forms of disconnectedness: social (sociological),9 legal, and ethical. After that, we introduce methodology and the case. “Case” means the statement of what we learned about the event and the historical development preceding it. In order to obtain information about the event, we screened German newspapers, broadcasts and online documents as well as academic studies and published reports from institutions such as the German Trade Union Confederation (DGB) and the Hans Böckler Stiftung that were published between September 2015 and January 2021. Weber’s epistemology and ideal-type methodology provide a foundation for the analysis of causal processes and the formation of precise concepts. In our analysis, we associate Weber’s methodology with Polanyi’s categories to describe the HDE as a Weberian “rationalized,” multicausal development. Although Weber and Polanyi were “economic contextualists” (Roth, 2003, p. 264), they used causal concepts and abstract categories to describe historical-empirical developments (Maurer, 2018). That Weber and Polanyi held “contrary interpretations of liberal capitalism” (Roth, 2003) does not touch upon our choice of methodology. The analysis of the HDE that we then present draws on a tabular comparison of two distinctions (movement/countermovement and local/trans-local) in the light of which we discuss what can be gained from the embeddedness/disembeddedness distinction for the explanation of the event. Finally, we explain why posted workers in the German meat industry in 2020 could become the target of the Corona virus SARS-CoV-2 much more often than other residents in the community they used to live. The chapter ends with conclusions, outlook, and discusses limitations of approach/research.

9

For an influential sociological perspective, see Granovetter (1985) and the discussion in Dequech (2003).

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Theoretical Foundations: Polanyi and Tönnies

10.2.1 Markets, Society, and Community In the Great Transformation, Polanyi (2001 [1944]) studied the development of capitalism and of the “market society” in the nineteenth and early twentieth century. It was a widespread view in the beginning of the twentieth century, shared by Weber,10 that society had collapsed into market society. Market, society, and state are interpreted in line with Hobbes’s social philosophy, according to that society is an aggregation of isolated individuals—a view giving rise to “the Hobbesian question of how society is possible” (Svensson, 2005, p. 219). Hobbes’s answer was that individuals, by social contract, create an authority, a common power: “the merger of singularities into a unity may be seen as the very heart of the notion of society” (Svensson, 2005, p. 220). Ferdinand Tönnies (1855–1936) was impressed by the Hobbesian question but he did not think that Hobbes’s response was complete. Tönnies considered Hobbes’s sociological approach as valid only for the modern, rational society but thought that it had to be completed by a “law of nature concerning community (Gemeinschaftsnaturrecht)” (Salomon, 1936, p. 357). Insisting on the coexistence of a community form of social life with the society form, Tönnies established “a genuine type of sociological thinking” (Salomon, 1936, p. 349). According to Tönnies, “community” and “society” are concepts which have to be understood first of all as “trans-historic” or as general types of the social structure present in concrete historical situations. Tönnies’s concept of community includes local life communities and “ideational communities, motivated by solidarity” (Tönnies, 2018 [1934], p. 305). Epistemologically, Tönnies draws on Weber’s ideal type methodology having roots in Descartes and Kant (Dieckmann, 1967; Salomon, 1936). According to Tönnies’s social philosophical foundation of sociology, both categories, society and community, are based on the idea that there is a human nature identifiable and subjectable to empirical investigation. Thus, communities as well as the capitalist society that emerged in the eighteenth century are conceived of as expressions of human nature. Society coexists with manifestations of communities: “In the community of the people, only the man and the woman who share common speech, common custom, and common mentality are cast in the same mold, while in the exchange society everyone is welcome who obeys its status” (Tönnies, 2018 [1934], p. 306). The common basis of society and community in human nature is manifested in characteristics which find historical expression in community and market relationships (for the former, sympathy, tolerance, peacefulness, the coincidence of morals and law; for the latter, self-interest, utilitarianism).

“In substantial agreement with Toennies, but also with such American sociologists as Park and Becker, Weber regards the market model as typical for a Gesellschaft type of society and therefore inapplicable to traditional societies” (Cahnman, 1965, p. 270).

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10.2.2 Embeddedness/Disembeddedness As anthropologist, Polanyi studied premodern or precapitalist societies—societies of which it can be said that there was no economy or, in other words, no realm designated by a specific word such as “economy.” Later on in history, a small group of thinkers paid attention to the “nameless” (Polanyi, 1957, p. 71) realm: It can not be merely a matter of chance that until very recent times no name to sum up the organization of the material conditions of life existed in the languages even of civilized peoples. Only 200 years ago did an esoteric sect of French thinkers coin the term and call themselves économistes. Their claim was to have discovered the economy. (Polanyi, 1957, p. 71)

Polanyi was concerned about the “embeddedness” of “the economic process” (Polanyi, 1957, p. 71). However, as he neither attached meaning to the expression “economic” nor identified a line of thought on which such meaning could be grounded, his analysis left out a number of issues. From the study of ancient communities, Polanyi obtained the insight that it is difficult to identify “the economic process under conditions where it is embedded in noneconomic institutions” (Polanyi, 1957, p. 71). Anthropologists might have a clear view on what noneconomic institutions (kinship, tradition, social norms, etc.) are; however, as there is no “economic life” (Polanyi, 1957, p. 70) in premodern communities, what the economy is and what the economic institutions are not clearly specified. If status prevails, and if reciprocity and redistribution are assumed to be the main means of coordination, “no concept of an economy need arise” (Polanyi, 1957, p. 70). In ancient communities, what today might be called “economic process” was associated with household or communal activities and governed by social norms. This led Polanyi (1957, p. 70) to conclude: “The elements of the economy are here embedded in noneconomic institutions, the economic process itself being instituted through kinship, marriage, age-groups, secret societies, totemic associations, and public solemnities.” The fundamental problem we face here is that without a concept of the “economic,” the “economy,” the “economic process,” or “economic embeddedness” cannot have any “obvious meaning” (1957, p. 70). The meaning of the economic can only be grasped by using an economic lens, be it preclassical, classical, or neoclassical, orthodox, or heterodox. Polanyi remains vague in this regard. Against the backdrop of his examples of noneconomic institutions, “noneconomic” has been equated with “social” and “disembeddedness of markets” with “social disembeddedness of markets.” For two reasons, this equation cannot be satisfactory: First, as “noneconomic” can have meanings other than indicated by the term “social,” forms of disembeddedness other than social disembeddedness are possible (e.g., ethical disembeddedness, O’Neill, 2009). Second, “noneconomic” implies taking reference to “economic,” thus again underlining the meaning of “economic.” Scholars who consider economics as social science and not as being opposed to it might feel invited to close the gap.

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What the next example provides evidence for is the effect of contemporary orders of thought (categories) on the description of premodern societies (in Weber’s eyes, a methodical flaw). Polanyi (1957, pp. 68–69) outlined what he called the sociological background of the distinction between embedded and disembedded economies—a background. first mooted by Hegel in the 1820’s and developed by Marx in the 1840’s. Its empirical discovery in terms of history was made by Sir Henry Sumner Maine in the Roman law categories of status and contractus, in the 1860’s; finally, in the more comprehensive terms of economic anthropology.

This line of thought finds expression in Tönnies’s (1887) Gemeinschaft und Gesellschaft (community and society) in that “‘community’ corresponded to ‘status,’ ‘society’ to ‘contractus’” (Polanyi, 1957, p. 69). Polanyi (1957, p. 70), after having described the visions of human civilization by Hegel, Marx, Maine, and Tönnies, concludes: “It is now possible to say that status and gemeinschaft dominate where the economy is embedded in noneconomic institutions; contractus or gesellschaft is characteristic of the existence of a motivationally distinct economy in society.” Note that the quote above presupposes the existence of an economy and, with it, of economics—as explicated above, a precondition not given in premodern societies, to which the distinction between status and contractus on the one hand and gemeinschaft und gesellschaft on the other hand does not apply. In light of this discussion, we make use of the terms “social embeddedness/social disembeddedness” not with the intention to equate “social” with “noneconomic.” We complete this subsection with three remarks on the interpretation of our theoretical sources: First, as mentioned above, for Tönnies, “society” is a transhistorical concept. For the founder of a “genuine type of sociological thinking” (Salomon, 1936, p. 349), the advocate of trans-historical and ideal-type concepts, society was extant before capitalism entered the stage and will be still there after capitalism has come to an end.11 This society is no nameless area but, together with community, an essential constituent of social structure. Based on his readings of Hobbes, Tönnies identified social behavior patterns in modern, capitalist societies “linked by utilitarian means-end relationships. Here contracts and conventions are the types of these modern social relations, and rational conventions, instead of the folkways of a community, determine the prestige of social groups” (Salomon, 1936, p. 357). A consequence of Tönnies’s view is that there are no universal “laws” or “logics” which govern the market sector, detaching the market from society. At this point, Tönnies and Weber again shared views. Second, regarding the embeddedness of markets, it is possible to reconstruct Tönnies’s and Polanyi’s thought as coinciding. Both markets and society are interpretable as categories of the social or, in Weber’s view, constituents of cultural reality, i.e., as unintended consequence of social action:

11

Both Polanyi and Tönnies advocated political ideas which, from a contemporary perspective, could be circumscribed by “democratic-socialist” (Tönnies, 2018 [1934]; Block, 2003; Salomon, 1936).

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The market, the firm and the forms of rational action are not explained with reference to the effects of efficient coordination and also not as consequences of a structural law, but as unintended consequences of socially embedded, individual meaningful action. (Maurer, 2018, p. 118; our translation)12

Third, one cannot expect of Tönnies or Polanyi to have renewed economic theory. They referred to ideas or ideologies which “were in the air” during their lifetime.

10.2.3 Movements and Countermovements As mentioned above, Polanyi’s idea of “always embedded market economies” implies that there are no disembedded markets. Policies directed at the “embedding” of markets are in fact a change from one form of “embeddedness” (e.g., the market liberal type of embeddedness) to another one (e.g., a less market liberal or different type of embeddedness). Notwithstanding, market liberal policies have tried to establish or approach self-regulated markets. Polanyi (2001 [1944]) elaborated on the dangers and negative consequences of such politics: “The reaction to market fundamentalism could be as bad as the curse itself” (Burawoy, 2010, p. 301; see, e.g., Frerichs, 2019). Protectionist countermovements “brought social democracy and the New Deal but also Facism and Stalinism” (Burawoy, 2010, p. 301). Polanyi’s analysis encompasses the rise of capitalism in England from the end of the eighteenth century to the beginning of the twentieth century. Burawoy (2010, p. 301) argues that Polanyi was wrong in assuming that humanity would never again “indulge in such a dangerous experiment,” i.e., engaging in “marketization.” Burawoy (2010, p. 309, Fig. 1), identifies three waves of “marketization” (or movements) and respective countermovements that we, in anticipation of the methodological section, reinterpret the waves as trans-local, macro-level representations of historical developments. As abstract ideal type, each wave represents typical characteristics of a historical “wave-type” development. In other words, these “waves” are representations of policies (e.g., the Poor Law Reform in 1834 in England), measures (e.g., the abolition of the gold standard in 1933), or movements (toward the ecological catastrophe) which have been aligned to constitute a wave-like development (marketization) or its change (countermovement). As Burawoy (2010) argues, humanity could stop the ongoing marketization process and, with it, the formation of patterns of this type. Weber (at the end of his life) and Polanyi shared the view (for different reasons) that the development of “liberal capitalism” or “economic liberalism” has come to an end (Roth, 2003, p. 266). Perhaps Burawoy’s (2010) Figure is marking the endpoint of all historical developments, the ecological catastrophe.

12 Maurer (2018) contrasts Weber-oriented explanations of the market or the firm with neoclassic and new institutional economic ones.

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10.2.4 Fictitious Commodities and the Liberal Market According to the Great Transformation, the creation of fictitious commodities— labor, land (nature), and money—is a major expression of policies devoted to “marketization.” It is impossible to turn these entities into commodities exchangeable on markets without establishing an apt institutional framework and, with it, a kind of “socioeconomic embeddedness”: Labor cannot be “detached from the rest of life, be stored or mobilized; land is only another name for nature, which is not produced by man; actual money, finally, is merely a token of purchasing power which, as a rule, is not produced at all, but comes into being through the mechanism of banking or state finance. None of them is produced for sale. The commodity description of labor, land, and money is entirely fictitious.” (Polanyi, 2001 [1944], pp. 75–76)

Without the respective legal property rights, for example, natural entities cannot be changed into resources—this is an example for an “economic process” (Polanyi, 1957, p. 71) embedded in economic and social institutions. Several authors have extended or specified Polanyi’s list of fictitious commodities (Burawoy, 2010; Frerichs, 2019). Frerichs (2019) juxtaposes two basic ideas concerning law: law as institution can promote public interest or embody the collective reasoning in a community of citizens (Frerichs refers to Commons, 1924) and law as commodity serves private interests, is price-tagged, and is available for sale on the law market. One may think about nation states who, by adaptation of tax laws, compete for site quality. The EU facilitated the transfer of commodified labor within its borders and engaged in the commodification of law. The commodification of nature (animals), human activities (labor), and law (EU legislation) went hand in hand. As mentioned above, our chapter aims at the explanation of the HDE with reference to categories, conceptualizations, and distinctions originating from the works of Weber, Tönnies, and Polanyi. In the next section, we briefly introduce Weber’s ideal-type methodology and describe the case.

10.3

Methodology and Case Study

10.3.1 Epistemological Background and Methodology Weber (1973) presented a general outline of the methodology of cultural reality (Kulturwirklichkeit), mapping out a strategy of social-scientific knowledge generation by imparting Kant’s teleology from the natural to the social sciences (Dieckmann, 1967). Dieckmann points to the roots of Weber’s ideal type in Descartes’s philosophy of knowledge, arguing that Weber constructed rational

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teleological schemes for the analysis of the cultural world.13 As Weber “rationalizes” the knowledge generation processes, the knowledge generated about cultural reality (Kulturerkenntnis) is a consequence of the use made of rational procedures and values-based choices regarding the objects of study. Dieckmann (1967) identifies four forms of knowledge generation in Weber’s methodology: (1) causal rationalization, applicable to the causal analysis of single historical situations; (2) adequate causation, based on the abstraction from or change of components taken for granted in a causal process, aiming at the construction of nonreal causal processes in order to recognize actual causal factors;14 (3) general ideal-type constructs (models, hypotheses) which, depending on the situation, may lead to valid (true) empirical statements; and (4) the ideal type as a unique utopian rational construct of thought.15 Abstract ideal types are means obtaining knowledge; and only as ideal types precise concepts are determinable. It is assumed from (4) that it can be used to create a measure to assess the distance between a concrete ideal-type construct and the part of cultural reality under investigation. Regarding the conceptualization of HDE and the explanation of the event, our analysis draws on (1), (2), and (3). Weber rejected the view that societal and cultural phenomena can be grasped through laws like those constituting the natural order. The study of cultural phenomena should avoid two mistakes: first, confusing the abstract-typical with the abstract-general; the identification of idiosyncratic characteristics of social reality (cultural world) is in the foreground of this methodology. Second, while generic concepts and knowledge about social orders may result from the methodology, general knowledge is only a means for improving our overall knowledge about cultural phenomena but no end in itself. This brings the scholarly value judgment into play again, which asks about the value of the research. Notwithstanding, ideal type-based hypotheses or models can add to the empirical knowledge about social orders. (1)–(4) make comprehensible what Tönnies, a scholar with comprehensive philosophical knowledge, may have attracted to Weber’s methodology. Tönnies was convinced that sociological categories are trans-historical and that their relevance (e.g., explanatory power) is not restricted to specific, historical periods. Communities are analyzable with reference to idiosyncratic characteristics of concrete communities as well as abstract or generalizable characteristics. Thus, communities do not need to share a place or geographical location.16 Belief systems shared among 13

Weber (1973) refers to the new Kantians Wilhelm Windelband (1848–1915), Georg Simmel (1858–1918), and Heinrich Rickert (1863–1936). 14 “Um die wirklichen Kausalzusammenhänge zu ergründen, werden unwirkliche konstruiert.” (Dieckmann, 1967, p. 33). 15 “Utopian” can mean “unrealistic,” “fictive,” or “idealized” as well (Haase, 1995). Normative ideals are not subject to the formation of ideal types. 16 Varman and Costa (2008, p. 143) distinguish two approaches to community: the structural approach, equating “community” with “a group of people having common interests and inhabiting a definite geographical area,” and the nonstructural approach that identifies communities based on

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communities are a characteristic transcending the part of cultural reality selected as object of study. As Weber would have put it: We transcend the concrete cultural reality, selected or created as thought object for some reasons. As Weber (1973) states, historical-empirical developments are analyzable as ideal types. Drawing on his methodology, but also on Tönnies and Polanyi, we reconstruct a concrete, historical development (HDE) as ideal type. Our analysis connects the local (the substitution of standard employment by posted work) and the trans-local (e.g., bilateral agreements between Germany and the home countries of posted workers after the fall of the iron curtain) as well as Polanyian movements with countermovements. The Polanyian concepts as well as Tönnies’s conceptualization of “community” are interpreted as abstract ideal types; now, “community” can range from representations17 of concrete entities in the cultural world (i.e., concrete communities) to representations which draw on abstract or idealized concepts (e.g., the community of meat eaters in Germany or the world). The next subsection describes the event, the living and working conditions of posted workers prior to 2021, the structural change in the German meat industry in association with commodified law, and aspects of the German/EU legislation.

10.3.2 Posted Work in the German Meat Industry 10.3.2.1

The Event

Germany is one of the largest producers and exporters of meat in the EU (Salomon et al., 2021; Wagner & Hassel, 2016). As reported by the Albert Schweitzer Stiftung (, 2020), 763 million animals died in German slaughterhouses in 2019; the majority of them were chicken (620.5 million). The average German consumer accounts for sixty kilos meat per person and year (Verschwele & Wernicke, 2020). The largest meat producer in Germany in terms of turnover and still by far the largest in terms of number of slaughters18 is the Tönnies Group, based in Rheda-Wiedenbrück in North Rhine-Westphalia. The industry leaders also include Vion (a Dutch group), Westfleisch, and the PHW Group (Reimer, 2020). Corona outbreaks have occurred in particular among these larger meat producers (Ahrens, 2020). Some of the communities in which slaughterhouses and meat processing facilities are located had to go into lockdown because of the huge number of acute COVID-19 infections. In mid-May, a facility of the manufacturer Westfleisch in the municipality of Coesfeld had to be temporarily closed as over 260 of their employees were tested

symbolic, democratic, responsive, and moral characteristics. Tönnies (2018 [1934]) would have not put these two approaches into opposition. His category of community encompasses both local and ideational communities. 17 Note that what a representation represents is a “thinkingly (thought-based) order of empirical reality“(Weber, 1973: 150; our translation [denkende Ordnung der empirischen Wirklichkeit]). 18 In Rheda-Wiedenbrück, Tönnies slaughters twenty thousand pigs daily (Solomon et al., 2021).

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positive for the SARS-CoV-2 virus. The manufacturer Müller Fleisch in Birkenfeld was faced with a COVID-19 outbreak in April 2020, whereupon the entire company was quarantined (Preuss, 2020). Tönnies also experienced Corona outbreaks in June 2020 at its slaughterhouse in Rheda-Wiedenbrück (Gütersloh county), where 7000 people had to be quarantined and over 1550 infected persons were identified (Reimer, 2020). Subsequently, in Gütersloh county, 15,000 people were quarantined, and 640,000 people were involved in the “Tönnies-Lockdown” (Verschwele & Wernicke, 2020). In Verl, Zollhausweg (county Gütersloh), a building complex was fenced off by the police inhabited by one hundred posted workers tested positive for Corona.

10.3.2.2

Verl, Zollhausweg

Posted workers used to live in mass accommodations under poor hygienic conditions (Neues Ruhr-Wort, 2020; Solomon et al., 2021). Up to ten people had to share an apartment in Verl, Zollhausweg, in June 2020; each inhabitant, earning minimum wage, had to pay the subcontractor 250 Euros per month for accommodation (Verschwele & Wernicke, 2020). Subcontractors used “sick tricks” (Solomon et al., 2021) to skim wages including the fees the posted workers had to pay for accommodation and other services (e.g., transportation to the workplace). As the local authorities tried to quarantine posted workers at Tönnies, the Süddeutsche Zeitung reported that Tönnies did not know where these workers dwelled (Verschwele & Wernicke, 2020). In the meantime, after the passing of the Occupational Safety and Health Act (Arbeitsschutzkontrollgesetz) in December 2020, Tönnies has bought the buildings in Verl for its new employees. Posted workers in the meat industry did not enjoy the community form of social life in Germany. Isolated from German workers during the work operating processes but also because of their housing, the posted workers were separated from the local workforce and were not part of the community. While some citizens showed resentment against the mostly foreign factory workers (for Rheda, see, e.g., Roth, 2020), demonstrations took place in front of meat factories and slaughterhouses, pointing out the housing situation and demanding to end this kind of modern slavery (Neues Ruhr-Wort, 2020).19

10.3.2.3

Contracts for Work and Labor

In April 2020, a total of around 100,000 people were employed by German slaughterhouses and meat processing facilities with more than 50 employees (Statistisches Bundesamt, 2020). Due to the employment relationships and the high fluctuation of

19 For the use of the term ‘modern slavery’ in connection with posted work in the EU, see Richard (2014).

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employees, precise employment figures are difficult to collect. Many employees were not directly employed by the slaughterhouse but by personnel service providers or subcontractors. In large slaughterhouses, less than 50% of the employees were own permanent staff. Almost a third of the employees in the industry comes from abroad, mostly from Eastern Europe (Hans Böckler Stiftung, 2020). According to the German Federation of Trade Unions (DGB, 2020), the large German slaughterhouses employed a minimum of ten and a maximum of fifty percent of their personnel as regular staff. Main motives for the use of contracts for service (or contracts for work and labor, CWL, see, e.g., Haase & Kleinaltenkamp, 2011) are industry-independent: the use of external specialized competencies and know-how while concentrating on own competencies, cost efficiency, and the use of flexible execution capacities in case of fluctuating utilization or utilization peaks (Schütz et al., 2017). The flexibility of the production factor labor allows companies to absorb seasonal peaks in the demand for labor (Welt, 2020); it changes fixed costs into variable costs. However, cushioning production peaks as argument is often seen as obscuring the main objective, i.e., to save personnel costs by using temporary employment and CWL (Klawitter, 2020). Thus, CWL have been misused to circumvent collective bargaining and social standards (Hans Böckler Stiftung, 2020). There are several reasons why CWL are a widespread practice in the German meat industry. First, the widespread use of CWL in the industry is also due to industry-specific traditions, as CWL have been used for more than 30 years. In the past, when the operation of own slaughterhouses ceased to be profitable for many meat-processing companies, a service industry developed and the number of companies making use of CWL began to rise (Wagner & Hassel, 2016). Second, CWL are used in the core area of production in order to keep wage costs low and to counteract the pressure for flexibility by reducing the core workforce (DGB, 2012). Third, the use of CWL has also been justified by the lack of available, suitable workers. The reason for this is seen in the physically exhausting and sometimes health-endangering demands associated with this work, as well as in the negative image of the industry on the training and labor market (Hertwig et al., 2015).

10.3.2.4

The Rules of the Game

The EU started as an economic union with the 1957 treaty establishing the European Economic Community (EEC). The Community passed 282 laws between 1985 and 1992 “to sweep away the technical, regulatory, legal and bureaucratic barriers that stifled free trade and free movement” (European Commission, 2010). Free market ideology evoked the mass consumption of industrial capitalism, connected wealth with growth and furthered the transfer of commodified labor within the EU. Since the introduction of the EU Single Market in 1993 (European Commission, 2010), German slaughterhouses had increasingly replaced the permanent workforce by cheap labor from abroad. After the EU enlargement in May 2004, this labor mainly came from the East European accession countries. Germany was the top receiving

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country in percentage of postings (close to thirty percent) among the top seven receiving countries within the EU between 2005 and 2013 (Wagner & Hassel, 2016, p. 169, Fig. 1). According to the Posted Workers Directive’s hard core minimum rule (Directive 96/71/EC), posted workers were employed in their home country at the wage and working conditions of the host country—unless otherwise regulated by national, unilateral standards or generally applicable collective agreements (Wagner & Hassel, 2016). Richard (2014) has pointed out that the underlying idea of the Directive 96/71/EC was that posted workers’ renumeration and working conditions are adjusted to the receiving state or to the level of the sending state, if more advantageous for the posted worker (principle of the most advantageous social law). The German meat industry, however, was excluded from the Posted Workers Act that implemented the Directive 96/71/EC. The remuneration and working conditions of posted workers in the German meat industry were leveling off below German standards, in accordance with the legal regulations of the home country (Czommer & Worthmann, 2005). As the meat industry was not included in the German Posted Workers Act (Arbeitnehmerentsendegesetz) prior to 2014, posted workers did not earn the German minimum wage until then. In comparison to the core workforce, posted workers experienced strong discrimination with regard to working and employment conditions and working hours up to 15 h per day. The workers accepted this for a guaranteed stable monthly wage. Opportunities for co-determination were also very limited and due to physical separation and frequent language barriers, social integration of posted workers in the companies usually did not take place (Brinkmann & Nachtwey, 2014). There have been a number of political efforts over the years to address these deficiencies at the local and trans-local (European) level. The Belgian Ministers for Finance and Labor issued a complaint against Germany’s “social dumping” (European Parliament, 2013). The EU reacted to the “avalanche of subcontractors,” “letter box companies,” “shell companies,” and the weak monitoring procedure that facilitated all this with issuing the Directive 2014/67/EU (Richard, 2014, p. 5): “The Commission aim is to strengthen the means to prevent and to counter posting fraud and to integrate, in a community standard, the main lessons learned from the Court of Justice’s jurisprudence” (Richard, 2014, p. 5). In Germany, the meat industry was included in the catalogue of the Posted Workers Act in 2014. For this reason, the minimum wage collective agreement concluded in early 2014 could be extended to all workers in the industry, leading to a gradual increase in the minimum wage for the meat industry from 7.75€ (from 2014) to 8.75€ (from the end of 2016 to the end of 2017). From the beginning of 2018, the established general statutory minimum wage applied without restriction (Bundesregierung, 2014). In 2014, a voluntary code of conduct was also adopted, in that sixty-six companies (Verband der Fleischwirtschaft, 2015) committed themselves to maintain minimum standards with their Eastern European work contract partners. This referred, for example, to decent accommodation for the contract workers as well as reasonable prices for accommodation and transport to the workplace. However, this nonbinding voluntary

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commitment hardly led to any improvements and, moreover, the minimum wage was often circumvented, for example, through manipulation of time recording or wage deductions for work clothing and work equipment (Küppers & NothelleWildfeuer, 2018). The code of conduct was followed by a self-commitment of six companies from the meat industry in which the parties undertake to stop the practice of using posted work (issued September 2015) and instead to employ the workers in line with German law (Sozialpolitischer Ausschuss der Fleischwirtschaft, 2018).20 Due to persistent abuses in the meat industry, the Act to Secure Employees’ Rights in the Meat Industry was passed in 2017 (Bundesministerium der Justiz und Verbraucherschutz, 2020, July 10) that introduced general contractor liability so that the contracting companies could be held responsible for violations by subcontractors (Küppers & Nothelle-Wildfeuer, 2018). However, none of these regulations, measures, or codes could prevent ongoing violations of the rules of the game in terms of working hours, accommodation, and occupational health and safety (Rademaker, 2020). Table 10.1 provides a brief chronic of law-related developments in the EU and Germany. In consequence of the Corona outbreaks in German slaughterhouses and the exposed continuing precarious work conditions, the Federal Labor and Social Affairs Ministry drafted a law to ban subcontracting and the use of temporary, leased work in the meat industry coming into force as of January 2021 (subcontracting) and April 2021 (leasing of temporary workers). The cornerstones of the “occupational health and safety program for the meat industry” (Bundesregierung, 2020a) include “compliance with occupational health and safety, infection prevention and health protection standards,” “butchering and processing of meat may only be performed by employees of the company itself. Contract workers and the leasing of temporary workers will no longer be permitted.” Further, minimum requirements for shared accommodation and the obligation to record working hours electronically were established (Bundesregierung, 2021). Companies with less than 50 employees are exempt from these regulations (Plaß, 2020). Using Polanyi’s categories, we rationalize the HDE in the next section, identify three forms of disembeddedness, and explain the event.

10.4

Case Analysis

We make use of Weber’s causal rationalization to describe the HDE, i.e., construct a rational teleological scheme. We present this scheme in two steps, beginning with the comparison of the local with the trans-local and movement with 20

The Social-Political Committee of the meat industry (Sozialpolitischer Ausschuss der Fleischwirtschaft) issued three reports, the last one in 2018, on the development of working conditions in those companies that have signed the self-commitment. Two ministries, the Federal Ministry of Economic Affairs and Energy and the Federal Ministry of Labor and Social Affairs, were the receivers of the report.

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Table 10.2 Title: Local and trans-local movements and countermovements Local Substitution of contracts of work and labor for employment contracts in Germany Division of the labor market in two segments: standard employment and nonstandard employment

Movement

Countermovement

Collective labor agreement establishing minimum wages in the meat industry and inclusion of the German meat industry in the Posted Workers Act (2014) Act to Secure Employees Rights in the Meat Industry 2017 (GSA Fleisch, 2017) Passing of the Occupational Safety and Health Act (Arbeitsschutzkontrollgesetz) in Germany in 2021

Trans-local EU Single Market Act Bilateral Agreements between Germany and posted workers’ home countries after the fall of the iron curtain EU labor legislation starting in 1996 (Directive 96/71/EU) Belgium lodged a complaint with the European Commission against the way posted working is executed in Germany’s meat industry (European Parliament, 2013) Directive 2014/67/EU

countermovement in a two-by-two table (Table 10.2). After that, we identify three forms of disembeddedness (social, legal, and ethical) and, by integrating these steps, explain the event.

10.4.1 The Rationalization of the HDE 10.4.1.1

Movement/Local (Cell 1, 1)

Using the tool of CWL and making a market for transnational labor, the meat industry taylorized the industry, restructured the work force, continually diminishing skilled labor for unskilled labor and standard employees for posted workers (MensePetermann, 2018; Wagner & Hassel, 2016). In Tönnies’ main plant in Rheda, 3500 of 6500 workers were posted ones (Verschwele & Wernicke, 2020). We interpret this development as the local dimension of a Polanyian “movement” or “marketization.” The COVID-19 pandemic has shed light on the downside of a marketing system based on cheap labor and cheap meat (Wagner & Hassel, 2016). The structural change of the labor market in Germany led to a division between a “primary labor market . . . largely reserved for narratives and characterized by stable employment relationships” and a “secondary labor market (that) contains jobs at the bottom of the hierarchy” (Wagner & Hassel, 2016, p. 165). The event brought two interrelated problems to the surface: first, the structural development in the German meat industry (and other industries) giving rise to at least two different classes of workers

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(standard and posted) and, second, the social inequality between these two groups of workers. The COVID-19 “pandemic has become a revealer of injustices and inequalities across the globe” (Ackerly et al., 2020, p. 453).

10.4.1.2

Movement/Trans-local (Cell 1, 2)

The EU started as a union of member states devoted to the idea to establish a common market, i.e., an “area where goods, services, capital and persons can circulate freely” (European Commission, 2010). The Single Market Act and the Directive 96/71/EC can be considered as regulation system established by a group of comparatively similar member states to govern their exchange relationships. What we, in Polanyi’s terms, can observe here is the interaction between commodified labor and law, driving an economic process or marketization. A precondition for this development was the social inequality of workers and/or of living conditions among the EU’s membership states. The EU extensions in 2004 and 2007 provided a number of Eastern European countries with access to the common market; these extensions, however, turned out to be a “game changer,” necessitating the “management of posted workers” (Richard, 2014) in the EU.

10.4.1.3

Countermovement/Local (Cell 2, 1)

The untenable situation of the posted workers in the German meat industry did not go unnoticed by the local authorities, which made several attempts to counter the marketization process (see Table 10.2). Finally, after years of attempts to legally enclose the meat industry and to fight fraud and infringements, Karl-Josef Laumann, minister for employment, health, and social affairs in North Rhine-Westphalia, bemoaned the meat industry’s “organized irresponsibility”21 and the ineffectivity of controls described by him as being like “putting hands into jelly” (Verschwele & Wernicke, 2020). The inclusion of the meat industry into the German Posted Workers in 2014 and, later in 2020, the passing of the Occupational Safety and Health Act (Arbeitsschutzkontrollgesetz) are local legal drivers of this countermovement. The unions, the media, and the public exerted pressure on the meat industry as well that reacted, e.g., by adopting a code of conduct in 2014 (Verband der Fleischwirtschaft, 2015) and a self-commitment in 2015 (Sozialpolitischer Ausschuss der Fleischwirtschaft, 2018). Drawing on Langthaler’s and Schüßler’s (2019, p. 220) discussion of countermovements, we consider this countermovement as “reformist,” i.e., “maintaining the current business logic, while avoiding the most detrimental effects for workers.” It remains to be seen whether or not the new law will live up to expectations. Sceptics

21 Hubertus Heil, federal minister for labor and social affairs, also speaks of “organized irresponsibility in sub-contractor constructions” (Bundesregierung, 2020b).

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point to looming court battles and that “monitoring any violations or loopholes is up to the same political class that ignored the problem for decades” (Solomon et al., 2021). This is perhaps a bit too hard a judgment; however, the fact that not much changed in the meat industry for decades waits for an explanation.

10.4.1.4

Countermovement/Trans-local (Cell 2, 2)

The developments regarding posting in the EU, the violation of the principle of the most advantageous social law as established in the Directive 96/71/EC, the fraud, and human rights violations caused by the main actors in the posting business, all this motivated a group of EU member states to try a u-turn. The Directive 2014/67/ EU could have marked the point where a movement changes into a countermovement. Richard (2014) gives an impression of interest conflicts behind the formulations of the Directive or of the ideas motivating them. These ideas include equal pay, joint liability for the whole chain of subcontractors, and an open list of measures set against fraud and social dumping. Mense-Petermann (2018, p. 26) refers to the collectively negotiated minimum wage in 2014 that became effective for postings by the amendment of the German Posted Workers Act, as “a major re-ordering of the transnational labor market in question.”

10.4.1.5

Distinctions, but No “False Dichotomies”

The distinctions underlying Table 10.2 should not be interpreted as dichotomies. Webster (2010, p. 386) warns us against “false dichotomies” such as “posing the local and the global as alternatives.” German (and foreign) companies engage in local activities in Germany and abroad; thus, “the global is often in the local” (Webster, 2010, p. 386). Although global value chains are by definition global or nonlocal, they cannot operate without the emergence of manifestations, which are both local and global in character. These manifestations include local use and processing of resources—including labor that stems from East Europe. This is in line with the results obtained from a case study “that shows that the making of the transnational labor market scrutinized here went hand in hand with the fabrication of the industry of meat production” (Mense-Petermann, 2018, p. 28). Ideational communities exist at local and global levels as well. What, using contemporary lenses, has been named “value regime” (Gollnhofer et al., 2019) or “value chain community” (Haase & Kleinaltenkamp, 2004), is related to Tönnies’s category of community.22 Value chain communities may be intentionally established by, e.g., fair trade organizations and their stakeholders; they may also arise from the

22

Tönnies (2012 [1955]), however, rejected the view that community forms of social life can be established by the use of the ‘rational will.’

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belief systems of meat eaters (Abbate, 2021) who, used to cheap meat, do their part to keep the system afloat.

10.4.2 Three Forms of Disembeddedness The EU enlargements in 2004 and 2007 have opened the door for Eastern European firms to function as subcontractors for the German meat industry. The subcontractors offered citizens of the Eastern European accession countries jobs, but the work had to be conducted not in the home country but abroad and (until 2014) under the rule of the home country’s legal labor standards. Under the rule of the Directive 2014/67/ EU, i.e., main contractor liability, minimum wage, middlemen (recruiters), and subcontractors continued to transfer work force from Eastern Europe to Germany. Thus, the posted workers were legally disembedded with regard to work area, employment contract, and labor law. Although posted workers’ “employment relations are embedded in the two national contexts of their respective home and host countries” (Mense-Petermann, 2018, p. 26), both the respective home and the host country’s regulations are too weak or toothless because posted workers cannot claim their labor rights, which, like human rights, “are exercised via national industrial relations systems and posted workers are partially outside these systems” (Lillie, 2016, p. 40; quoted by Mense-Petermann, 2018, p. 26). In this sense, posted workers are “stateless” (Lillie, 2016, p. 40). While “society” is often associated with “market,” “community” can designate a concrete, local place associated with a sphere not ruled by “market laws.” The communal form of social life can be assumed to be able to thwart marketization tendencies. Although the slaughterhouses and meat processing factories and the posted workers’ accommodations were located within German communities and the posted workers may have conducted work operations at the same place, perhaps inside the same buildings than the permanent workforce, regarding their social and workplace environment they remained strangers. The respective local life communities and “ideational communities, motivated by solidarity” (Tönnies, 2018 [1934], p. 305) did not reach out to the posted workers. So, they were not only “stateless” (Lillie, 2016) but also “communityless.” They were socially disembedded in two meanings of the term: first, they had to live with strangers, i.e., other posted workers to which they had no personal relationship in their private environment (three to five people in one room, a situation that furthered the dissemination of the SARS-CoV-2 virus). To posted workers applied what Ackerly et al. (2020, p. 454) observed about “the ten thousands of Americans living in or near poverty . . . They are more likely to live in crowded housing that does not allow distancing or quarantining.” Second, because of the taylorized work organization, the workload, the working speed, and language barriers, posted workers got barely into touch with the permanent workforce, representatives of local trade unions, or members of the respective community.

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Finally, we observed ethical disembeddedness. Drawing on Polanyi, O’Neill (2009, p. 317) points to the ethical criticism market economies face as “Patterns of production and distribution are not the result of any individually or socially determined ethical ends. In that sense, market economies are ethically disembedded economies.” This brings us to the role of actors for the making of markets for cheap meat products (Mense-Petermann, 2018). It is difficult to confirm that ethical objectives played any role in the value chain of the meat industry. Until today, representatives of the German meat industry reject the responsibility they held in case of the posted workers: “Thomas Dosch, a spokesman for Tönnies, says his company never tolerated abuse. . . . ‘There has always been trouble with subcontractors . . . But the responsibility is put on the slaughter companies instead’” (Solomon et al., 2021).

10.4.3 Explanation of the Event We aimed at the explanation of a single event: the series of outbreaks of the Corona disease among posted workers in the German meat industry in 2020. Drawing on Weber’s ideal type methodology, we “rationalized” the historical development to obtain information about potential causes (or “drivers”). The analysis made use of Polanyi’s and Tönnies’s conceptualizations and categories: commodification, movement/countermovement, society/community, and local/trans-local to draft an argument that gives sufficient or satisfactory reasons for the presence of causes and their impact on the event—this is what we mean by “explanation.” In sum, we explain the event as consequence of a particular historical development and multicausal process. First of all, the commodification of labor, law, and nature facilitated the event. One group of causes, including the facilitators (FG), was sufficient to bring the event about—in conjunction with a second group (SG). The commodification of law, labor, and nature worked hand in hand at a transnational level. The Single Market Act, the Directive 96/71/EC, and the EU expansions in 2004 and 2007 prepared the ground for the transfer of work force within the EU borders and the structural development of the German meat industry. Weber was convinced that, in cultural reality, nothing happens with natural law-like determinism. Thus, the commodification of law, labor, and nature did not push the German meat industry on a path that, associated with the COVID-19 pandemic, would have brought about the event anyway. Potential causes that could have crisscrossed the event to occur are summarized in Tables 10.1 and 10.2. The EU took a number of steps to ensure that the transfer of commodified labor was based on ethically and legally adequate grounds. The idea underlying the Directive 96/71/EC was that posted workers can profit from the differences between member countries in social and labor standards not that they are employed because of these differences. In practice, instead of the principle of the most advantageous social law a hard core of minimum standards has won. Until the Directive 2014/67/ EU, the regulations proposed after the Directive 96/71/EC document the EU’s

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incapability to change the movement’s direction. The same applies to the German development that was an ongoing movement back on forth—forth pushed by the unions, civil society, and the media and back because there was no substantial change. As the event reveals, the EU and Germany were unable to stop the movement. Explaining the event implies explaining this failure. This brings again the actors and their interest in making a market for cheap meat into play. The history of posted work in the German meat industry is the history of a group of actors that managed to create a market in line with their interests and determined by unethical, partly even illegal or criminal action. The SG-causes that enkindled the infections among posted workers (the supportive environment, i.e., the housing situation or the low workplace temperatures in connection with the ventilation system at production sites) account only partly for the impact of medical/virologic causes on the event. The major cause among the SG-causes was the organized irresponsibility of those representatives of the German meat industry, subcontractors, or recruiters who managed to maintain their rules of the game until 2021. The most important recognition from this history is perhaps regulations come and go, but the main actors remain the same (see, e.g., Salomon et al., 2021). In short, the event occurred because the virus found favorable conditions for its dissemination in the tayloristic work organization and the working conditions at production sites, because the main actors in the German meat industry and Eastern European subcontracting business organized their business or established marketing systems devoid of ethical reflection and because posted workers remained without effective legal protection and communal association in Germany.

10.5

Conclusions, Outlook, and Limitations

The preceding discussion has taken the view that markets are always embedded and that, because of the vagueness of the meaning of “embedded” and “economic,” the meaning of “disembedded markets” remains unclear. Notwithstanding, “disembedded market” is often used to designate the result of deregulation policies. In our case, marketization follows from regulation—the regulation of something that was not extant before, i.e., the EU Single Market. Our analysis reveals, in Weberian terms, how categories “make” the cultural world. Distinctions such as those between contractus and status, society and community, and the ideas or ideologies associated with them have shaped cultural reality. We pointed to the vagueness of Polanyi’s ideas with regard to the “always embedded market economy” and mentioned that Weber’s and Polanyi’s views do not always coincide. In methodological terms, however, Polanyi’s categories are associable with Weber’s fundamentals. Historical analysis, multicausality, and interpretive sociology go hand in hand. Although Polanyi’s framework needs amendment with regard to the microsociological dimensions of historical

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developments, they may pave the way to a renewed interest in economical-historical analysis (Maurer, 2018). This brings us to limitations of our work and the outlook. In line with Weber’s methodology, based on our values, research interest, and resources, we studied a part of cultural reality. We made use of rational causation, posing a direction on our analysis. Our tables are ideal-type constructs. By focusing on commodified labor and law, we constructed a Weberian unreal causal process thus neglecting or abstracting from factors which might be considered relevant if using other lenses. Our analysis, for example, did not include movements and countermovements in the posted workers’ home countries or the interaction of the German meat industry with the German civil society. Like Polanyi, we have not drawn on the full potential of Weber’s methodology. Thus, our analysis is amendable with regard to microlevel analyses shedding light on interpretive aspects of human action. Additional insights could be obtained, e.g., through qualitative interviews with representatives of the German meat industry, communities, labor unions, or previously posted workers (Mense-Petermann, 2018). Future research could address the historical development after the event. Will the Occupational Safety and Health Act be able to bring the desired changes about? From a macromarketing perspective, the question arises how marketing systems can be created and maintained that do not build on organized irresponsibility or how such marketing systems (cultural realities) can be changed. Acknowledgment This paper benefitted from the comments and insights of Ingrid Becker.

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Michaela Haase is professor at Freie Universität Berlin. Her doctoral thesis addressed Galilean idealization and her habilitation thesis the social-theoretic and institutional foundations of business administration (Allgemeine Betriebswirtschaftslehre). She is co-editor of the Springer book series “Ethical Economy. Studies in Economic Ethics and Philosophy” and co-edited special issues of the Journal for Business, Economics & Ethics (zfwu), the Journal of Business Ethics, and the Journal of Business Economics. Michaela Haase is a member of the macromarketing society since 2009 and associate editor of the Journal of Macromarketing since 2016. As supervisor of a research project funded by the German Research Foundation (DFG), her recent research has focused on social value and social enterprise. Other research interests include services marketing, business and economic ethics, value philosophy, institution theory, and philosophy of science. Anne Schade is a marketing and brand management professional. She completed her undergraduate degree in Business Administration with focus on marketing in 2018 at Christian-AlbrechtsUniversität Kiel and Oslo Business School. She finished her graduate degree in Management & Marketing in 2021, after studies at Freie Universität Berlin and Università Bocconi. From 2019 to 2021, Anne Schade was a student assistant at the Marketing Department of Freie Universität Berlin, focusing on social value and social enterprise. She worked with Prof. Dr. Michaela Haase on the research project “Social value and social enterprise: an institutional and ideology-critical analysis.”

Chapter 11

Ghana’s Response to the COVID-19 Pandemic Charlene Ama Dadzie

Abstract Ghana’s response to the COVID-19 pandemic was shaped by the unique and informal nature of marketing systems as in many African countries. This chapter presents a case study on Ghana’s response and management of the COVID-19 pandemic. Further, this chapter draws on the framework of Shultz et al. (Journal of Eastern African Studies 6(1):47–63, 2017) and reviews African marketing systems to explain how policymakers and organizations in Ghana adapted them to facilitate mitigation efforts during the COVID-19 pandemic. Further, the chapter identifies the interventions that catalytic institutions implemented to abate the pandemic’s impact on already distressed communities. The chapter closes with implications for consumer quality of life and identification of best practices. Keywords Covid-19 pandemic · Ghana · Catalytic institutions · Systemic Framework to QOL in Distressed and Flourishing Communities

11.1

Background on Ghana, West Africa

The country has one of the strongest and most stable economies in Africa, although dominated by agriculture, which employs about 40% of the labor force. Ghana is one of the world’s leading cocoa exporters. It is also a significant exporter of commodities such as gold, lumber, and crude oil. The country spans more than 238,500 km2. As of 2013, Ghana has an estimated population of 25,199,609 consisting of more than 100 ethnic groups—each with its own unique language. English, however, is the official language, a legacy of British colonial rule. The Greater Accra region, which includes the nation’s capital, Accra, is the smallest in size. Greater Accra is the country’s second most densely populated region, with approximately three million inhabitants. The region is comprised of two metropolitan areas, Accra and Tema (Fig. 11.1)(The Permanent Mission of Ghana to the United Nations, 2020).

C. A. Dadzie (*) University of South Alabama, Mobile, AL, USA e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_11

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Fig. 11.1 Map of Ghana. Source: The Permanent Mission of Ghana to the United Nations

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Marketing Systems in Africa

A marketing system is defined by Layton as: a network of individuals, groups, and/or entities; embedded in a social matrix; linked directly or indirectly through sequential or shared participation in economic exchange; which jointly and/or collectively creates economic value with and for customers, through the offer of assortments of products, services, experiences, and ideas and that emerge in response to or in anticipation of customer demand. (Layton, 2011, p. 259)

Marketing systems occur at various levels beginning with a transaction between two individuals in a micro-system on the one hand, all the way to aggregate marketing systems that encompass entire sectors in a nation or beyond (Layton, 2007). One can situate Ghana’s response to the COVID-19 pandemic within the African marketing system at a broad level. An aggregate marketing system is composed of many nations, each with their own formal and informal sectors, including informal cross-border trade (ICBT). Marketing systems result from dynamic evolutionary processes, including formation, growth, adaptation, and, potentially, their collapse (Layton & Duffy, 2018). Layton has identified the critical components of marketing systems (2009, 2011). Marketing systems work to serve key consumer groups’ needs through their operation and the resultant assortments they produce in response to consumer needs (Layton, 2009, 2011). Structural and functional elements or marketing systems also exist. They include the logic of exchange and the exchange context, flows and roles, networks (including their dynamics), and governance (Layton, 2009, 2011). African marketing systems have been studied and analyzed in numerous fields outside of marketing (Ingenbleek, 2020). This body of work has included analysis of specific cases at the micro-level (Arnould, 2001; Arnould & Mohr, 2005; Bohannan & Dalton, 1962; Kambewa et al., 2008), ranging to broader works done at the macrolevel (Fafchamps, 2004; Hopkins, 1973) (for a review, see Dadzie & Sheth, 2020). African marketing systems usually involve the exchange of products such as agricultural outputs, food, textiles, body ornaments, and body care products and take place within local or nearby communities. Further, exchange actors from outside the local community participate in these marketing systems for the purposes of aggregating products for the formal sector, or to secure other products for consumers in other parts of the continent (Babah Daouda et al., 2020). In this context, trade is best understood as taking place within marketplace networks that exist at various levels: local, central, capital, or intersectional markets. Within these markets, product transportation involves inherent risk and transaction costs, which are the key determinants of how far products can travel (Ingenbleek, 2020). Exchange actors provide value by bridging structural holes (Burt, 2001) and facilitating connections between buyers and sellers (Ingenbleek, 2020). Resource scarcity pervades the transactional environment, making both buyers and sellers vulnerable to information asymmetry and increased the risk of conducting repeated transactions based on credit. Kinship relations and cooperative social organizations provide the key social mechanisms by which buyers and sellers buffer themselves from risk. The African

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marketing system extends outside via buyers and sellers located in cities bordered by the Sahara Desert that facilitate trans-Saharan trade with North Africa and seaports at the Atlantic and Indian oceans. The system is delineated between the formal and informal sectors. Informal sector microenterprises consist of a single, or at most a few, persons. In contrast, in the formal sector, formal companies can be large and often have strong connections with government actors (Ingenbleek, 2020; Layton, 2011). Despite their size, they often depend on informal sector traders to purchase products from communities or to reach consumers in these communities, especially concerning last-mile product distribution. At a macro-level, African marketing systems contain a sizeable informal sector, an emphasis on agricultural products rather than processed products and services and a small number of indigenous businesses (Arnould & Mohr, 2005; Hounhouigan et al., 2014). Informal work, not surprisingly, makes up a large employment sector, given the sizeable informal sector. Approximately 70% of informal sector workers maintain hand-to-mouth livelihoods, making them particularly vulnerable to economic shocks and social turbulence. Informal sector, hand-to-mouth workers address their immediate daily needs based on daily labor alone. Consequently, these workers have particular difficulties when investing, saving, and accessing future financial packages (Aguiar et al., 2020). Informal and formal marketing systems coexist (Babah Daouda et al., 2020) with some scholars acknowledging that formal and informal marketing systems exist in parallel (e.g., Godinho et al., 2017). More recent scholarship points to the opportunity for strong interconnections between the two sectors as a path to mutual success.

11.2.1 Shortcomings of the African Marketing System Informal and formal marketing systems in Africa serve to offer consumers goods, products, services, and experience. They operate within the context of state fragility, poverty, rural to urban migration, food security, economic reform, inequality, economic empowerment, and formal and informal markets (Ingenbleek, 2020). Furthermore, these marketing systems experience particular challenges. That is, marketing systems are characterized by infrastructure, facilitating technologies, legal frameworks, and institutional regulations that increase transaction costs (e.g., Adekambi et al., 2015; Arnould & Mohr, 2005). Thus, fragmented markets can be common here, and market differences exist in terms of preferences, available products, and services for communities (e.g., Layton, 2009; Wooliscroft & Ganglmair-Wooliscroft, 2018). Market fragmentation ultimately stymies the development of economies of scale (Redmond, 2018; Sheth, 2011), thwarts marketing systems development, and harms quality of life and economic growth given that consumers can only access relatively homogeneous product assortments (Layton, 2009).

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11.2.2 Essential Goods Distribution Network In many African economies, there is a well-established network for the distribution of essential goods (e.g., soap, imported foods of all kinds, medicines) through the rural towns and villages. While these networks can deliver essential goods to nearly every town and village, they have often been criticized as being inefficient or profitdriven at the expense of social needs (Meagher, 1995; Sheth, 2011).

11.2.3 Commodity Supply Chains Commodity supply chains represent a key component of the African marketing system (Williams, 2009). Commodity supply chains are supply chains that support global trade for major agricultural products such as cocoa (Ghana, Ivory Coast, and Cameroon) and coffee (Kenya, Tanzania) (Babah Daouda et al., 2020). This system’s major feature is that it is primarily adapted to goods and services within the internal markets (Arnould & Mohr, 2005). The system comprises major buying centers located in many major farming towns and villages (Williams, 2009). Farmers sell their produce to buying agents whose network expands across a given county to reach the majority of towns and villages (Babah Daouda et al., 2020). Once purchased from a buying agent, produce is then consolidated at major towns and then reshipped by carriers to the ports. These networks are ideal for both inbound and outbound logistics flows. Inbound flows include materials such as fertilizers, farming equipment, and information (Dadzie, 2015). In addition, commodity supply chains are adaptable to rural societies in that they have maximum reach (Arnould & Mohr, 2005). They are increasingly integrated with the banking system to produce purchasing and financing and help enhance another important part of the supply chain—the flow of funds (Dadzie, 2015; Dadzie et al., 2013). In contrast, commodity supply chains are rarely integrated and are therefore characterized by duplication and redundancy, especially at the community level (Yadav et al., 2014). This shortcoming is intensified when it comes to reaching victims of disaster relief programs, including infectious disease. While they exhibit high service accessibility in that produce officers constantly travel to various buying centers, the produce-buying agencies are not currently part of the supply chains for formal humanitarian agencies (Kovacs & Spens, 2012). However, there is an opportunity to form collaborative arrangements between actors to increase the reach of preexisting logistics infrastructure to an increased number of towns and villages. Consequently, the biggest obstacle to the commodity supply chain is the high potential for low service availability. There are no local coordinating mechanisms within the existing logistics infrastructure to ensure that essential humanitarian goods are likely to be adequately and equitably distributed to rural communities (Kovacs & Spens, 2011).

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11.2.4 Informal Cross-Border Trade in African Marketing Systems Informal cross-border trade (ICBT) is an important component of marketing systems in Africa. Kahiya and Kadirov (2020) define informal cross-border trade (ICBT) as market-based exchanges of legally produced/acquired goods across national borders, which occur outside the realm of formal commercial activity. Exchanges fall outside the regulated space because (1) the traders involved may not be formally registered, and (2) the transactions may be sporadic and of such a low or hard to quantify commercial value that they do not draw sustained interest from regulators. Further, understanding ICBT is significant to conceptualizing COVID-19’s impact on consumer quality of life and well-being, during the pandemic. The Organization for Economic Cooperation and Development (OECD) identifies three types of informal cross-border trades: (1) firms that operate completely outside the formal economy; (2) firms that are legally registered but, in part, circumvent taxes and duties; and (3) firms that completely avoid paying the required taxes and commercial duties required of them (Lesser & Moisé-Leeman, 2009). Fourth, organizations and individuals facilitate trafficking and smuggling as a form of ICBT (see Titeca, 2012). ICBT is part of the socioeconomic fabric of the marketing system in sub-Saharan Africa and other marketing systems on the continent located at the meso- and microlevels. ICBT has been studied extensively (e.g., Afrika & Ajumbo, 2012; Dobler, 2016; Ellis & MacGaffey, 1996; Fadahunsi & Rosa, 2002; Flynn, 1997; Meagher, 2003; Peberdy & Crush, 2001; Peterson & Zehra, 2018; Raeymaekers, 2012; Tschirley & Jayne, 2010). Recent scholarship refers to ICBT as a substratum marketing system, a key element that aids in the birth and development of formal marketing or formalization (Layton, 2015). Importantly, recent macromarketing scholarship argues that visible market structures are the “tip of an iceberg” nested within a complex web of culturally embedded hybrid exchange relationships and practices. It is only when national boundaries are traversed that ICBT becomes evident (Kahiya & Kadirov, 2020). Previous research on ICBT focuses at mostly the micro-level, while some macro-level analyses also having been undertaken (e.g., Dobler, 2016; Layton, 2007; Walther, 2012). Of particular note is Layton’s (2007) examination of Accra, Ghana’s Makola market, which addresses the retail component of ICBT. In reference to the African marketing system, various scholars describe the socioeconomic context in Africa based on a number of related dimensions. These dimensions include rural to urban migration, the decline in agricultural production, the legacy of botched economic structural adjustment programs, unemployment and underemployment, lack of opportunities for the youth, and porous borders (Akinboade, 2005; Alusala, 2010; Ama et al., 2014; Little et al., 2015; Manjokoto & Ranga, 2017; Meagher, 2003; Muzvidziwa, 2001; Ndlela, 2006; Ogalo, 2010). Further, micromarketing scholars have suggested that according to the neoclassical

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view, ICBT arises from the obstacles to doing business that Africa’s business environment poses (Kahiya & Kadirov, 2020). Well-established obstacles to conducting business in Africa include high transaction costs, bureaucracy, corruption, lack of knowledge, restricted access to financing, and limited education and skills. The comparatively low ranking of African countries concerning ease of doing business, economic freedom, corruption perception, and human development are also widely cited to further implicate Africa’s business environment (Kahiya & Kadirov, 2020). To be sure, multilateral lending agencies and supranational organizations including the African Development Bank (e.g., Afrika & Ajumbo, 2012), Food and Agriculture Organization (e.g., Koroma et al., 2017), OECD (e.g., Lesser & Moisé-Leeman, 2009), and the United States Agency for International Development (e.g., Blumberg et al., 2016) espouse this viewpoint. Importantly, informal cross-border trade activity has taken place on the African continent prior to modern Africa, arising from socio-ethnic ties that even predate colonialism (Ellis & MacGaffey, 1996; Koroma et al., 2017; Little, 1992; Mohamadain & Ati, 2015; Ogalo, 2010). For example, scholarship undertaken during the early postcolonial period elucidates the fact that the 54 countries that currently make up the African continent are actually reflective of more than 800 distinct ethnic geographies, each with its own multilayered jurisdictional hierarchy that extends past local villages (Murdock, 1967). Not surprisingly, these socio-ethnic matrices coalesce to create a collectivistic culture (Kahiya & Kadirov, 2020) responsible for producing economic exchanges that occur within a social matrix (Hounhouigan et al., 2014; Layton, 2011). As borders cropped up following colonization, ICBT became a symbol of both contempt and defiance, directed at colonial settlers for creating borders, which some considered as artificial (Flynn, 1997; Mohamadain & Ati, 2015; Nshimbi, 2015; Walther, 2012). Modern Africa has retained these traditional ties between social and ethnic groups, and some communities view national borders as bridges instead of boundaries (Dobler, 2016; Flynn, 1997). Importantly, ICBT has important implications that endure today. For example, many women are employed in ICBT work (Kahiya & Kadirov, 2020). Consequently, this activity has enduring implications for their livelihoods and those of their children. Going forward, the next section of the chapter will explicitly address COVID-19’s impact on the informal sector, including ICBT activity.

11.2.5 Vulnerabilities in Ghana’s Marketing System Considering the overview of the marketing system in Ghana, prior to the pandemic, several key areas of vulnerability arise. Recent urban planning and development activities rendered the most impoverished consumers in Ghana particularly vulnerable to the pandemic’s impacts. Prior to the onset of the pandemic, more than six million slum residents in Ghana lacked access to habitable housing facilities (Abu-Salia et al., 2015) equipped to support social distancing and frequent washing

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of hands under running water. To further complicate matters, on April 16th, 2020, during the lockdown, the Accra Metropolitan Assembly (AMA) demolished numerous wooden shanty structures in Old Fadama, Accra. The demolition was undertaken in order to continue the Korle Lagoon dredging and reconstruction project. However, more than 1,000 slum dwellers became homeless as a result of the demolition exercises (MyJoyonline, 2020, April 15th). As a result, slum residents at Old Fadama, Accra (especially during the lockdown), were forced to sleep outdoors, increasing their risk of exposure to COVID-19. Further, their homes’ demolition increased the difficulty for them to practice social distancing rules and access running water and other facilities to execute the necessary hygiene practices. Additional elements of the marketing systems are represented by the fact that tropical sub-Saharan African countries such as Ghana have unique advantages. According to Dr. Augustina Sylverken, a lecturer at Kwame Nkrumah University of Science and Technology, consumers in these nations may have cross-protective immunity from other microbial exposures as individuals in the tropics have had multiple exposures and infections with microbial organisms (Wright, 2020). Additionally, public health officials, doctors, and scientists in Ghana who are working to mitigate the current pandemic have experience with managing previous, localized epidemics such as meningitis, cholera, measles, and others. However, pandemic containment at the national level represents an unprecedented challenge.

11.2.6 Ghana’s Healthcare System Several factors characterize the healthcare component of the marketing system in Ghana prior to the pandemic. The low number of health facilities, medicine availability, and research capacity were a key point of vulnerability prior to the onset of the COVID-19 pandemic. Additionally, the system was already working to address high rates of infectious and noninfectious diseases (Godman et al., 2020; United Nations Africa Renewal, 2020) alongside a fragile healthcare system. Not surprisingly, at the pandemic’s onset, concerns regarding the availability of face masks, gloves, hand sanitizers, and diagnostic materials for testing COVID-19 in LMICs existed (Afriyie et al., 2020). Furthermore, PPE and diagnostic materials are seldom manufactured in LMICs, such a Ghana. In order to address consumer needs, two hospitals in the Greater Accra Region of Ghana—Ga East Municipal and Bank of Ghana Hospitals—were designated as COVID-19 treatment centers. Also, three major laboratories in the country, located at Noguchi Memorial Institute for Medical Research (NMIMR), Kumasi Centre for Collaborative Research (KCCR), and the National Public Health Reference Laboratory (NPHRL), as well as nine other state and government hospital laboratories were identified for use. These laboratories were designated to provide logistical support in performing tests on samples and to help with track and trace testing (Ghana News Agency, 2020a, 2020b).

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Ventilators have been identified as a key resource for critically ill COVID-19 patients; as of January 2020, Ghana had over 100 health facilities available to manage critically ill COVID-19 patients. In addition, the government purchased 307 ambulances for the National Ambulance Service equipped with mobile ventilators (Zurek, 2020). Efforts were taken to secure 50 more ventilators (Zurek, 2020). Furthermore, a team of local professionals from Academic City University College, Ghana, developed a baseline prototype of a mechanical ventilator to support critically ill COVID-19 patients (Ghana News Agency, 2020a, 2020b).

11.3

Ghana’s COVID-19 Containment Measures

The Shultz et al. (2017) framework illustrates that programs and policies that focus on consumers’ lower-order needs can be viewed in terms of nine dimensions: (a) environmental pollution, (b) disease incidence, (c) crime, (d) housing, (e) unemployment, (f) poverty and homelessness, (g) cost of living, (h) community infrastructure, and (i) illiteracy and lack of job skills. Thus, during the pandemic, key actions were taken to address the lower-order needs of disease incidence, unemployment, poverty, and cost of living. Several key catalytic institutions were involved in thwarting the spread of COVID-19 in Ghana. First, key government activities to fight the source of COVID-19 included issuing and enforcing directives on restricted movement, including a lockdown. Initially, the government issued indefinite closure of universities, schools, churches, and mosques. A ban on all public gatherings was issued on March 15, 2020. Next, a lockdown was ordered on March 27, 2020, for the country’s two epicenters: the Greater Accra Metropolitan Area and the Greater Kumasi Metropolitan Area (Nkansah, 2020). Ghana closed its land, sea, and air borders to all human traffic on March 21, 2020, immediately impacting the hand-to-mouth workforce engaged in local and informal cross-border trade. Further, the border closure included a 14-day mandatory quarantine and testing for all travelers from countries with more than 200 known COVID-19 cases. On March 26, 2020, the President granted amnesty to 808 prisoners based on the recommendation of the Prison Service Council and in consultation with the Council of State in accordance with the Ghana Constitution. These efforts sought to reduce overcrowding in the prisons as a precautionary measure (Nkansah, 2020). A particular feature of Ghana’s response has been the use of public disinfection campaigns involving vector-control and waste management companies (Nkansah, 2020). The Minister of Local Government and Regional Development, in response to the President’s order, started disinfection of all open spaces, markets, and lorry stations in the country starting from the Greater Accra Metropolitan Area on March 23, 2020, as a precautionary measure against community transmission. Second, catalytic institutions worked together to ensure consumers’ lower-order needs’ satisfaction (Shultz et al., 2017). Since the detection of COVID-19 in Ghana, there have been numerous cash and charitable contribution donations from

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individuals, churches, the private sector, the aviation industry, the political parties (notably the leading opposition party, the National Democratic Congress), etc. Importantly, these catalytic intuitions channeled donations directly to other catalytic institutions—hospitals, research centers, prisoners, impoverished consumers, etc.— as well as directly to the government. In addition, the government has taken efforts to provide for the welfare of vulnerable consumers through additional actions. The Ministry of Gender and Social Protection, in collaboration with the National Disaster Management Organization (NADMO); Metropolitan, Municipal, and District Chief Executives (MMDCEs); and faith-based organizations distributed food and other essential supplies to consumers located in communities impacted by the lockdown. Further, on Wednesday, March 25th, 2020 Ghanaians, with the leadership of President Akuffo-Adoh, observed a National Day of Prayer and fasting, seeking God’s intervention over COVID-19. In early April, the government and local leaders also announced a plan to offer free water and a 50% waiver on electricity consumption for residents for the period of April–June 2020. Frontline health workers were offered a 50% increase in basic salary and a Life Insurance Cover in addition to the easements mentioned above. To this end, the One Million Ghana-Cedi fund, was established by Otumfuo Osei Tutu II, King of the Ashanti Kingdom, on April 1, 2020. The government introduced a variety of interventions to assist those affected by the coronavirus pandemic. In addition, soft loans were offered to qualified micro-, small-, and medium-sized enterprises. The Government of Ghana also worked with a number of community stakeholders, including faith-based organizations, traditional rulers, market women, owners of public transport, pharmaceutical manufacturers and industries, and the leadership of parliament to partner with the government and use their various platforms to help in public education, expansion of infrastructure, and local manufacture of personal protection equipment (PPEs). Consequently, these efforts have ensured that education materials have been translated into eight local languages. Additionally, skits and recorded messages by social media influencers have also been leveraged to increase awareness and social distance compliance. Importantly, press and media, with the leadership from the Minister of Information, have been used as vehicles to disseminate information and provide a feedback mechanism from the government to the Ghanaian people and vice versa. Media outlets have been instrumental in providing free airtime and space for COVID-19 public education local response strategies. The President met with the National Media Commission’s leadership, journalists, and media houses as a reaction to conspiracy theories circulating via media on April 26, 2020.

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11.3.1 Activity and Innovation Among Healthcare Catalytic Organizations Ghana Medical Association is a key catalytic institution responsible for public education on COVID-19 prevention, testing, and treatment. They have worked in conjunction with telecommunication companies in Ghana and Ghana Health Service (GHS) to provide the necessary data for effective contact tracing. The Ghana Health Service (GHS) also created and maintains a real-time COVID-19 online monitoring system for domestic cases. Further, GHS advises the government on effective COVID-19 contact tracing and case management strategies. The Noguchi Memorial Institute of Medical Research (NMIMR) in Accra and the Kumasi Centre for Collaborative Research (KCCR) have been designated to test COVID-19 samples. Further, academics at the Kwame Nkrumah University of Science and Technology (KNUST) and other institutions began producing alcohol-based hand sanitizer for the country. The College of Engineering of KNUST designed and constructed a ventilator called “IBV and KNUST Ventilators,” which is awaiting clinical testing. In addition, scientists at KNUST, together with Incas Diagnostics (a diagnostic company), have created a rapid diagnostic test (RDT) kit to test for the novel coronavirus. The Centre for Plant Medicine Research (CPMR) serves to authenticate and integrate herbal medicine claims into the COVID-19 management and treatment. The Noguchi Memorial Institute of Medical Research (NMIMR) in Accra and the Kumasi Centre for Collaborative Research (KCCR) in Kumasi were tasked with testing COVID-19 samples in the country.

11.3.2 Expansion of Infrastructure for COVID-19 Testing, Treatment, and Management Though the Noguchi Institute of Medical Research and the Kumasi Center for Collaborative Research have been the designated institutions for testing COVID19 from the onset of the pandemic, eight additional testing faculties located across the country were established to help the situation. Also, in the quest to shorten the time between sample taking and testing in remote communities, Zipline Company, which is in charge of medical drones in Ghana, started transporting COVID-19 test samples from April 2020, reducing the psychological stress associated with waiting days to receive test results. On April 17th, the President of Ghana did a virtual sod-cutting of a 100-bed isolation and treatment facility in the Ga East Municipality. A number of centers have also been secured around the country, with the private sector and faith-based organizations acting on consumers’ interest (Nkansah, 2020).

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11.3.3 Other Funding Interventions and Stimulus Packages Government actions to fight the pandemic included a number of other actions to fight the pandemic. First, in order to facilitate the collection and distribution of funds, cash, and in-kind donations from NGOs, churches, and the private sector, the Ghanaian President inaugurated a Board of Trustees on March 29, 2020. As an act of solidarity with the Ghanaian citizens, the President and Vice President promised to contribute their 3-month salaries from April to June to the fund. In addition, certain parliamentary members also donated a portion of their April to June salaries to the fund. Most countries implemented some measures to support poor households and small-, micro-, and medium-sized enterprises. In Ghana, a GH¢1.2 billion (about USD200 million) Coronavirus Alleviation Programme was established by the government to support affected households (Haider et al., 2020). In contrast to the above actions, there are programs and policies that target higherorder needs involving nine different dimensions: (a) work productivity and income, (b) consumption of nonbasic goods and services, (c) leisure and recreational activities, (d) educational attainment, (e) community landscape, (f) population density and crowdedness, (g) arts and cultural activities, (h) intellectual activities, and (i) religious activities (Shultz et al., 2017). During the early days of the COVID-19 pandemic, catalytic institutions in Ghana worked to address the following higherorder needs: income and religious activities by hosting a National Day of Prayer and Fasting and further activating the social safety net.

11.3.4 Social Safety Net Interventions Used During the Pandemic Working with the World Bank, Ghana launched the Ghana Productive Safety Net Project in 2019 as a means to procure financial and technical assistance to the government in order to support its downstream social safety net program implementation. One of the key resulting social safety net programs is the Livelihood Empowerment Against Poverty (LEAP) program. LEAP provides bimonthly cash transfers to approximately 332,000 households (about 1.5 million individuals). Cash transfer amounts range from an equivalent of USD12 to USD20. The program serves Ghanaians throughout the country, but the majority live in northern Ghana. With the onset of the pandemic, LEAP provided an additional round of one-time cash transfers to beneficiaries in May. In order to follow social distancing protocols, cash transfers were moved from community sites, and contactless transfers were conducted. Recipients used an electronic benefit transfer card to withdraw cash from an ATM, with LEAP providing a top-up benefit of 10 Ghana cedis (approximately USD1.75) for urban beneficiaries and 20 Ghana cedis (approximately USD3.50) for rural beneficiaries to help offset the cost of transportation to the ATM. Later, in July, cash transfer distributions were resumed at community sites. Consequently, LEAP

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made masks, disinfection, and hand-hygiene supplies available and enforced social distancing at the sites. The Labour-Intensive Public Works (LIPW) program was created to provide work opportunities in northern Ghana during the pandemic. According to program guidelines, LIPW participants work for up to 180 days (no more than 6 h per day) over two consecutive agricultural off-seasons and are paid the national minimum daily wage, which in 2020 is 11.8 Ghana cedis (equivalent to USD2). LIPW work projects include maintenance and rehabilitation of rural roads and small earth dams and dugouts, soil conservation, and tree planting. Additionally, program requirements stipulate that at least three-fifths of LIPW beneficiaries must be women. Approximately 14,000 individuals (from just as many households) were working under LIPW at the onset of the COVID-19 pandemic in Ghana. As the government closed schools to reduce virus spread, LIPW reduced the number of required work hours for mothers and caregivers but continued to pay full daily wages. The program has also taken steps to protect workers’ health by reducing the size of work crews, adjusting crew rotations, and enforcing physical distancing. All LIPW sites have made masks and disinfection and hand-hygiene supplies available.

11.4

Implications for Individual and Community Quality of Life and Best Practices

As described above, the Ghanaian government and other catalytic institutions in the country took numerous measures to provide support and relief to an already distressed community at the onset of the COVID-19 pandemic. Given the nature of the African marketing system, particularly the components of the marketing system in Ghana, millions of the country’s citizens were employed by the informal sector, including informal cross-border trade activity. In addition, government projects such as the dredging of the Korle Lagoon negatively impacted acutely distressed communities within the Greater Accra region. Consequently, these individuals living in acutely distressed communities needed the strongest interventions. In light of these ongoing areas of attention, catalytic institutions made strides in addressing consumers’ lower-order needs. Furthermore, certain interventions also addressed consumers’ higher-order needs. Going forward, we propose actions to address how future pandemics might better be addressed through the design of marketing systems that reflect the rural and urban nature of Ghana’s supply chains. First, the government should work with the World Health Organization, local and international NGOs, and civil society institutions to ensure that vaccines and testing go hand in hand. It should also ensure that both the vaccines and testing are affordable to everyone who wants it. An equitable distribution system must be developed. Second, policymakers and health care professions should focus on equal access to vaccinations for urban and rural consumers. In order to facilitate vaccinations and ensure penetration to the various rural towns and villages in the

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country, the preexisting commodity supply chain distribution model should be deployed. That is, measures should be taken to develop and utilize rural distribution centers. Cocoa produce-buying centers and weighing centers can be used as hubs for testing and vaccine distribution to this end. Going forward, healthcare development can increase the quality of goods and services available to Ghanaian consumers, increasing their quality of life. For example, President Akufo-Addo has acknowledged the need to digitize the country’s public health systems (Nkansah, 2020). Furthermore, the President announced plans to build 88 new district hospitals, increasing the scope and reach of the healthcare service ecosystem in the country. Ghana’s GDP projected growth of 3.3% for 2020 is expected to decline to less than 2.9% as a result of the COVID-19 partial lockdown restrictions (Deloitte Ghana, 2020). Trading volumes and values in the supply chain are expected to decline with a high net loss of revenue to the government, with hospitality and export industries being the worst affected (Deloitte Ghana, 2020). Nemzoff et al. (2020) note that Ghana’s economy has been adversely impacted by COVID-19 pandemic restrictions largely because the greater majority of the workforce is employed in the informal sector. Relatedly, the pandemic has caused economic shocks to the country, leaving the most vulnerable individuals and communities at the mercy of future large-scale shocks and trade crises with international and domestic trade partners, all key components of the African marketing system (Dadzie & Raju, 2020). Consequently, social safety net programs represent a vital instrument to meet consumers’ needs and respond to these risks (Dadzie & Raju, 2020). However, there is room to improve these programs in terms of the number and categories of individuals covered, their reach into urban areas, and the number of benefits offered (Nkansah, 2020). Unfortunately, these limitations impair the effectiveness of these programs in addressing poverty and the effects of the pandemic (Dadzie & Raju, 2020). To provide timely and effective support during crises, these programs will also need to incorporate structures and processes that allow authorities to smoothly and swiftly expand coverage, accurately target populations, raise benefit amounts, or adjust the frequency of benefits (Dadzie & Raju, 2020).

11.5

Conclusion

Utilizing the Shultz et al. (2017) framework, this chapter sought to provide an overview of Ghana’s response to the COVID-19 pandemic given the African marketing system’s unique and informal nature. Many communities within the country were easily classified as distressed, before the onset of the pandemic. Government restrictions on movements were uniquely challenging for the large number of informal workers in the economy. However, catalytic institutions and the government orchestrated numerous actions to address vulnerable consumers’ lower-order and higher-order needs. Despite these successes, there is additional room for these actors within the marketing system to further address an increased

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number of consumers’ higher-order needs. Careful consideration of areas of improvement for Ghanaian consumers’ well-being and quality of life by the government, citizen consumers, NGOs, and business will certainly increase the extent to which communities within the country can move from distressed to flourishing, going forward.

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public policy role of marketing in rural bank programs in Ghana. Journal of Public Policy and Marketing, 32(1_suppl), 59–69. Deloitte Ghana. (2020). Economic impact of the COVID-19 pandemic on the economy of Ghana. Retrieved from https://www2.deloitte.com/content/dam/Deloitte/gh/Documents/about-deloitte/ gh-economic-Impact-of-the-COVID-19-Pandemic-on-the-Economy-of-Ghana_06042020.pdf Dobler, G. (2016). The green, the grey and the blue: A typology of cross-border trade in Africa. The Journal of Modern African Studies, 54(1), 145. Ellis, S., & MacGaffey, J. (1996). Research on Sub-Saharan Africa’s unrecorded international trade: Some methodological and conceptual problems. African Studies Review, 39(2), 19–41. Fadahunsi, A., & Rosa, P. (2002). Entrepreneurship and illegality: Insights from the Nigerian crossborder trade. Journal of Business Venturing, 17(5), 397–429. Fafchamps, M. (2004). Market institutions in sub-Saharan Africa. MIT Press. Flynn, D. K. (1997). “We are the border”: Identity, exchange, and the state along the Bénin-Nigeria border. American Ethnologist, 24(2), 311–330. Ghana News Agency. (2020a). Ghana tops Africa’s ranking for COVID-19 testing. Retrieved April 20, 2020, from https://newsghana.com.gh/ghana-tops-africas-ranking-for-covid-19-testing Ghana News Agency. (2020b). Ghana’s locally made mechanical ventilator needs support. Retrieved from https://newsghana.com.gh/ghanas-locally-made-mechanical-ventilator-needssupport Godinho, V., Venugopal, S., Singh, S., & Russell, R. (2017). When exchange logics collide: Insights from remote Indigenous Australia. Journal of Macromarketing, 37(2), 153–166. Godman, B., Basu, D., Pillay, Y., Mwita, J. C., Rwegerera, G. M., Paramadhas, B. D. A., et al. (2020). Review of ongoing activities and challenges to improve the care of patients with type 2 diabetes across Africa and the implications for the future. Frontiers in Pharmacology, 11, 108. Haider, N., Osman, A. Y., Gadzekpo, A., Akipede, G. O., Asogun, D., Ansumana, R., et al. (2020). Lockdown measures in response to COVID-19 in nine sub-Saharan African countries. BMJ Global Health, 5(10), e003319. Hopkins, A. G. (1973). An economic history of West Africa. Routledge. https://doi.org/10.4324/ 9781315835792 Hounhouigan, M. H., Ingenbleek, P. T., Van der Lans, I. A., van Trijp, H. C., & Linnemann, A. R. (2014). The adaptability of marketing systems to interventions in developing countries: Evidence from the pineapple system in Benin. Journal of Public Policy and Marketing, 33(2), 159–172. Ingenbleek, P. T. (2020). The biogeographical foundations of African marketing systems. Journal of Macromarketing, 40(1), 73–87. Kahiya, E., & Kadirov, D. (2020). Informal cross border trade as a substratum marketing system: A review and conceptual framework. Journal of Macromarketing, 40(1), 88–109. Kambewa, E., Ingenbleek, P., & van Tilburg, A. (2008). Improving income positions of primary producers in international marketing channels: The Lake Victoria—EU Nile Perch Case. Journal of Macromarketing, 28(1), 53–67. Koroma, S., Nimarkoh, J., You, N., Ogalo, V., & Owino, B. (2017). Formalization of informal trade in Africa: Trends, experiences and socio-economic impacts. The Food and Agriculture Organization. Kovács, G., & Spens, K. M. (2011). Trends and developments in humanitarian logistics – A gap analysis. International Journal of Physical Distribution & Logistics Management, 41(1), 32–45. https://doi.org/10.1108/09600031111101411 Kovacs, G., & Spens, K. M. (2012). Relief supply chain management for disasters: Humanitarian aid and emergency logistics. Information Science Reference. Layton, R. A. (2007). Marketing systems—A core macromarketing concept. Journal of Macromarketing, 27(3), 227–242. Layton, R. A. (2011). Towards a theory of marketing systems. European Journal of Marketing, 45(1/2), 259–276. https://doi.org/10.1108/03090561111095694

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Layton, R. A. (2015). Formation, growth, and adaptive change in marketing systems. Journal of Macromarketing, 35(3), 302–319. Layton, R., & Duffy, S. (2018). Path dependency in marketing systems: Where history matters and the future casts a shadow. Journal of Macromarketing, 38(4), 400–414. Lesser, C., & Moisé-Leeman, E. (2009). Informal cross-border trade and trade facilitation reform in Sub-Saharan Africa. OECD Trade Policy Papers, No. 86, OECD Publishing. https://doi.org/10. 1787/225770164564 Little, P. D. (1992). Traders, brokers and market ‘crisis’ in southern Somalia. Africa, 62, 94–124. Little, P. D., Tiki, W., & Debsu, D. N. (2015). Formal or informal, legal or illegal: The ambiguous nature of cross-border livestock trade in the Horn of Africa. Journal of Borderlands Studies, 30(3), 405–421. Manjokoto, C., & Ranga, D. (2017). Opportunities and challenges faced by women involved in informal cross-border trade in the city of Mutare during a prolonged economic crisis in Zimbabwe. Journal of the Indian Ocean Region, 13(1), 25–39. Meagher, K. (1995). Crisis, informalization and the urban informal sector in Sub-Saharan Africa. Development and Change, 26(2), 259–284. Meagher, K. (2003). A back door to globalisation? Structural adjustment, globalisation & transborder trade in West Africa. Review of African Political Economy, 30(95), 57–75. Mohamadain, E., & Ati, H. A. A. (2015). Informal cross-border trade in Eastern Sudan a case study from Kassala and Gedarif states. Sudan Working Paper. Murdock, G. P. (1967). Ethnographic atlas: A summary. Ethnology, 6(2), 109–236. (128 pages). Muzvidziwa, V. (2001). Zimbabwe’s cross-border women traders: Multiple identities and responses to new challenges. Journal of Contemporary African Studies, 19(1), 67–80. MyJoyonline.com. (2020, April 15). Over 1,000 slum dwellers homeless after demolishing exercise at Old Fadama. https://www.myjoyonline.com/news/national/over-1000-slum-dwellers-home less-after-demolishing-exercise-at-old-fadama/ Ndlela, D. B. (2006). Informal cross-border trade: The case of Zimbabwe. Institute for Global Dialogue. Nemzoff, C., Chalkidou, K., Walker, D., & Sullivan, R. (2020, April 24). Are strict lockdowns suited to populations who live hand-to-mouth? A closer look at Malawi. https://www.cgdev.org Nkansah, M. A. (2020, June 3). Ghana’s multifarious response to COVID-19: Through a citizen’s lens. International Network for Government Science Advice. https://www.ingsa.org/covidtag/ covid-19-commentary/asantewah-nkansah-ghana/ Nshimbi, C. C. (2015). Networks of cross-border non-state actors: The role of social capital in regional integration. Journal of Borderlands Studies, 30(4), 537–560. Ogalo, V. (2010). Informal cross-border trade in EAC: Implications for regional integration and development. CUTS Geneva Resource Centre. Peberdy, S., & Crush, J. (2001). Invisible trade, invisible travellers: The Maputo Corridor spatial development initiative and informal cross-border trading. South African Geographical Journal, 83(2), 115–123. Peterson, M., & Zehra, S. (2018). Putting African country development into macromarketing perspective. In Emerging issues in global marketing (pp. 333–368). Springer. Raeymaekers, T. (2012). Reshaping the state in its margins: The state, the market and the subaltern on a central African frontier. Critique of Anthropology, 32(3), 334–350. Redmond, W. (2018). Marketing systems and market failure: A macromarketing appraisal. Journal of Macromarketing, 38(4), 415–424. Sheth, J. N. (2011). Impact of emerging markets on marketing: Rethinking existing perspectives and practices. Journal of Marketing, 75(4), 166–182. Shultz, C. J., Rahtz, D. R., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In Handbook of community well-being research (pp. 403–421). Springer.

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The Permanent Mission of Ghana to the United Nations. (2020). https://www.ghanamissionun.org/ map-regions-in-ghana/ Titeca, K. (2012). Tycoons and contraband: Informal cross-border trade in West Nile, NorthWestern Uganda. Journal of Eastern African Studies, 6(1), 47–63. Tschirley, D. L., & Jayne, T. S. (2010). Exploring the logic behind southern Africa’s food crises. World Development, 38(1), 76–87. Walther, O. (2012). Traders, agricultural entrepreneurs and the development of cross-border regions in West Africa. Entrepreneurship and Regional Development, 24(3–4), 123–141. Williams, T. (2009). An African success story: Ghana’s cocoa marketing system. IDS Working Papers, 2009(318), 01–47. Wooliscroft, B., & Ganglmair-Wooliscroft, A. (2018). Growth, excess and opportunities: Marketing systems’ contributions to society. Journal of Macromarketing, 38(4), 355–363. Wright, A. (2020, April 22). Fishing communities in Ghana brace for worsening coronavirus crisis. Forbes.Com. https://www.forbes.com/sites/andrewwight/2020/04/22/fishing-communities-inghana-brace-for-worsening-coronavirus-crisis/?sh¼680bb5b25495 Yadav, P., Lydon, P., Oswald, J., Dicko, M., & Zaffran, M. (2014). Integration of vaccine supply chains with other health commodity supply chains: A framework for decision making. Vaccine, 32(50), 6725–6732. Zurek, K. (2020). Coronavirus: Ghana has over 400 ventilators. Retrieved from https://www. graphic.com.gh/news/general-news/coronavirus-ghana-has-over-400-ventilators.html

Charlene A. Dadzie (PhD, University of North Texas) is an Assistant Professor of Marketing in the Department of Marketing and Quantitative Methods, Mitchell College of Business, University of South Alabama. Her research sits at the intersection of marketing and public policy and her research interests include marketplace inclusion, rural and urban poverty alleviation, and services marketing. Her publications have appeared in the Journal of Macromarketing, Journal of Public Policy and Marketing, Journal of Consumer Affairs, European Journal of Marketing, and Journal of Services Marketing, among others.

Chapter 12

Community and Market Development in India During Coronavirus: A Focus on the Migrant Worker (MW) Population Nicholas J. C. Santos and Subhasis Ray

Abstract In this chapter, we consider India’s response to the coronavirus pandemic, focusing particularly on the plight of the migrant worker (also referred to throughout the paper as MW) population resulting from various lockdown measures enacted by the Indian government. The time period that we study is from March 25 to May 31, 2020 which corresponds to the four phases of the lockdown. We use the theoretical lens of consumer vulnerability to better understand the situation of this population and the challenges they faced. We assess the quality of life in the migrant worker community using the systemic framework that Shultz et al. (Handbook of community Well-being research (pp. 403–421). Dordrecht: Springer, 2017) propose. Of the three catalytic institutions in this framework, we found that only nongovernmental organizations were concerned about the well-being of the migrant worker population. Our analysis reveals the need for more data as well as institutional and policy support for migrant workers in India. Keywords COVID-19 · India response to pandemic · Migrant workers · MW · India

12.1

Introduction

On March 11, 2020, as 114 countries reported that over 100,000 people had contracted COVID-19, the disease caused by the SARS-CoV2 virus, the World Health Organization (WHO) declared the rapidly spreading coronavirus outbreak a pandemic (Branswell & Joseph, 2020). As of January 9, 2021, close to 90 million people in 191 countries had contracted the disease and close to two million had died from it (John Hopkins University, 2021). Of these countries, India had over ten

N. J. C. Santos (*) Creighton University, Omaha, NE, USA e-mail: [email protected] S. Ray XIM University, Bhubaneshwar, India e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_12

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million cases (about 11% of the global number) with over 150,000 casualties (Allen et al., 2021). Of course, it should be noted that toward the end of January 2021, India was reporting daily cases around 10,000 (Frayer, 2021) in comparison to over 150,000 reported in the USA (Feuer & Rattner, 2021).1 According to Worldometer (2021a), India’s population as of January 2021 is estimated to be around 1.39 billion with a population density of 1202 people per square mile. In contrast, the USA has a population of a little over 330 million with a population density of 94 people per square mile (Worldometer, 2021b). India is the second most populous country in the world after China. India made international headlines when the Modi Government enacted a nationwide lockdown on March 24, 2020, 13 days after the WHO declared COVID-19 a pandemic, ordering all people in the country to stay home for 3 weeks (Gettleman & Schultz, 2020). India’s lockdown was considered the largest national lockdown globally (Miglani & Jain, 2020; The Lancet, 2020). However, it was criticized as being poorly thought through as people were given just 4 h notice before the order took effect (BBC News, 2020). The lockdown, which was extended three times, exposed the deep inequalities in Indian society and particularly brought to light the hardships suffered by migrant workers. The International Organization of Migration (2019, p. 132) defines a migrant as “a person who moves away from his or her place of usual residence, whether within a country or across an international border, temporarily or permanently, and for a variety of reasons.” However, this is rather broad definition and can include even tourists. We understand an Indian internal migrant worker as one who moves from rural areas to cities in search of jobs and livelihood. These consist of frontline workers in factories, shops, and daily laborers but also micro-entrepreneurs running small businesses or shops on their own. Thus, there can be those who migrate for a longer term and those who are seasonal migrants (Srivastava, 2020). In this chapter, we consider both these types together. Migrant workers are part of India’s informal economy, without documents, social security, or other state benefits. They typically stay in urban slums or poor neighborhoods, often with people from their home state or village and have minimal access to health care and education. According to Census 2011, the total number of internal migrants in India was about 139 million for both inter- and intrastate migration (Sharma, 2017). In this chapter, we focus on the four phases of the lockdown from March 24 to May 31, 2020 and its impact on migrant workers. The theoretical lens that we use is that of consumer vulnerability (Baker et al., 2005). For our analysis and subsequent discussion, we use the systemic framework that Shultz et al. (2017) propose to facilitate quality of life in distressed and flourishing communities.

1

Unfortunately, as of June 10, 2021, India was reporting the highest number of daily Covid deaths in the world (Choudhury, 2021).

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12.2

253

The Great Indian Lockdown

India’s first coronavirus case was reported on January 30, 2020 and by February 3, the number had risen to three cases (Ray & Subramanian, 2020). However, it was only at the beginning of March when the Ministry of Health and Family Welfare launched its COVID-19 awareness program. By mid-March there were over 100 confirmed cases and the infection appeared to move into community transmission. India’s population density coupled with its poor sanitation and high rate of internal migration made community transmission of the virus inevitable (Sen, 2020a). As the virus spun out of control, the Prime Minister of India, Narendra Modi, announced at 8 pm on March 24 that India would enter into a lockdown in 4 h. This resulted in total chaos as panicked mobs rushed to stock up on supplies. And, as buses and trains were cancelled, millions of migrant workers took to the roads on foot (Ray & Subramanian, 2020). Below, we consider the four phases of the lockdown, particularly in terms of its impact on the migrant worker population in India.

12.2.1 Phase I (March 25 to April 14) Reporting of the issues related to migrant workers took some time to surface. Initially, many workers thought that lockdown was a temporary measure and they could get back to work soon. Soon, workers from neighboring states started walking or moving back to their home state. For example, those staying in Delhi or the National Capital Region started moving back to bordering states like Rajasthan, UP, and Punjab. As a relief measure, the Indian government announced extra free food (rice/ wheat, lentils, sugar) for the below poverty line citizens through the country’s public distribution system. Indians accessing the public food distribution system have a “Ration Card” for getting subsidized food grains. Those with such cards had to stand for hours in the scorching heat to get their due ration. They had to face great difficulty in accessing these services and there were reports that ration dealers would often not give consumers their due shares and hoard as much as they could for selling in the open market. Most consumers did not know their entitlement of additional free food and often found themselves short-changed. It is a usual practice for migrant workers to pawn their ration cards to local money lenders. These workers were unable to avail the extra ration announced by the government. A large number of MWs also leave their cards at their village and could not use it for a contingency such as this one. Finally, a large number of MWs simply did not have the cards in the first place as they did not have documents for getting one. Around 90% of the MWs surveyed by Stranded Workers Action Network (SWAN) were not paid by wages by their employers (Pandey, 2020). While the MW issue grew bigger, the Indian government arranged special flights to bring back stranded Indians from abroad.

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During this phase of the lockdown, migrant workers were subjected to harm (Hill & Sharma, 2020) as they could not access food. Regular shops were closed or inaccessible, there were no wages for the daily laborers, and the state system provided them no control over the most basic of human necessities—food. In a way, the external condition (Baker et al., 2005), lockdown due to COVID-19, provided the first push toward a new phase of vulnerability. The already precarious condition of the MWs in the urban social structure when added with restrictions to movement and access to food created a context that led to a second phase of vulnerability. As subsistence consumers of public goods and services, they were left in a lurch by the system. Social exclusion took on a different meaning at this stage with MWs completely shunned by the society and state apparatus.

12.2.2 Phase 2 (April 15 to May 3) The lockdown was extended by 2 weeks from April 16th. The plight of MWs worsened at this stage. More people started using whatever mode of transport they had—two wheelers, cycles, and ice-cream carts. Many workers were forced to pay exorbitant sums to truck drivers and private vehicle/bus owners to reach their home state. Many such workers were “caught” at the state borders by the local police for flouting COVID norms. News reports mentioned how several MWs were found traveling, huddled inside a cement mixer vehicle, for days without food and water. At this stage there was an effort by some of the state governments (such as Uttar Pradesh) to use buses and ferry back stranded workers. Many governments like that of the state of Bihar openly rejected the idea of allowing MWs to travel back citing health risk. Due to public and media scrutiny, the Central government allowed buses to ferry MWs only if they were genuinely stranded. The Supreme Court responded to a public interest litigation saying that it cannot do anything if people decide to walk and it would not like to interfere in the policy of the government. In some states, the migrants were asked to kneel down on the highway and disinfectants were sprayed on their bodies. Unable to bear with acute hunger during their travel back home, migrant workers were found biting off a dog’s carcass. They reported being treated like “stray dogs” both in the cities and during the lockdown (Bhowmick, 2020). In terms of customer vulnerability (CV), in this phase we see the consumer response and market and policy response (Baker et al., 2005). The socially excluded MWs action of walking back defied logic. Vulnerability literature does not talk about irrational consumer action in response to a specific context. However, in this case we see the socially excluded taking road trips covering thousands of miles with no resources and no transport, driven by a desperation to avoid the present reality of being stuck in the urban slums and hoping that village homes could provide some succor in such tough times. The market and policy response of providing them special buses to return was clearly inadequate for a country of the size of India and there were simply not enough buses for the millions stranded. This piecemeal arrangement increased the inequality of citizens under lockdown—MWs were

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discriminated against (Baker et al., 2005) and clearly suffered from unequal distribution of resources (transport). Rather than facilitating control, the market and policy impeded the MW’s control (Baker et al., 2005) over their resources. As we see in the third phase of the lockdown, this prompted a new set of responses from the affected population which was driven by their biophysical and psychosocial resources.

12.2.3 Phase 3 (May 4 to May 17) The crisis worsened in this phase with thousands, seeing no hope of business starting and getting no help from any quarters, starting to walk. Many people died on the road. A 12-year-old girl died after walking for 3 days, more than 150 kilometers (km) [1.6 km ¼ 1 mile], just 14 km short of her home (Pandey, 2020). Thinking that trains were not running and too tired to think about safety, 16 laborers decided to sleep on rail tracks. They were mowed down by a train (Jadhav, 2020). The government relented at this stage and decided to run trains as transporting MWs to far flung places was otherwise impossible. The trains were termed as Shramik Special (Labor Special) trains (Gettleman et al., 2020). The states were asked to requisition the trains and the Railways department would then arrange for the same. In reality, enormous chaos and confusion broke out. The Central and State government got into a duel as states claimed that the railways (run by the Central government) were either not sending enough trains or sending them without proper intimation. Without proper communication and awareness, thousands crowded around stations in Mumbai and Delhi waiting to go home. Some trains took 9 days to reach their destination, passengers—starved of food and water—dying by the time they reached. Many were forced to drink from the train’s toilet. Long queues of families were seen across the country, waiting to get information about their train. They kept complaining about mistreatment by the local police, who would often use force to disperse the home-bound crowd. Babies were seen tugging the saree of their mother, oblivious of the fact that the mother had died (Tewary, 2020). Alarmed by the mass exodus of MWs, many industry leaders lobbied with local governments not to send them back as in the state of Karnataka (Babu & Dutta, 2020). The host state stopped trains and started offering incentives for people to stay back, but soon had to relent following public outcry. Back home, returnees were often labelled as a “risk” and problem. They faced stigmatization from not only their own communities and neighbors but also from the residents of the state. Many states looked at returnee migrants with fear and suspicion, with some states using statistics to show how many infections were spread due to the returning workers. In some states (e.g., Odisha), homesick returnees often jumped quarantine, leading the state to enforce curfew around quarantine centers. Millions of returning MWs would push a large part of rural India into deeper poverty and vulnerability. MWs faced new dimensions of inequality and exclusion at this phase—as they traversed the country on foot or whatever transport they could manage. They would walk for hours without food and water, wait outside stations for days for their trains

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to come, and manage their journey back home in train without any facilities. This adaptation (Baker et al., 2005) shows how excluded citizens would take steps to neutralize the burden of exclusion through optimal use of whatever resources they can manage.

12.2.4 Phase 4 (May 18 to May 31) Increasing relaxations in rules marked the phase 4 of the lockdown that ran from May 18th to May 31st, 2020. States got more power to decide on restrictions, including marking of containment zones. States like Uttar Pradesh and Madhya Pradesh complained that the MWs were burdens and bringing them back in packed trains could cause further problems. Thus, MWs were not just disowned by the Indian government, but also regions where they belonged. Special trains carrying MWs were labeled “Corona Express” by state chief ministers (Asian News International, 2020). Uttar Pradesh, the largest Indian state, was among the first to change labor laws that made the lot of MWs even more vulnerable. Work shift was increased from 8 to 12 h and industries could now hire and fire at will (Gowda, 2020; Srivastava & Nagaraj, 2020). However, these decisions were soon overturned as the Supreme Court ordered that the State was bound to take care of the transport and food and water for the MWs. In an interesting change of political stance, states like Uttar Pradesh (UP) announced that anybody wanting to hire MWs from UP now had to take the permission of the UP government as returnee MWs were ill-treated by the host states. UP also announced that it would undertake a skilling program and find jobs for its migrant population within the state. This phase of the lockdown reveals how one type of inequality, exclusion, and vulnerability leads to the other. MWs, excluded from the social milieu of urban markets and stranded due to COVID-19 were branded by the media, the government, and other institutional structure in such a way that they found new vulnerability on their return home. The market and policy response, like increase of working hours and removal of basic protection from getting fired, enhanced both their inequality and vulnerability. An example of this was the work offered to them when they returned to their villages. India’s basic income scheme, the “100 days work” program found few takers among the MWs. Such work involved hard physical work like digging for ponds and roads.

12.3

MWs and Consumer Vulnerability

The phenomenon of MWs is not unique to India. Similar demographic groups exist in other developing economies like South Africa, Brazil, Russia, and China. We know that much of China’s manufacturing prowess comes from MWs moving from

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rural China to urban clusters, creating “ghost villages” (Hornby & Lee, 2013; Liu et al., 2015). The favelas of Brazil (Bucciferro & de Souza, 2020) and the sprawling slums at Soweto, Johannesburg, South Africa (Peberdy et al., 2004), are all testimonies of how global economic equality rides on inequality and vulnerability at urban slums and rural hinterlands. COVID-19 has brought this to the fore when consumer, producer, and the state are caught unaware about their own vulnerabilities and how it affects the others. Migrant workers are linked to consumer vulnerability in many ways: they themselves are vulnerable due to their bio, physical, and psychosocial characteristics (Moschis, 1992). They are semi-educated, poor, without documentation or skills, and away from their rural home. They are the invisible consumers of public and private goods and services in urban and industrial clusters. They are also part of a larger network of poor consumers in emerging countries. One may argue that the mega-slums that build megacities are entirely built upon the MWs. Vulnerability studies, quite naturally, have never considered a context like a global pandemic that is long drawn out and spread over large geographies. In many ways, the vulnerability of MWs is aligned to findings from previous studies: it is caused by individual states, characteristics, and external conditions (Baker et al., 2005). However, Consumer Vulnerability (CV) studies have focused on the consumption context and argue that vulnerability is short term (Baker et al., 2005). The case of the MWs in India shows that vulnerability is multistage and long term; external conditions are not static but dynamic and one type of vulnerability (inability to move) leads to other types (stigmatization and use of force by state machinery). The conceptual model provided by Baker et al. does not consider: (1) the fact that adaptation by vulnerable consumers (starting to walk home) can lead to new adverse external conditions (run over by trains) and (2) consumer response and market and policy response are not independent but linked and related. Most important, vulnerability can be in stages but in different contexts. Being a MW in COVID-19 affected India meant vulnerability not only in the host states but also in one’s own villages where own families or neighbors refuse entry to a stranded laborer suspected to be infected. Looking at the condition of MWs, one can argue, contrary to Baker et al. (2005), that vulnerability can indeed be enduring.

12.4

Evaluating Quality of Life (QOL) in the MW Community During the Coronavirus

QOL is a compound, complex variable that various researchers have measured in various ways and one that includes both objective and subjective dimensions (Mittlestaedt et al., 2006). Constanza et al. (2007, p. 269) define QOL as “the extent to which objective human needs are fulfilled in relation to personal or group perceptions of subjective well-being.” Human needs being the basic requirements for subsistence, reproduction, security, etc., while subjective needs would be more

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concerned with happiness, life satisfaction, utility, or welfare. The Quality-of-Life Scale that was originally developed by the psychologist John Flanagan (1978) and then tested, validated, and modified by Burckhardt and Anderson (2003) measures five conceptual domains of QOL. These are: (a) material and physical well-being; (b) relationships with other people; (c) social, community, and civic activities; (d) personal development and fulfilment; and (e) recreation. Likewise, Sirgy (2011) describes six major theoretical concepts that underlie most QOL indicators: (1) socioeconomic development, (2) personal utility, (3) just society, (4) human development, (5) sustainability, and (6) functioning. According to Shultz et al. (2017), community flourishing is a construct that evolves and shifts over time. They propose that communities exist on a continuum ranging from distressed to flourishing and that various internal and external forces or events can cause the movement of the community toward being either distressed or flourishing. They argue that the speed at which the community moves in one direction or the other depends on a set of community characteristics that are related to vulnerability and resilience. In this chapter, we are focusing on QOL in the MW community in India. MWs belong to two communities, the community that is formed together with other migrant workers in the cities and the other one that they belong to back home in their villages. With the coronavirus lockdown, the MW communities in the cities were disrupted and the MWs were forced to go to their other communities in the villages. We will therefore consider both these aspects of the MW community. In order to evaluate QOL in the MW community in India, we will use the systemic framework that Shultz et al. (2017) develop to facilitate QOL in distressed and flourishing communities. This framework is a refinement of Shultz et al.’s (2012) one for transformative research in developing markets. To actualize community well-being and QOL, which is the focus of the framework, various macro and micro factors need to be linked and supported by catalytic institutions such as the government, private business, and nongovernmental organizations. Shultz et al. (2017) identify nine salient macro factors: geography/environment, population, political/legal, economic, social/cultural, education, administration, infrastructure, and technology. We elaborate on these in the context of the MWs and then discuss the role of catalytic institutions such as government, business, and NGOs that enable the marketing system that MWs belong to.

12.4.1 Macro Factors Shultz et al. (2017) point out that the macro factors are the “fundamental underpinnings of any community.” Ironically, in the case of the MWs, the lack of these fundamental underpinnings is what pushes the MWs toward the cities. While marriage is perhaps a big reason for migration among women (Krishnan, 2019), the MWs affected by the lockdown were those who migrated to the cities for employment. Lack of labor, employment, or business opportunities in the villages

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force MWs to move to the cities. In the cities, the MWs mostly engage in temporary, unskilled, and low-paying jobs. As they do not have much disposable income and as they want to save whatever they have for their families back in the villages, they live a life of near destitution. The slums (shantytowns) in all the major cities of India are filled with MWs. These places have poor sanitation, minimal infrastructure, poor housing quality, etc. (Auerbach, 2016). For instance, the Dharavi slum in Mumbai has a population density of over 700,000 persons per square mile making it one of the most densely populated areas in the world (Eeshanpriya, 2020). A study by Babu et al. (2017) of the living conditions of internal labor migrants in 13 Indian cities found that the majority of migrants are deprived of basic amenities and in addition, struggle to access several social entitlements. MWs have to suffer harsh working conditions and discrimination in the labor market (Srivastava, 2020). Since they did not grow up in the place where they migrated to, the social networks that they are part of are weak. Further, as they do not have proper documentation, they cannot get loans from banks or avail of social security programs. Because of the situation of the lockdown, many MWs were turning to loan sharks and labor traffickers, thus further worsening their condition (Nagaraj, 2020).

12.4.2 Role of Catalytic Institutions The three forms of catalytic institutions are business, government, and nongovernment organizations (NGOs). According to Shultz et al. (2017, p. 414), various endogenous or idiosyncratic factors, the macro factors, and the catalytic institutions “interact to determine whether an appropriate marketing system will emerge that can yield best practices to deliver goods and services in ways that enable a community to recover from distresses it may be enduring.” As stated earlier, MWs are attracted to urban areas because of labor and business opportunities. However, on account of various vulnerabilities that they have such as low literacy, lack of civic identity, etc., they are taken advantage of and are often subject to exploitation from multiple parties. The MW crisis revealed how the employers of MWs, regardless of whether they were large or small or state or private, did not provide health-care or any other income support and relief to the MWs (IHRB, 2020). Though the government has the responsibility of caring for the least advantaged and most vulnerable members of the population, as could be seen from the lockdown measures enacted, there was not much thought given to or concern shown for the migrant workers. The national government was criticized for attempting to enforce an aggressive lockdown that was unreasonable and oppressive (Ghosh, 2020). In fact, nearly 200 migrant workers died in road accidents while trying to return to their village homes during the lockdown (Banerji, 2020). If one adds the number of non-COVID deaths because of starvation or suicide, the number increases phenomenally (Adhikari et al., 2020). While the Indian government was criticized for its handling of the lockdown and the impact on the migrant worker population, the

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government was praised by the World Health Organization (WHO) in January 2021 for its efforts at controlling the spread of the virus (Ray, 2021). Of the three catalytic institutions, the NGOs are the only ones that help the MWs recover from various distresses that they encounter. Consider, for example, the Working Peoples’ Charter (WPC), a network of more than 150 local organizations of informal workers, which has a presence in more than 13 states of India. In the first 2 months of the lockdown, the WPC had provided food to over 80,000 migrant workers (Sen, 2020b). Another example is that of Goonj, a NGO that is based in Delhi. In less than a month after the lockdown was imposed, Goonj, together with 92 partner NGOs, had delivered rations to about 17,700 families (Ramachandran, 2020). NGOs helped provide food, clothing, shelter, health care, etc. to the MWs. An analysis done by IndiaToday found that in 13 states and union territories, NGOs outperformed the state governments in providing humanitarian relief (Rawat, 2020). Some of these NGOs were recognized by entities such as the Schwab Foundation (Sharma, 2020). Even the Supreme Court of India lauded the role played by NGOs in helping the migrants during the pandemic (Press Trust of India, 2020). Ironically, between 2011 and 2021, the licenses of over 20,000 NGOs to receive foreign funds under the Foreign Contribution Regulatory Act were canceled by the Indian Government (Press Trust of India, 2021).

12.5

Implications and Discussion

We used the theoretical lens of Consumer Vulnerability to understand how the COVID-19 induced global pandemic affected inequality and social exclusion. We considered the example of millions of migrant workers in India who were left stranded when the country announced a lockdown with a notice of 4 h. Migrant workers, who already faced social exclusion at their urban workplace, faced a series of harms caused by the four phases of the lockdown. We argue that vulnerability, harm caused by lack of access to and control over resources (Hill & Sharma, 2020), is the first step toward inequality and social exclusion. For those already facing exclusion, vulnerability makes their situation even more precarious. The Consumer Vulnerability lens helps us to situate workers as consumers of public and private goods and examine how several antecedents cause such vulnerability and how one stage of vulnerability leads to another. We then used the “Systemic Framework to Facilitate QOL in Distressed and Flourishing Communities” to analyze the QOL in the MW community (Shultz et al., 2017). According to Shultz et al. (2017), “distressed communities tend to have large numbers of underserved citizen-consumers; indeed, residents often are disenfranchised and are not, or may not feel as if they are, citizens of any community” (p. 413). This statement explains the situation of the MW community well. The MWs felt unwelcome in the cities they migrated to and even were not welcomed back to their villages. They lacked the macro factors that were the fundamental underpinnings of any community. Of the three catalytic institutions, the only

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catalytic institution that was really concerned about the well-being of the MWs were the NGOs. The state, as the provider of basic goods and services like food and transport, failed to take care of the most vulnerable section of the population creating new vulnerabilities and exclusion for them. At a policy level, there are several implications of the MW crisis. The migrant worker crisis has exposed certain structural issues in the Indian economy, society, and polity. These issues include urbanization at the cost of the informal workforce, focus on “nation building” (to sacrifice personal good to fight COVID-19) and “corona warriors” (doctors and paramedics) at the cost of the poor, and inequity in the distribution of welfare. Moving ahead, we suggest the following from a policy perspective: (a) Need for data: The fact that India could announce a lockdown without considering the 139 million MWs shows that there is no national level cognizance of the MW’s existence. This can be addressed by creating a national database of such workers allowing them access to public goods and services across the country. (b) Need for institutional support: As we see in the case of ration cards being pawned as a security deposit to local money lenders, vulnerable consumers are often those who are outside the ambit of local and national institutions. Last mile linkages with such groups need to be redesigned for better access. Institutional delivery of welfare, health, and governance is crucial for the survival of the most vulnerable. In the case of COVID-19, the condition of quarantine centers themselves have been questioned, forcing many MWs to jump or flee the centers. (c) Policy support: The quick changes in labor laws in three Indian states shows the pro-industry bias of the government at the cost of increasing vulnerability of workers. The pandemic showed how unequal policies were: airline passengers were considered safe, not requiring quarantine, while it was mandatory for those returning by special trains or buses.

12.6

Conclusion

While countries like India strive to be more equal to their global counterparts like China, Russia, or Brazil—such equality comes at the cost of a worsening inequality at the bottom of the pyramid. The COVID-19 crisis has put a mirror on the reality of multidimensional inequality that plagues the growth story of emerging economies. It has also helped mainstreaming the inequality narrative in India, which now cannot be brushed under the carpet of “growth story.” That could be the only positive fallout of the pandemic.

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Nagaraj, A. (2020, October 6). Fearing loan sharks and slavery, Indian workers ask gov’t for cash aid. Reuters. Retrieved from https://www.reuters.com/article/india-workers-trafficking-idINL4 N2GX194 Pandey, G. (2020, April 21). Coronavirus in India: Desperate migrant workers trapped in lockdown. BBC News. Retrieved from https://www.bbc.com/news/world-asia-india-52360757 Peberdy, S., Crush, J., & Msibi, N. (2004). Migrants in the city of Johannesburg: A report for the city of Johannesburg. Southern African Migration Project. Press Trust of India. (2020, June 9). NGOs deserve all appreciation for helping migrants during COVID-19 pandemic: SC. The Hindu. Retrieved from https://www.thehindu.com/news/ national/ngos-deserves-all-appreciation-for-helping-migrants-during-covid-19-pandemic-sc/ article31786947.ece Press Trust of India. (2021, February 9). Govt cancelled FCRA license of over 20,600 NGOs in 10 years. The Economic Times. Retrieved from https://economictimes.indiatimes.com/news/ politics-and-nation/govt-cancelled-fcra-licence-of-over-20600-ngos-in-10-years/articleshow/80 772291.cms Ramachandran, B. (2020, May 5). Where India’s government has failed in the pandemic, its people have stepped in. The Guardian. Retrieved from https://www.theguardian.com/globaldevelopment/commentisfree/2020/may/05/where-indias-government-has-failed-in-the-pan demic-its-people-have-stepped-in-coronavirus Rawat, M. (2020, April 9). Coronavirus in India: In 13 states, NGOs fed more people than govt did during lockdown. India Today. Retrieved from https://www.indiatoday.in/india/story/in-13states-ngos-fed-more-people-than-govt-during-coronavirus-lockdown-1665111-2020-04-09 Ray, M. (2021, February 11). India should be very, very proud: WHO’s praise amid falling Covid19 cases. Hindustan Times. Retrieved from https://www.hindustantimes.com/india-news/indiashould-be-very-very-proud-who-s-praise-amid-falling-covid-19-cases-101613056206080.html Ray, D., & Subramanian, S. (2020). India’s lockdown: An interim report. Indian Economic Review. Retrieved from https://debrajray.com///wp-content/uploads/2020/05/RaySubramanian.pdf Sen, S. (2020a, April 25). Modi’s government has botched its response to India’s pandemic. Jacobin Magazine. Retrieved from https://jacobinmag.com/2020/04/india-narendra-modipandemic-coronavirus-bjp. Sen, S. (2020b, May 14). Corona warriors: This Delhi NGO has fed over 80,000 migrant workers across India amid lockdown. The Logical Indian. Retrieved from https://thelogicalindian.com/ story-feed/get-inspired/twitter-campaign-ngo-21084 Sharma, K. (2017, October 1). India has 139 million internal migrants. They must not be forgotten. Retrieved from https://www.weforum.org/agenda/2017/10/india-has-139-million-internalmigrants-we-must-not-forget-them/ Sharma, U. (2020, September 23). Indian NGO Founder who helped migrants in lockdown on Schwab list of social innovators. The Print. Retrieved from https://theprint.in/india/indian-ngofounder-who-helped-migrants-in-lockdown-on-schwab-list-of-social-innovators/509106/ Shultz, C. J., Deshpande, R., Cornwell, T. B., Ekici, A., Kothandaraman, P., Peterson, M., Shapiro, S., Talukdar, D., & Veeck, A. (2012). Marketing and public policy: Transformative research in developing markets. Journal of Public Policy and Marketing, 31(2), 178–184. Shultz, C. J., Rahtz, D. R., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), Handbook of community Well-being research (pp. 403–421). Springer. Sirgy, M. J. (2011). Theoretical perspectives guiding QOL indicator projects. Social Indicators Research, 103(1), 1–22. Srivastava, R. (2020). Vulnerable internal migrants in India and portability of social security benefits. Center for Employment Studies Working Paper Series: WP 02/2020. Delhi: Institute for Human Development. Srivastava, R., & Nagaraj, A. (2020, May 12). Workers’ rights at risk as Indian labour laws face post-lockdown challenge. Reuters. Retrieved from https://www.reuters.com/article/us-health-

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Nicholas J.C. Santos is an associate professor of marketing at the Heider College of Business, Creighton University, Nebraska, USA. His research interests include business ethics, business and society, Catholic social teaching, corporate social responsibility, marketing strategies and ethical issues at the base-of-the-pyramid market, social innovation, and entrepreneurship. He has published widely in a number of journals such as Business and Politics, Journal of Business Ethics, Journal of Catholic Social Thought, Journal of Macromarketing, Journal of Public Policy and Marketing and is an invited reviewer for a number of journals. Subhasis Ray is a professor of marketing at the Xavier Institute of Management, Xavier University, Bhubaneshwar, India. His research interests include corporate social responsibility, sustainability, marketing, circular economy, and social entrepreneurship. He is the founding chairperson of the Center for Business and Society at Xavier Institute of Management. He has published widely in a number of journals such as Journal of Global Marketing, Marketing Intelligence and Planning, Journal of Cleaner Production, Journal of Non-profit and Public Sector Marketing, Journal of Business Research. Professor Ray has presented at a number of international conferences and has spoken or taught in 22 countries.

Chapter 13

The Pillars of Survival in the COVID-19 Pandemic: The Case of Indonesia Primidya K. M. Soesilo and Fathony Rahman

Abstract The COVID-19 global pandemic has affected every country, including Indonesia. Indonesia is the largest archipelago and fourth most populous country in the world; it has significant diversity in geography, people, and cultures. The combination of these characteristics creates many challenges when dealing with a pandemic. This chapter provides an examination of Indonesia’s response to the COVID-19 pandemic; it explores that response using a variety of methods, including content analysis of materials from the national and local news and media, as well as the authors’ direct observations and personal interviews conducted with a crosssection of the Indonesian population. The research helped to identify four pillars that serve as a foundation for effective responses to the pandemic. The four pillars comprise two catalytic institutions (government and community), the Indonesian digital ecosystem, and a resilient set of national values. The chapter highlights how Indonesia has leveraged these pillars to respond more effectively to this public health crisis. Keywords COVID-19 · Indonesia · Survival pillars · Government · Community · Digital ecosystem · National values

13.1

Background: The Virus Arrives and a Nation Reacts

Indonesia, similarly to so many countries, has been grappling with the COVID-19 pandemic. The country has faced significant challenges due to its unique archipelago geography and large population (over 273 million according to the World Bank, P. K. M. Soesilo (*) Business Management and Marketing Program, Management Department, BINUS Business School International Undergraduate Program, Bina Nusantara University, West Jakarta, Indonesia e-mail: [email protected] F. Rahman School of Business and Economics, Universitas Prasetiya Mulya, South Jakarta, Indonesia e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_13

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2020). When compared to its much smaller neighbors, Indonesia was predicted by many to face debilitating long-term difficulties (Djalante et al., 2020). Significant funds from a variety of sources have been spent in Indonesia to fight the pandemic and shore up the economy. In March 2020, the Asian Development Bank approved $3 million grant to support Indonesia’s government in fighting the pandemic. This initial support came in the form of immediate purchases of key medical equipment (ADB, March 21, 2020). As part of a partnership between the Japan Government and the Asian Development Bank, in July 2020, Indonesia received ¥52 billion [equivalent of Indonesian Rupiah (IDR) 7.14 trillion] from the Japanese government to curb the spread of COVID-19, execute socioeconomic recovery and stabilization, and initiate sustainable development in Indonesia (IDN Financials, July 21, 2020). The funds spent to fight the pandemic and revive the economy help to illustrate the enormity of the unprecedented impacts of COVID-19 on the country. Some in Indonesia and from around the world feel that the impact of the novel coronavirus, SARS-CoV-2, on peoples and economies is ending as vaccines arrive and lockdowns are lifted. Such hope may be premature. The British Academy suggests that we should see ourselves being in the COVID decade. A period in which the social, economic, and even cultural impacts of COVID-19 will continue to shed a long silhouette into the next decade or beyond (British Academy, 2021). The first evidence of the outbreak in Indonesia appeared in early 2020. Since this arrival, the Indonesian government has implemented countermeasures. These countermeasures include social distancing, mandatory mask-wearing in public space, work/study-from-home policies, etc. Indonesia has not implemented lockdowns— instead, the government chose to apply a large-scale social restriction (LSSR) in many regions, especially those with a high number of COVID-19 cases and deaths. Despite the pros and cons toward the decision among Indonesians, the decision to implement LSSR clearly factored in economic reason—perhaps to prevent a deep economic recession in the future. President Jokowi stated that he wanted the economic activities to remain going during the pandemic, with the mandatory warning, however, that the people must always maintain social and physical distancing as well as health protocols (Kompas, April 2, 2020). Clearly, these mandates have disrupted consumers’ habits and businesses’ operations. In general, Sheth (2020) identified some changes in consumers’ habits during COVID-19, which included stockpiling of essential products, improvising when constrained, postponing purchases of discretionary products, embracing digital technology, home shopping, blurring of work–life boundaries, reuniting with friends and families, as well as discovering new talents. On the business’ side, some changes included increased demand for constant innovation as evidenced in the restaurant industry; learning to adapt as evidenced in the education sector, ability to deliver services at a distance as evidenced in the health-care industry, and digital transformation as evidenced in most industries (Weforum, 2020). In Indonesia, three industries experienced immediate impacts as the result of large-scale social restrictions: retailers, education, and health services (Chan et al., 2020). The pandemic has significantly accelerated Indonesia’s push toward a digital economy at a much faster rate than expected.

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In the time since the arrival of COVID-19, numerous articles and reports have been generated focused around the pandemic. Past articles on this theme have mostly looked at the impact of COVID-19 pandemic on the economy, society well-beings, policies, and governments’ responses. This chapter seeks to describe how people, both as consumers and members of communities in Indonesia, respond to the COVID-19, longitudinally. The chapter also discusses how certain cultural values, ones that are particular to Indonesia, affect people and society’s responses in coping with the pandemic in Indonesia. To allow timeliness of information dissemination, this chapter does not intend to provide comprehensive lists of responses by the people and communities, but instead highlight major and impactful actions by the communities prior to the final draft. This chapter is structured as follows. First, it provides an overview of Indonesia and some key momentums along with the timeline. Second, we highlight and discuss the immediate changes from the COVID-19 pandemic on Indonesian consumer behavior. In particular, we examine how risk perception evolved over time, as well as the factors that contributed to that evolving risk perception. Third, we expand the discussion around the overall framework of crisis mitigation used in Indonesia by identifying how certain catalytic institutions affected consumers and the general population. Finally, we describe how the unique national motto (and domestic viewpoint) of Indonesia created a strong driver to the national community’s various responses for coping with the pandemic.

13.1.1 Overview of Indonesia: Geography, Political Structure, and Its People As noted, Indonesia is the fourth most populous nation in the world with more than 273 million inhabitants. Strategically located at the crossroads of two oceans, the Pacific and Indian oceans, Indonesia consists of more than 17,000 islands (comprising 5 major islands and about 30 smaller groups of islands) of which about 6000 are inhabited, the country has over 200 major ethnic groups, and over 300 spoken languages. Bridging two continents, Asia and Australia, Indonesia’s strategic location has for centuries shaped the cultural, social, political, and economic life of the country. A significant geographical characteristic of Indonesia is that the archipelago is home to a major juncture of the Earth’s tectonic plates—making it susceptible to significant seismic and volcanic activity. Hence, the country has faced and survived numerous natural disasters during its history through the precolonial, colonial, and national times. As the largest archipelagic country, Indonesia is rich in natural resources, cultures, traditions, and customs—to name but a few of its riches. The number of ethnic groups in Indonesia shows how diverse the people and cultures are. Every island in Indonesia has a unique mixture of people, culture, and natural resources—a mixture that can be very different from island to island. Even on the same island, various

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ethnic groups and cultures can exist. Thus, the country deserves the tagline used by the tourism sector to highlight that all are welcome here: “Ultimate Diversity.” The diversity of Indonesia, however, does not appear only as a tourism tagline; it is the very foundation of the nation’s motto. “Unity in Diversity” is the national motto that binds together an extremely diverse society to unite as one nation. In the recent past, the country has transitioned successfully from authoritarian to democratic governance (About Indonesia, 2017). The democratic governance has improved from free and fair elections and the rising influential power of the regional centers (because of government decentralization in 2001). The direct election of President Jokowi in 2014 was further evidence of the growing democratic and political stability. As a vibrant economy with average economic growth of over 5% the past few years, Indonesia is predicted to be the world’s seventh largest economy by 2030 (Oberman et al., 2019). Currently, it is the largest economy in Southeast Asia and the only Southeast Asian country in the G-20. As the third largest global democracy, with one of the most diverse geographical and social environments, governing Indonesia can be most challenging. Therefore, while broad diversity is a uniqueness of the country, the same diversity requires that the government come up with a variety of unique, yet widely applicable, approaches for mitigating threats to the safety and well-being of all its peoples and citizenry. The arrival of COVID-19 to Indonesia presents one of the most challenging tests for that endeavor in modern-day Indonesia.

13.1.2 COVID-Related Key Events and Timeline As the world started to report cases of COVID-19 in early 2020, Indonesia reported having zero cases during January and February 2020. The country was in the global spotlight as it claimed no cases of COVID-19 while the surrounding countries had reported several cases. Researchers and health experts from Harvard University stated their concerns regarding potential undetected cases along with fears that Indonesia was ill-prepared for an outbreak (Mulyanto & Firdaus, 2020). In late January, Indonesia issued travel restrictions and quarantine orders for visitors coming from affected countries. Shortly after, the government evacuated 243 Indonesian nationals from Wuhan and quarantined them in Natuna Islands (Ministry of Foreign Affairs of the Republic of Indonesia, 2020a, 2020b). On March 2, 2020, President Joko Widodo officially announced and confirmed the first two cases of COVID-19. These two infections were linked to contact with an infected Japanese colleague at a social event. By March 6, 2020, Indonesia had only tested 450 individuals of the 270 million population—an act soon to be criticized and highlighted as a slow response to the crisis by the international media. On March 19, 2020, President Joko Widodo declared seven critical points to act on for controlling the spread of the virus in Indonesia: (1) conduct mass rapid tests, (2) provide incentive for medical personnel, (3) involve religious leaders and influencers, (4) stop exporting medical equipment, (5) stop people from traveling

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for pleasures and vacations, (6) provide incentive for small and medium enterprises, and (7) increase food stocks (Ihsanuddin, 2020). Following extended debate regarding mandated country lockdowns, at the end of March 2020, President Joko Widodo ordered large-scale social restrictions coupled with civil emergency policies. In late September 2020, the government announced plans for the distribution of the COVID-19 vaccine to begin by January 2021. The distribution plan identified priority groups that would be recipients of the vaccines in timed waves. The first priority wave recipients included medical personnel/frontliners, people with close contacts to COVID-19 patients, and public servants. The second priority wave focused on the elderly, market vendors, teachers and education industry workers, hospitality industry workers, state-owned employees, religious leaders, athletes, journalists and media workers, and public transport workers. While the number of people infected with the virus continued to increase, they were in parallel with the number of people recovering from the virus. By October 2020, six institutions in Indonesia were working to develop COVID19 vaccines. In December 2020, the first batch of vaccines from China arrived in Indonesia, giving hopes to the people. President Joko Widodo volunteered to be the first person to be vaccinated in Indonesia. This quickly built confidence of the people toward the safety of the vaccine. Batches of vaccines continued to arrive in Indonesia. By March 2021, the government rolled out an initiative called “Vaksin Gotong Royong” that involved state and private companies using their own funds in purchasing vaccines for distribution to their employees and families. Despite some delays in logistics and distribution, vaccines are still being distributed on a massive scale to all citizens of the Republic of Indonesia.

13.2

Changes in Indonesian Consumer Behavior

Consumption and consumer behavior are linked to location and time (Sheth, 2020). Consumption is contextual in that consumption may change due to changes in circumstances. According to Sheth (2020), four major contexts may disrupt consumption patterns: (1) social context (e.g., marriage, moving out), (2) technology context (e.g., emergence of smartphones, IoT, e-commerce), (3) rules and regulations (e.g., mandatory mask-wearing, health protocols, smoking prohibition in public space, and (4) natural disasters (e.g., hurricanes, pandemic). Natural disasters are a less predictable context that may instantly disrupt consumer habits. The current global pandemic has driven consumers to adopt different ways of acquiring and consuming a variety of products and services. Consumers’ choices to shop are limited due to social distancing and lockdowns (in some countries). Almost all activities have become centered around the home—including working and schooling. Any activities that previously required face-to-face physical encounters are now pushed to find ways to deliver the same experience through digital platforms. These changes are currently occurring around the world, all at once and in a similar fashion. Some changes, however, might be very country specific in both the

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manner and speed in which they occur. In the first few months of the beginning of the global pandemic, immediate changes were observed worldwide. Two of the most visible changes that occurred in Indonesia are highlighted in the sections below.

13.2.1 Digitally Transformed Consumers The COVID-19 global pandemic has absolutely driven faster digital transformation—not only in businesses, but also in consumer markets. There is no doubt that consumers have been switching to online channels as the COVID-19 cases spike. Not surprisingly, e-commerce companies in Indonesia reported a staggering volume of online sales (Chan et al., 2020). People’s purchases online showed spikes in health-care products, sports equipment, all working/studying-from-home necessities, and groceries. Sales of hand sanitizers, for instance, jumped at a staggering 5000%, at an increasing price level, while other health-care products increased 1000% in sales. iPrice—an online shopping aggregator that allows consumers to browse products and compare prices from various online stores—also reported that interest in webcams was up by approximately 1500%, bicycles by 1000%, and game consoles by 150% (Devita, 2020). In March 2020, the growth of new users/accounts rose by more than 10% in one of the biggest online marketplaces in Indonesia. As a result of store hour limitations, online grocery shopping has increased exponentially as well. E-commerce as a preferred way to shop rose sharply to 66% (vs. 24% before COVID-19), whereas visits to physical stores dropped significantly to 24% (vs. 73% before COVID-19). Online grocery apps preference rose to 21%; visitation to wet markets dropped to 30% (vs. 52% before the COVID-19) (DBS, September, 2020). While that was intuitively predicted, an interesting highlight is the huge jump in sales of fruits and vegetables, by the online platform, Sayurbox (Novika, 2020). Sayurbox is an e-commerce start-up that was built to disintermediate the distribution channel by connecting farmers directly with end-consumers. The traditional fragmented distribution channel for farming products has contributed to the rising consumer prices for fruits and vegetables but leaves thin margins for farmers (Reily, 2019). This suggests that digital marketplaces have become the “goto” source for acquiring essential products for consumers—even for those who previously had never imagined buying veggies online.

13.2.2 Shifts in Consumer Preferences and Consumption Behavior While the sharing economy had successfully disrupted many industries a few years ago, the pandemic has forced consumers and providers to face some harsh realities. The sharing economy platforms had grown very successfully in Indonesia due to the

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positive attitudes about and the acceptance of Indonesians toward the entire sharing economy concept and its services. Research by Nielsen in 2014 showed that 87% Indonesians were likely to use shared products and services in their communities in comparison to 66% of the global population (Liem & Bruegel, 2015). Those days are clearly gone as COVID-19 has disrupted the sharing economy. From the very beginning of the pandemic, Indonesians were switching from using sharing economy services, especially ride-hailing such as Uber, GrabCar, GoCar, GoJek, etc., back to using their own vehicles. Running in parallel to that trend is the rapid growth of bicycling as a mode of transportation among Indonesians. Preference toward health/hygiene products and home-cooked meals increased significantly as 54% of respondents indicated a higher preference for the products, with about 90% stating their personal hygiene has been higher than before the pandemic. Respondents choosing home-cooked meals jumped to 69% (vs. 42% before the COVID-19) and those who choose eating out dropped to as low as 5% (vs. 35% before the COVID-19) (DBS Asian Insights, 2020).

13.3

The Unique Phenomenon of Diminishing Risk Perception in Indonesia

With the arrival of the global pandemic, people gradually developed anxiety and fear toward the situation—many people around the world became, at least temporarily, germophobic. Of course, this is not surprising given that the virus was novel and neither COVID-specific medications nor vaccines were yet available. Behaviors appropriate to mitigate the risks were unclear and fraught with uncertainty. People around the world were stockpiling and even hoarding basic necessities, such as toilet paper, food, disinfectants and sanitizers, vitamins, etc. In Indonesia, prices of healthcare products (e.g., masks, disinfectants, hand sanitizer) skyrocketed, yet people lined up to purchase them. Some irresponsible vendors took advantage of the situation by piling up inventories and later selling them at incredibly high prices. People stopped eating out, shopping for groceries, and meeting with friends and relatives. Suddenly, people saw risks in everything they did. This risk perception was extremely high, and it drove people to engage in a variety of irrational behaviors. Risk perception refers to intuitive evaluations of people toward hazards they might potentially be exposed to, along with the undesirable effects associated with a specific cause (Rohrmann, 2008; Rohrmann & Renn, 2000). Individuals’ perceptions of risk are influenced by many factors, such as controllability, voluntariness, catastrophic potential, and degree of outcome uncertainty (Slovic, 1987). Cerase (2017) later added familiarity, immediacy of danger, and level of knowledge to the mix. The choice to mitigate depends on the perceived risks. For instance, if an individual’s perception toward the risk of a certain hazard is low, then there is little chance that the individual would act to reduce his/her exposure to the hazard

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(McCaffrey, 2004). Although risk perception can trigger precautionary action, in the context of COVID-19 pandemic, sometimes the decision to engage in preventive health behaviors is not determined by the awareness of the health risks, but also determined by health beliefs and cognitions (Wiedemann & Schutz, 2005; Renner et al., 2008). At the beginning stage of the pandemic, people viewed COVID-19 as uncontrollable, potentially catastrophic, and great uncertainty regarding the outlook. Unlike people in Taiwan, Hong Kong, and China who had prior experience with similar infectious outbreaks, people in Indonesia were unfamiliar with severe acute respiratory syndrome (SARS)-type illnesses. They had very limited knowledge about related diseases and ways to cope with them. Unfamiliarity and lack of knowledge created significant anxiety and fear; Indonesians developed high-risk perceptions toward the hazard. While some people were eagerly engaged in careful health protocols (e.g., wearing masks, washing hands, maintaining social distance, and avoiding crowds), some others showed less concern. They were aware of what the virus could do to their health, but they had strong beliefs that the virus would only be major threats to “a certain group of people other than themselves.” Until June 2020, 46% of people (n ¼ 4000) said they were still worried about leaving home, according to a report by market research firm Kantar (Jakarta Post, July, 2020). While the percentage is not low, it does not surpass 50%, indicating that more people might still feel fine with leaving home. Over time, however, people began to adapt their perceptions to the situation. Risk perception seemed to decrease gradually—as did fear and anxiety, which had gradually built up at the beginning stage of the pandemic. We began to see more people visiting retail shops, eating out, meeting with friends and relatives, joining hobby communities, engaging in outdoor sports and activities, etc. We also started to see people traveling domestically—in groups and individually. People who used to lock themselves in the house—and only leave the house to pick up package deliveries on the front porch—were now starting to meet friends outside of their home. The diminishing risk perception continues as we move through the current pandemic environment. What has driven this diminishing risk perception? Why have people seemed to be less anxious and afraid of the situation? What is the mechanism? Using Slovic’s (1987) framework of risk perception, we may speculate that, despite virus mutations into new strains with more contagious effects, people have learned and better understand (or at least they think they have learned and better understand) the pandemic environment. They have become more aware and informed about the circumstances, impacts, and preventive actions surrounding their place. They seem also to perceive that the circumstances have become more controlled as emergency hospitals were built; pharmaceutical companies around the world were racing to develop vaccines; more health-care establishments began to provide various COVID-19 tests at the convenience of consumers; accommodation establishments offered self-isolation facilities, etc. People used these as cues to assume that the pandemic situation was getting under control, and that the government knew/knows what to do to manage this crisis.

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One may speculate that the change of risk perception in Indonesia can be attributed to the collectivist culture of the Indonesian people. While most Asian countries are renowned for their collectivist character, Indonesia is found to score the lowest (highest) on individualism (collectivism) in Hofstede’s framework, with an individualism score of 14 (i.e., collectivism score of 86) (Country Comparison, 2020), making it an extremely collectivist country. One could speculate that collectivism might be the driver for people’s willingness to socialize amidst the ongoing pandemic. However, while collectivism refers to “a society where individual and social ties are strong, and where people are part of a strong cohesive group” (Chan, 2011), it does not necessarily mean that one is constantly in need to be around other people. Italy, for instance, scores high on individualism, yet mingling and socializing are the very spirit of Italian culture, which has been counterproductive during this pandemic (Horowitz & Bubola, 2020). Clearly, this issue cannot be reduced simply to collectivism vs. individualism. Based on the preceding line of thinking, we posited that perhaps the real driver of risk perception change is rooted in a deeply seated human need: the high need for social interaction among Indonesians. The COVID-19 pandemic has not only disrupted how businesses and consumers behave, but more importantly, it has significantly disrupted social interaction (Chou et al., 2020). Past research has shown that while social distancing might mitigate the spread of infectious diseases such as SARS, it might also increase the likelihood of social isolation. The social isolation and loneliness, in turn, drive a higher risk of morbidity and mortality (Hawkley & Cacciopo, 2010; Holt-Lunstad et al., 2015). That is, social distancing and isolation are negatively associated with mental health during the pandemic. Indeed, research has shown that mental health may suffer when an individual is distanced and isolated, perhaps even damaging one’s immune system (Bavel et al., 2020; Elmer et al., 2020). In general, the social distancing and/or restriction order has caused mixed feelings among people, with loneliness undoubtedly identified as one of them. Cacciopo and Patrick (2008) defined loneliness as “a subjective distressing emotion results from a discrepancy between one’s actual and desired social relationships.”. Many studies have shown the impact of loneliness on social functioning (Hu et al., 2020). When people are feeling socially isolated, they tend to be more socially anxious, yet having a stronger desire for social connection (Segrin & Kinney, 1995). In addition, people who feel lonely would tend to find physical warmth to enhance social coldness (Shalev & Bargh, 2015). Therefore, a stronger need for social interaction during this pandemic can intensify feelings of loneliness as a result of social distancing. In Indonesia, this feeling is most likely heightened by the unexceptionally high need for social interaction as a unique character of the people. A study by Kantar Market Research (April 2020) indicated that social interaction was the most difficult sacrifice for Indonesians. The affiliative culture of Indonesians finds that social interaction is the most valuable life asset and that restriction on social interaction is the most difficult lifestyle change. When asked about the three most difficult changes in daily life during COVID-19, social interaction (47%) and leaving house (39%) were most frequently mentioned by respondents, aside from the sense of

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safety. Across other Southeast Asian countries, Indonesia scored the highest in the percentage of people who find social interaction as most difficult to give up [cf. Singapore (35%), Philippines (34%), and Thailand (17%), to name but a few countries].

13.4

Pillars of Survival in Fighting COVID-19 in Indonesia

Situated at the intersection of the Ring of Fire and the Alpide Belt, where 90% of all earthquakes strikes within the Ring, Indonesia and its people face almost constant threats of natural disasters (Deutsche Welle (www.dw.com), 2021). Indonesia has a long-recorded history of natural disasters, with one of the most tectonic disasters the eruption of Krakatoa, in 1883. Located about 100 miles west of Jakarta, this event killed 36,000 people. Another, more devastating catastrophe was the 2004 tsunami; casualties in Indonesia were claimed to reach somewhere between 130,000 and 160,000 lives. Some disasters in Indonesia have been financial. In the 1990s, the worst financial crisis to hit Indonesia (and other Asian countries) led to a political crisis and sent the country into a deep recession, with widespread rioting and poverty, which eventually forced the incumbent president at that time, President Suharto, to resign under public pressure. The long history of natural disasters and crises in Indonesia has shaped the nation to become resilient in enduring and recovering from extreme hardship. How Indonesia rose from the 1997 to 1998 financial crisis is praiseworthy—it did not take too long for the economy to recover (Yan, 2020). From a deep 13% GDP in 1998, jumped to 0.79% in 1999, and to 4.92% in 2000. Since then, Indonesia’s economy has recovered with growth accelerated at around 4–6% (Adiningsih, 2007). While the underlying causes of the Asian Financial Crisis and COVID-19 pandemic crisis are obviously different on the surface, the situations of the two have similarities. In both instances, economic and political impacts were/are significant, including economic contraction and potential political and social instability; had the situation stretched longer than expected, capital outflows and other damaging outcomes also likely would have ensued (Guild, 2020). As Indonesia had a history of rapid recovery from the past financial crisis, it bodes well that there is potential that the nation can and will survive this pandemic. The future ahead is still unknown and challenging; however, significant efforts have been undertaken by the catalytic institutions of Indonesia, as well as by the Indonesian people to position the country to survive and ultimately recover from this public health crisis. Our direct observation as Indonesian citizens ourselves, who are daily witnesses to these efforts, has allowed us to identify the key pillars for the COVID-19 pandemic survival. Specifically, we have identified four critical pillars that have demonstrated an ability to support the nation to survive the crisis: (1) government, (2) society and community, (3) technology and digital transformation, and (4) national values and principles (see Fig. 13.1). The following sections explore each of these pillars.

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•National Policies, Presidential Decrees & Regulations, Government Regulation •Large-scale social restrictions •Health protocols campaign •COVID-19 National Task Force •National vaccination program

•Neighborhood association (The "RT/RW" Concept) •Social media circle & communication •Community act of altruism

Society & Community

Government

Digital Transformation & Technology

National Values & Principles

•The growth of online start-ups •The Unicorns' critical role •Rapid technology adoption

•The "Unity in Diversity" Value •The "Mutual Cooperation" Principle

Fig. 13.1 The four pillars of survival in the COVID-19 pandemic

13.4.1 Government The government of the Republic of Indonesia has undertaken numerous measures in responding to the COVID-19 pandemic through policies, presidential decrees, and government regulations. Some of the initial responses carried out by the government from the early stages of the pandemic were critical to the nation and its people’s very survival. These included (1) the establishment of the Fast Response Team, (2) creation of the COVID-19 National Task Force, (3) enhanced protection for medical workers, (4) direct purchase of medical supplies and testing kits from a variety of sources, (5) designation of referral hospitals for COVID-19, and (6) conversion of athletes’ village’s apartment towers into emergency hospitals (Ministry of Foreign Affairs of the Republic of Indonesia, 2020a, 2020b). In the social sector, the government also poured trillions of IDR into logistical supports for basic necessities aimed at the poor and low-income citizens, an upgrade in the number of recipients of social welfare package and amount of package, a provision of free electricity for the poorest households to help them cope with the resulting economic shock (Harsono, 2020). Tax incentives and fiscal policies have been adjusted to reduce income tax by 30% for certain sectors, reduce corporate income tax to 22% in 2020 and 2021, and 20% starting from 2022. The government has also extended loan relaxation, as well as a credit restructuring program, and reduced interest on loans for small-to-medium enterprises (SMEs) in an effort to support the SMEs as the backbone of the Indonesian economy (EKONID, 2020). These were just a few other equally impactful economic recovery programs. Aside from economic, health, and social sectors, the government has also imposed large-scale restrictions, and created and supports continuous health protocol

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campaigns. Large-scale social restrictions are aimed to limit specific activities in regions across Indonesia. The scope of restrictions includes limitations of activities in public spaces or facilities and modes of transportation; closure of shopping malls, schools, and the workplace; and restrictions of religious and social-cultural activities. Some exemptions to the large-scale social restrictions include health centers and facilities, businesses or providers of necessities such as food and beverages, groceries, financial and strategic industries, public utilities, logistics and accommodations, energy, communication and information technology, and constructions. The government also has aggressively promoted nationwide vaccination programs. Initially, while some people were excited about these programs, some others were skeptical or less informed or had doubts; for some others, simply fear to get “jabbed.” In such a diverse nation, it seemed there was really only one way to proceed toward successful mediation and control of the pandemic. Provincial and local governments were given authority by the central government to execute the vaccination program in a manner that fits well with the demography and local customs of the region. Consequently, locally focused and customized approaches were developed and implemented effectively. For example, in a small town in East Java, the local government found unique and creative ways to motivate the citizens to get vaccinated. They provided incentives in the form of prizes: 35 goats and 80 chickens as a lucky draw for citizens who were vaccinated. Another small town in West Java also used the same approach: one chicken prize for one senior citizen who gets vaccinated. Another region in the Central Java integrated cultural music in their vaccination program—a soothing medium to bring calmness and tranquility to the mind. While perhaps truly unique to Indonesia, the personal and creative approaches demonstrate sensitivity toward the diversity in Indonesia, and how differences are acknowledged and highly valued.

13.4.2 Society and Community Society and community play a large role in bolstering Indonesia during this time of crisis. One important element of community in this situation is the existence of neighborhood associations, called “Rukun Tetangga” (RT) and “Rukun Warga” (RW). The concept of RT and RW was initiated by the Japanese administration during the colonization era in the 1940s. RT and RW are the lowest administrative division in Indonesia, but not part of the government administration divisional structure; that is, the formation of these local communities is through the consultative function of the community service network. One RT comprises between 10 and 50 households, whereas one RW comprises between 3 and 10 RTs. During the pandemic, the role of RT and RW has been tremendously helpful as they are the extension hand of the government to assist communities in fighting COVID-19. For example, officials of RT and RW are responsible for several tasks related to the virus. These include (1) identifying and recording the members of community who contracted the virus to be reported to the health officials for further treatment;

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(2) educating the members of community about COVID-19 handling procedures and safety measures; and (3) inspiring and encouraging the members of community to help each other in any ways possible to support and care for neighbors who are in self-isolation, with standard health protocols and measures. Many neighborhood and community associations have implemented “love-thy-neighbors” community programs by providing food assistance, vitamins, attention, emotional support, and other forms of assistance. The social media community in Indonesia is perhaps one of the strongest and supportive social circles in the world. The power of the social media community in Indonesia has shown to be most effective in disseminating public health information. Unfortunately, on some occasions, social media are also used to spread misinformation regarding the virus. Emergency pleas for plasma donations and hospital vacancy information requests are recently the top two messages going viral through “regrams” and “retweets” by other social media users—most of them do not know each other in person. The role of social media influencers is surprisingly powerful in Indonesia, particularly to reach grassroots populations. In fact, social media influencers were among the first priority of vaccine recipients in the hope that they would convey positive influences and messages to their followers (Widianto & Lamb, 2021). Altruistic acts by communities swept across the country and still remain a force for positive outcomes and change. Social solidarity among members of society and community has proven to be a strong pillar to survive the pandemic.

13.4.3 Digital Transformation and Technology As the fourth most populous country, Indonesia’s digital economy has been growing at the fastest rate, making it the world’s fifth most active start-up ecosystem, following the United States, India, Britain, and Canada (Beritasatu, 2020). In ASEAN, Indonesia is not only considered one of the largest, but also the most diverse of the start-up ecosystems (Austrade, n.d.). In 2020, Indonesia had 2193 start-ups, including a decacorn (Gojek) and four unicorns (Tokopedia, Traveloka, OVO, Bukalapak). The rapid growth of start-ups in Indonesia continues to be driven by a government-sponsored program, #1000startupdigital. This program aims to drive the nation’s digital ecosystem to facilitate and support the birth of new startups in Indonesia. As with other start-ups in general, new endeavors in Indonesia aspire to provide solutions to people’s problems and social issues. These start-ups have moved away from developing mere social media digital platforms to those that tap real issues experienced by people, daily. The start-ups and digital platforms in Indonesia have touched and served people’s “knots of life.” Consider Gojek, an Indonesian decacorn, as an example. People’s daily needs can be facilitated through one platform, covering transportation (hail riding service), food and grocery shopping (shopper assistance service), payment system, shipping and logistics, cleaning services, etc. During the current COVID-19 pandemic, the platform links with

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other medical online platforms providing online consultation with medical doctors, doctor’s appointments, COVID-19 tests, and medication purchases. Tokopedia, a unicorn in Indonesia, does not only facilitate online shopping, but it also enables people to manage investments (e.g., stocks, gold), to borrow, to protect (insurance), and to make installment purchases. Hotel bookings, flight tickets, bills payment, and other transactions are all facilitated by the platform, making life easier. Digital transformation in the financial sector (often referred to as fintech) is reflected in the growing number of digital banks in Indonesia. The growth of digital banking in Indonesia finds its momentum coinciding with the global pandemic. The need for touchless transactions has been the logical consequence of movement restrictions. In the transportation sector, one of Indonesia’s major taxi fleets, Blue Bird, has extended its service to the online platform, which also enables people to order service to transport COVID-19 patients to hospitals, as the company dedicated a special fleet of taxis for this purpose. The pandemic has accelerated the already fast-paced digital transformation in Indonesia by several years. In terms of technology adoption, Indonesia’s Internet penetration has reached 73.7% in 2021 (Kemp, 2021). In January 2021, the number of mobile phone connections was equivalent to 125.6% of the total population (345.3 million mobile connections—many Indonesians own more than one smartphone), making the mobile connection rate greater than the country’s population. Social media users increased by 10 million between 2020 and 2021, making up 170 million users (61.8% of the total population) in January 2021. All these numbers reflect a high technology adoption rate in Indonesia, permeating from the top level to the bottom of the pyramid. As consequence, information is disseminated easily and quickly. Unfortunately, this trend can also include misinformation and hoaxes. Regardless, the benefits of accelerated communication and information technology adoption still outweigh the costs. When interactions are restricted, digital communication technology becomes the only media to connect with others. At the end of 2020, the Communication and Information Technology Minister stated that, in an effort to support the digital transformation of Indonesia in response to COVID-19, the construction of telecommunication infrastructure had been accelerated by one decade. The government of the Republic of Indonesia allocated US $2.06 billion for information and communication technology development in the 2021 state budget (Eloksari, 2020). The budget aims to support and accelerate the digital transformation in public services as well as improve connectivity inclusion in the country. Improvement in connectivity would also improve the efficiency of services in many sectors, including health, education, and government. Connectivity inclusion by the development of the information and communication technology is expected to provide Internet access to around 4000 villages and subdistricts, especially in Indonesia’s outermost, frontier, and least developed areas. While 5G networks were officially launched in Indonesia in May 2021, 4G networks are still considered a luxury in villages and subdistricts. Therefore, by 2022, current actions will lead to an expectation that more than 83,000 villages will have access to the 4G network.

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The COVID-19 pandemic offers mounting evidence that the availability and functionality of digital infrastructure are essential for survival. This is especially true for Indonesia, an archipelagic country. Unlike countries in Europe and other continents where people can easily commute by ground transportation, the archipelagic nature of Indonesia makes logistics and mobility of people slightly challenging. Thus, the role of telecommunications infrastructure in Indonesia is vital to bridging the social interactions and communications of people as events, people, geography, business, technology, and policy are aligning in the right places at the right time to advance positive changes and services it provides.

13.4.4 National Value and Principle Indonesia—as a vast archipelago comprising thousands of islands, hundreds of major ethnic groups, and nearly 300 million people—clearly is a very diverse country in every way. Significant cultural, ethnic, linguistic, and religious groups are found within the country’s boundaries. “Bhinneka Tunggal Ika,” translated as “Unity in Diversity,” is Indonesia’s national motto that refers to the variety of the country’s internal composition of people and culture, living in unity. The spirit underlying the motto is that despite the great diversity, the people of Indonesia remain united as one nation. As an expression of harmony and unity between dissimilar individuals or groups, unity in diversity is also known as a concept of “unity without uniformity and diversity without fragmentation” (Lalonde, 1994), and that is the value that must be shared forever among Indonesians. Another equally important construct is the principle of Gotong Royong, translated as Mutual Cooperation. In one of his speeches from 1964, Indonesia’s first president, President Soekarno, described mutual cooperation as a dynamic concept—even more dynamic than the family concept—as it reflects work, effort, and activities. Mutual Cooperation is the very essence of the Pancasila—the country’s ideology—which strengthens Indonesia’s motto of Unity in Diversity. Long before independence, however, mutual cooperation has been a synergistic power among Indonesians. One notable feature is “its basis on communal spirit of working together for the common good of all” (Butler, 2016). In the past, Gotong Royong or Mutual Cooperation principle would manifest in the forms of labor, materials, and funds sharing (usually for life-cycle ritual ceremonies); house building; crops planting and harvesting; public roads and waterway irrigation maintenance; as well as post natural disaster reconstruction. The very core of Gotong Royong lies in mutual assistance and communal collaboration, which play such an important role in strengthening social ties among members of the community (Barlocco, 2010). The COVID-19 global pandemic has revived Indonesia’s national values and principles as reflected in the altruistic acts and social resilience of the people during the pandemic. Since the beginning of the COVID-19 pandemic, we have seen a collective kindness and social solidarity evident in various acts to help the nation and the people. For example, when the country experienced shortages of medical

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supplies and equipment, the people took the liberty to contribute in any way possible, ranging from simple and free mask distribution to pedestrians and other fellow citizens, to fund raising for medical protective gear for the medical workers. Indonesian citizens could have chosen to place the responsibility on the government; yet, driven by the strong, shared value and principle, individual and communitybased initiatives regularly took place, as we see in the following sections. These values and principles are the backbones that strengthen Indonesian society when coping with the crisis.

13.5

Unity in Diversity and Mutual Cooperation as Foundation for Community’s Responses to the Pandemic

As described above, Unity in Diversity and Mutual Cooperation are integral to Indonesia and its society. In responding to the current global pandemic, we have witnessed how these values drive communities’ engagement in various altruistic ways. This section highlights some notable forms of action inspired by the values and principles.

13.5.1 The Mutual Cooperation Vaccine Program (Vaksin Gotong Royong) The “Mutual Cooperation” Vaccine Program—dubbed Vaksin Gotong Royong—is a collaboration program between the Chamber of Commerce of Indonesia and the Government of the Republic of Indonesia. The program is intended as a bid to accelerate and expand coverage of the COVID-19 vaccination program across the country to achieve faster herd immunity. The program provides and distributes vaccines for employees of private companies and their families. Under this scheme, the vaccines are to be purchased and paid by the private companies and to be distributed to their employees and families at no cost. The program was rolled out in March 2021 to move mitigation efforts forward as delays in overseas shipments from vaccine producers impacted Indonesia’s vaccine program. A parallel effort to the government’s initiative, the program helps the country to progress in ensuring more people are protected by the vaccine. The idea of the initiative was to reduce the amount of time to achieve herd immunity as well as cover the cost of the government’s free vaccine program (The Economist, 2021). Thus, instead of waiting passively for government-provided vaccines, private and state companies could procure their own vaccines for their employees, with their own funding. The business sectors have been very eager to work hand-in-hand with the government in sharing the burdens and efforts to achieve herd immunity. Many

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private and state companies have responded positively to this initiative through immediate participation.

13.5.2 Fabric Masks Production and Distribution by Volunteers and Industries At the beginning of the pandemic, Indonesia was experiencing shortages of face masks and disinfectant products—even medical protective gear. The national production and supply of disposable face masks failed to keep up with the surging demand. Shortages of these products led to the dramatic rise in prices—in some instances up to threefold—putting people of low income and weak economy at risk for not being protected from the virus. The circumstances drove communities and garment industries to produce and distribute fabric masks to the people. Fabric masks and medical protective gears were not only produced in the factory, but also in households. Communities of volunteers across the country produced and distributed thousands of fabric face masks to other fellow citizens free of charge, as well as medical protective gears for the medical workers, as part of their volunteering actions.

13.5.3 The Social Collaboration Platform Before the pandemic, many online platforms promoting altruistic acts, such as donations, have started and gained popularity in Indonesia. Accordingly, the Social Collaboration Program was/is an initiative by the provincial government of Greater Jakarta designed to provide a channel or connector for citizens who wish to participate in helping others in need through donation. The initiative is driven by the belief that mutual cooperation would help alleviate the burden felt and experienced by others. The platform enables donors to choose the beneficiaries of their donations through a publicly open database; therefore, allowing effective distribution of donation to the right target. Donors have the option to contribute to any of four categories: food provision, small businesses, education, and human settlement. In the food provision categories, for instance, donations can be in the form of staple needs, allowances, etc. In the small business category, donors can contribute money to facilitate educational training for small businesses, funding, and any other forms that will move small businesses forward and survive. An example of social collaboration in the education category is the provisioning of smartphones, tablets, computers, or laptops to students and educators in remote areas across the country to facilitate long-distance, online learning. Under the human settlement category, donors can focus on providing infrastructures especially in the underserved and especially poor areas.

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13.5.4 Practicing Self-restrain from “Mudik” “Mudik” (or translated as homecoming) is a unique Indonesian term referring to an activity where migrants in cities return to their origin or hometown, just days before major holidays—usually to celebrate spiritual or religious festivity with their family. Mudik has become an annual tradition and part of the culture, especially during Idul Fitri (the annual Muslim festival that marks the end of Ramadan). “Mudik” involves large-scale human mobility with massive transportation flow. The practice of “mudik” can be chaotic, sometimes. The COVID-19 global pandemic has restrained people’s mobility to “mudik.” The government has banned “mudik” for the past two years to control the coronavirus’ spread, with the exception of life-or-death family emergencies. All travelers must carry permission letters from their employers (in the case of work-related trips) and/or respective local administrators. Given the popularity of mudik and related tradition, this policy is not easy to accept. While some people have opposed the ban, many more decide to follow the government’s order not to “mudik” and practice self-restraint from visiting families during the religious holidays. Wargabantuwarga.comWargabantuwarga.com is a website containing comprehensive information on medical access and assistance to fight COVID-19 in Indonesia. The website was initiated by members of communities with the aim to collect, record, and provide various information that has been scattered in digital space. The website provides information about health facilities contact and locations, availability of medical supplies, hospital bed availability, locations of oxygen tanks vendors, plasma donor list, ambulance contact numbers, COVID-19 test and vaccine program schedule and locations, and available premises for self-isolation. The website also recruits volunteers to help collect and verify data before they are published in the website. The website brand is derived from the phrase “warga bantu warga,” translated as “citizens help other citizens,” which reflects the sense of communal collaboration and mutual assistance. The website was founded and continues to be run by volunteers. Since its beginning, the website has received many endorsements from prominent figures and influential personas. It is seen as a straightforward example of a pure social solidarity action moved by the “Unity in Diversity” value and “Mutual Cooperation” principle.

13.5.5 Convalescent Plasma Donor Community Convalescence plasma therapy is one of the methods regarded to elevate the survival rate for COVID-19 cases. Excov Community is an assembly of COVID-19 survivors who agree to donate their convalescent plasma to those in need. The initiative originates from concerns over the gap between the shortage and the growing demand for convalescent plasma as COVID-19 cases rise sharply. The community operates

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as a hub of assistance by processing inquiries from COVID-19 patients and then disseminating the information to the community subgroups. The role of Excov Community is to help patients gain access to and accelerate the process of receiving convalescent plasma.

13.5.6 The Rise of the Civil Society Through Volunteerism Early in the pandemic, Indonesia was pictured as ill-fated and helpless as reports and analyses from foreign media swarmed the world’s attention with somber scenes of how the government handled the situation (Preuss, 2020). The international media have highlighted Indonesia’s low level of COVID-19 infection testing and the government’s missteps in the early handling of the crisis. What the world may have missed seeing from Indonesia was the rise of civil society, reflected in numerous ways: 15,000 medical students signed up voluntarily and ready to be deployed to fight COVID-19 as early as March 2020; speedy innovations by universities in developing disinfection booths, affordable COVID19 testing kit (the GeNose), and ventilators; crowdfunding campaigns on private, local platforms that support government-led initiatives; and many more. Volunteerism is a national asset of the country that is mainly compelled by the “Gotong Royong” or “Mutual Cooperation” principle. Members of civil society are strongly aware that they have shared interests, purposes, and values; that the only way to survive and face the current hardship is by lending hands to each other through voluntary actions, which can come in many forms.

13.6

A Final Thought from a Diverse and Unified Indonesia

Indonesia is a country that has survived many ordeals, stretching from natural disasters to the fight for independence, from colonial rule to political conflicts, and more. It is with real confidence that Indonesians can say that these acts are reflections of the greater Indonesian community’s resilience to the crisis. While community resilience is understood as “a community’s sustained ability to use resources to respond, withstand, and recover from unfavorable situations (Bosher & Chmutina, 2017, p. 32),” the community resilience demonstrated by the people of Indonesia coincides with and operationalized the conceptual framework offered by Shultz, Rahtz, and Sirgy (2017). The authors note that community resilience is “an adaptive process driven by the possession of, or access to, resources that allow a timely restoration of its capacities to contribute positively to a sustainable and desirable state of flourishing” (Shultz et al., 2017, p. 410). Historically, our country has shown an ability to restore its capacities as a geographically large, populous and diverse nation, in a timely manner, to achieve sustainable and desirable prosperity. The Unity in Diversity motto and Mutual Collaboration principle are critical elements in

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the makeup and essence of today’s Indonesia. Unity in Diversity also manifests in such resilience as the ultimate goal of the nation is to be prosperous and in turn facilitate sustainable life and well-being now and for future generations.

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Primidya K.M. Soesilo is the head of Business Management and Marketing, International Undergraduate Program of Binus Business School, Indonesia. She holds a PhD in Marketing from Temple University and an MSc in Marketing from Georgia State University, USA. She has published in top refereed journals such as Journal of Retailing and Consumer Services, Journal of Consumer Affairs, Journal of Hospitality and Tourism Research, Journal of Marketing Communications, and Journal of International Consumer Marketing. Her research interests are in the area of consumer envy, social comparison and influence, relationship marketing, shopping experience, co-branding, and tourism marketing. Fathony Rahman is the dean of the School of Business and Economics, Universitas Prasetiya Mulya, Jakarta, Indonesia. He also serves as one of the Board of Directors of Tenggara Strategics— a business and investment research and advisory institute established by the Centre of Strategics and International Studies (CSIS), The Jakarta Post, and Universitas Prasetiya Mulya. He holds a DBA from Wilmington University, USA. His research interests cover areas such as corporate social responsibility (CSR), private label brand, relationship marketing, and brand management. He teaches courses such as Business Ethics and CSR, Marketing Research, Consumer Behavior, Marketing Strategy, and Digital Marketing. Most of his papers have been published in the Journal of Retailing and Consumer Services.

Chapter 14

Fighting COVID-19 in a Multicrisis Context: The Case of Lebanon Georges Aoun and Karine Aoun Barakat

Abstract The COVID-19 pandemic could not have come at a worse time for Lebanon. In 2019, the country started to witness the most profound economic and political crisis in its history, the result of years of betting on a windfall economic model that relies on imports and external remittances. Amidst this backdrop, the onset of the COVID-19 compounded existing weaknesses, further increased vulnerabilities, and represented one of many woes the country faced in 2020. This chapter studies the way in which the pandemic was successfully managed in the short term, but how the lack of sustainable policies, low government trust, and limited monetary means led to an economic catastrophe and eventual large-scale spread of COVID-19. Keywords COVID-19 · Lebanon · Political bias · Health governance · Vulnerable communities · Crisis management

14.1

Introduction

Lebanon is a typical example of a distressed community where the presence of recent and current negative states with regards to the collective well-being have inhibited health and members’ empowerment to affect prosocial outcomes for stakeholders (Shultz et al., 2017). Over the past couple of months, Lebanon’s capacity for continued growth and resiliency in these domains has been significantly diminished and pushed to breaking point following the spread of COVID-19. In facing the pandemic, the country has had to deal with a succession of social, economic, political, sanitary, and informational challenges, which could not have come at a worse time for the Lebanese (Bizri et al., 2020).

G. Aoun (*) Saint Joseph University of Beirut, Beirut, Lebanon e-mail: [email protected] K. A. Barakat INSEEC Grande Ecole, INSEEC U, Paris, France e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_14

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Firstly, the country has had to endure an acute economic and political crisis prior to the onset of COVID-19. Years of corruption and poor governance led to the collapse of the country’s economic system and forced the government to default on its debt payments in early 2020. This was followed by a sharp devaluation of the local currency and subsequent increases in unemployment and poverty, making Lebanon’s ability to tackle the pandemic excessively weak. Secondly, the country has suffered for many years from a fragmented health-care sector where private sector actors account for 84% of service providers and is entirely reliant on foreign sources for essential COVID-19 supplies, including N95 masks and ventilators, due to the absence of local manufacturing capabilities (Khoury et al., 2020). These factors have rendered its public sector incapable of dealing with the crisis without intensive national and international cooperation. Thirdly, citizens’ low trust in the government and official news agencies for reporting COVID-19 cases has led to increasing reliance on social media as a source of information. However, this channel is not immune to the spread of rumors and “fake news,” which in some cases instills fear, puts lives at risk, and stigmatizes people carrying the virus or those accused of spreading it. Finally, its high population density, especially in urban areas—where 87.2% of the country’s inhabitants live—the more than 1.5 million Syrian and Palestinian refugees it hosts who live in overcrowded camps, and the multigenerational nature of its households (DeQuero-Navarro et al., 2020; Khoury et al., 2020), as well as Lebanon’s collectivist culture, and religiosity of its people accelerate the quick spread of COVID-19. Despite all the above challenges, the Lebanese Ministry of Health succeeded in handling the pandemic in its early stages notably by imposing a strict lockdown, which also included shutting down schools and closing the country’s borders to incoming visitors. The success of this confinement strategy was also attributed to the “stay at home” campaigns launched by local media, which spread fear and panic among the Lebanese and encouraged them to adhere to the ministry’s guidelines. In the longer term, however, the enforcement of a lockdown without socioeconomic support did not prove to be sustainable (Kharroubi & Saleh, 2020) as increased economic hardships, coupled with deep government resentment and mistrust, pushed people to defy the imposed restrictions and ultimately led to a sharp increase in the number of COVID-19 cases.

14.2

A Trilogy of Political, Economic, and Health Troubles

On February 21, 2020, Lebanon confirmed its first case of COVID-19, the succession of events that followed, which led the government to impose a nationwide lockdown 3 weeks later, was in equal parts dictated by the prevailing political system’s sectarian roots, Lebanon’s dire economic situation, and the declining state of its health-care system. This lockdown, which lasted until June 2020, helped contain the spread of COVID-19 during its first stages and relieve pressure on the

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health-care system. However, the government’s inability to provide those most affected by the closure with sufficient economic support (Abi-Rached & Diwan, 2020) led to the destruction of the country’s already suffering economy and only offered a short-lived victory over COVID-19.

14.2.1 The Sectarian Political System Lebanon’s current sectarian system, which was formulated in 1989, established power sharing among the leaders of the country’s largest sects and distributed among clientelist networks (Clark & Salloukh, 2013), often at the expense of the state and good governance. In October 2019, huge demonstrations asking for the departure of the political elite were staged and ended with the resignation of the government representing the country’s various political parties. Two months later, a new government comprising bureaucrats with less visible political affiliations was formed. It brought brief hope of reducing the political tensions in the country, calming the intensity of demonstrations in the streets, and reviving the prevailing economy with the help of much-needed reforms. This newly appointed government was also tasked with managing the looming COVID-19 crisis. To do so, a National Committee for COVID-19 (NCC) was formed on January 31, 2020, with a mission of overseeing Lebanon’s COVID-19 preparedness and response plan (Khoury et al., 2020). The new government benefited from a 2-month respite before the appearance of COVID-19 and the controversy it created in Lebanon. At the time, the government’s seemingly “technocratic” ministers made a series of decisions that quickly revealed their interests, and the power of nonstate actors over the government was evidenced by the failure to enact controls on flights from Iran in February 2020. For 3 weeks, from February 21 until March 15, 2020, an open conflict arose between a portion of the population insisting on suspending flights from Iran and another portion of the population refusing this action despite the spread of the virus in that country. Lebanon’s government at the time, which was supported by Iranian-backed Hezbollah and its allies, only decided to ban entry to nonresident foreigners from Iran once COVID-19 had spread to other countries in Europe, and a decision was thus taken to impose a travel ban on arrivals from the four countries worst affected by the disease, including Iran. This conflict received widespread media coverage, and health experts tried to forecast the evolution of the pandemic with various alarming scenarios that showed the weaknesses of the public governance. Furthermore, in fighting the COVID-19 pandemic selective lockdowns were implemented in certain areas with high infection rates. This, however, was viewed unfavorably by some who considered it as serving sectarian or political agendas and insisted on closing an equal number of Christian and Muslim constituencies. By mid-March, as the COVID-19 infection count reached 99 cases, the government declared a generalized public mobilization, issued stay-at-home orders, closed the country’s land and

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air borders, and forced all nonessential businesses and services to shutdown (Khoury et al., 2020). Throughout the crisis, the presence of a weak central government also gave the political elite additional room to serve its “clientele.” As such, the COVID-19 pandemic was seen by many political parties as an opportunity to restore their community’s standing, which had been tarnished during nationwide protests against the prevailing corrupt governance and crippling economic troubles. Among the parties that deployed efforts to combat COVID-19, Hezbollah stood above the rest and was quick to offer services to its backers. As part of its nationwide response, the party unveiled two new COVID testing centers, a fleet of ambulances—many equipped with ventilators—and an entire hospital that was repurposed for coronavirus patients (Reuters, 2020). This was considered by some as a portrayal of the party’s “community-based resistance.” Ultimately, the Hezbollah-led Ministry of Health took credit, in large part, for the way the response to COVID-19 was handled in the first phase. In an unexpected twist of events, the pandemic had also managed to quell the protests initiated in October 2019 (Abi-Rached & Diwan, 2020) as the government had managed to instill fear related to the spread of COVID-19, and put in place curfews and restrictions that prevented protesters from gathering in the streets.

14.2.2 A Weak Economy Lebanon’s current economic crisis has been long in the making as the post-wartime boom and the rentier economy both hid and fostered the country’s structural weaknesses (Synaps, 2020). The country’s economy is to a large extent unproductive, relying primarily on the services sector and remittances from expatriates scattered across the globe. The ineffectiveness of such a model unraveled as the country struggled with a national debt of $93 billion—the highest debt-to-GDP ratio in the world. In March 2020, the government defaulted on outstanding Eurobond obligations amounting to $1.2 billion and suspended all foreign and local debt repayment, the first sovereign default in the country’s history, which sent the local currency into freefall (Euler Hermes, 2020). A few months earlier, the Lebanese banking system, likened by some to a giant “Ponzi scheme,” had crumbled, leaving the country short on local and foreign currency, depositors unable to withdraw their money, and the government controlling external transfers of funds. This situation prevented private sector operatives from importing critical medical supplies necessary to fight the pandemic. Furthermore, due to the dismal economic situation in Lebanon, the government was unable to set aside a financial package to help equip both public and private hospitals with much needed resources, including ventilators, protective equipment, and additional beds (Bizri et al., 2020). Amidst this backdrop, the Lebanese government, intent on building up its health sector and public health capacity in the early stages of the pandemic, adopted a very aggressive containment

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strategy and initiated a state of health emergency, which essentially shut down the country’s economic activities. Although effective in reducing the spread of COVID-19, the strategy came at a high economic cost, driving poverty levels from 30% to an expected 45% by the end of 2020 and unemployment to over 50% (Abi-Rached & Diwan, 2020). Additionally, this forced thousands of Lebanese small business owners to stop their activity in order to comply with the national curfew. In anticipation of a prolonged closure, some businesses reacted quickly and creatively; restaurants switched to delivery and takeout, retail outlets adopted e-commerce and social commerce, and service providers favored mobile solutions over in-person service delivery. While the economic crisis mainly hit the tradable sectors, the COVID-19 crisis extended the shock to other vital sectors, which the country relies on—namely, tourism, hospitality, and transportation (Abi-Rached and Diwan, 2020). This exacerbated an already devastating economic crisis and exposed the inadequacies of Lebanon’s social protection system. Moreover, the government was unable to provide monetary aid for people affected by the lockdown, many of whom were forced to keep working to feed their families. At the time, talk on the street was that “the Lebanese would either die of hunger or of COVID-19.” During the lockdown, COVID-19 infection rates in Lebanon remained relatively low compared to other countries; however, social and economic pressures pushed the government to lift the confinement and night curfew, and to restart the economy in a bid to reduce unemployment and prevent a deep recession. While easing the economic pressure, this measure also led to the renewal of street protests in several areas of the country. Protesters bemoaned the country’s deteriorating economy and devaluation of the local currency by two-thirds. To contain the anger on the street, the Ministry of Health was swift to ask the population to stay cautious and on alert for a resurgence of the virus and threatened a renewed lockdown if large public gatherings were to resume.

14.2.3 A Declining Health-Care Sector Lebanese citizens have historically faced geographical, cultural, societal, economical, and sometimes political barriers that have hindered their access to health care. From a geographical viewpoint, health-care services are mainly centralized within and around the country’s capital city, Beirut. Prevailing cultural and societal norms have led to limited awareness and health literacy, as well as widespread social and religious stigmas that have reduced the demand for certain health-care services in some communities. In terms of economic barriers, prohibitive service costs and the lack of universal health coverage have often prevented patients from receiving needed care. Furthermore, dominant sectarian structures and a widespread culture of political clientelism mean that individuals with lower political involvement may have less access to health-care services (Helou et al., 2020).

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In early 2020, Lebanon’s health-care sector, once considered one of the top systems in the region, was dealt an additional blow resulting from the country’s financial collapse. This led to shortages in medical supplies, a drop in the number of small-scale hospitals and medical centers that faced threats of bankruptcy, the closure of some hospital wards that were operating at suboptimal capacity, and the departure of many highly qualified physicians and nurses due to pay cuts and the depreciation of their salaries (Farha & Abi Jaoude, 2020). Amidst this backdrop, the appearance of COVID-19 put additional pressure on Lebanon’s failing health-care system. Firstly, due to the absence of local manufacturing capabilities, the country was entirely dependent on foreign sources for essential COVID-19 supplies, including N95 masks and ventilators, which delayed the government’s ability to tackle the pandemic. Secondly, the country has been heavily reliant on private sector actors who account for 84% of healthcare service providers (Khoury et al., 2020) and as such exerted minimal control over hospitals’ readiness to accept treating COVID-19 patients in the early stages. Thirdly, neglected for many years, the public health systems were insufficiently funded and therefore disposed of limited means to serve the local population. Finally, the health shock caused by the Beirut port explosion on August 4, 2020— which resulted in more than 6000 casualties, over 200 deaths, and destroyed three of the capital’s large hospitals—led to a huge surge in COVID-19 cases and further tested the resilience of the Lebanese health-care system (Hemadeh et al., 2020). Given the severity of the situation and in the absence of government public spending, the private sector, NGOs and civil society played a notable role in ensuring the health sector’s ability to face COVID-19. They mobilized their efforts toward fundraising to help local hospitals acquire relevant resources to fight the pandemic and raised public awareness about the dangers of COVID-19, thus controlling and limiting the propagation of the virus in the early stage.

14.3

Amplifying the Crisis: Religious, Cultural, and Demographic Specificities

Alongside political, economic, and health-care considerations, several other factors are interesting to study and thus to understand the spread of COVID-19 in Lebanon; they include the country’s religious, cultural, and demographic specificities. Firstly, past research has shown that religious beliefs potentially affect how people perceive their health, and may inhibit health-care utilization and alter health-care behaviors leading to poor health outcomes (Franklin et al., 2007). In some cases, the beliefs and practices of various religious groups can conflict with the recommendations of medical professionals and affect an individual’s well-being (Gall et al., 2005). In Lebanon, a country where 18 different religious sects coexist, religion plays an important role in social life (Kassem et al., 2020). At the beginning of the pandemic, despite the strong religious faith in the country, Christian and

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Muslim religious services were voluntarily suspended by priests and imams as the general public tried to avoid physical contact. This was followed a few weeks later by a decision from the local health authorities to close all places of worship as they feared the concentration of people in closed spaces would accelerate the spread of the virus. While the large majority of the country’s religious leaders complied with national health recommendations, some believers continued to defy scientists’ recommendations and preferred to rely on their faith. In this sense, some of the country’s Muslims who consider that life and death is controlled by Allah (God) refrained from adopting precautionary measures against COVID-19 by referring to the saying from the Holy Quran; “Allah is sufficient for us; and what an excellent guardian He is.” Additionally, a portion of Lebanon’s Christians who show a profound devotion to saints urged doctors to give COVID-19 patients blessed water for healing purposes (Hashmi et al., 2020). Furthermore, across the religious spectrum some Lebanese expressed fatalism or the belief that their health outcome is predetermined or purposed by a higher power and is not within their own control (cf. Franklin et al., 2007). As such, they believed that whatever the precautions they take, if it was their destiny to catch COVID-19 they could do nothing about it. These general beliefs accelerated the spread of the virus as some citizens failed to follow health officials’ guidelines and preferred to put their health in God’s hands. Secondly, from a cultural perspective, Lebanon is considered to be a part of a collectivist culture where people are heavily reliant on group memberships such as religious communities, close social contact, and community ties, which are all central to psychological well-being. It is with the help of such strong social ties and community involvement that the Lebanese have buffered the long-standing traumas associated with conflict and economic problems (Jaspal et al., 2020). Within such a context, there was a need for contextualized, tailored communication on the notion of physical distancing, mask-wearing in public, and avoiding large social gatherings (Kabakian-Khasholian et al., 2020); for many Lebanese, it is difficult to conceive of life without close social interaction. Furthermore, the major nationwide lockdown imposed by health authorities at the beginning of the COVID-19 pandemic proved to be especially tough to handle since it deprived individuals of access to social support, community involvement, and religious affiliation, all of which are potentially effective coping mechanisms in the Lebanese population. Additionally, there appeared to be a cultural misinterpretation of confinement, as in Lebanon, people considered that they could still see extended family members during this period. This meant that in many instances the general public did not comply with the guidelines regarding family gatherings, and therefore, it was common to find COVID-19 spreading among relatives. Thirdly, demographically, Lebanon is a small and crowded country; in addition to its 5 million citizens, it hosts 1.5 million refugees within an area of 10,542 km2, making Lebanon the eighth most densely populated country in the world (Worldometer, 2020). Given the fact that the spread of COVID-19 occurs between close contacts via aerosols and droplets, population density is a highly relevant factor that can explain virus occurrence and transmission (Goujon et al., 2020). However, the fact that Lebanon lacks public spaces and does not have mass public

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transportation services may in part clarify why the spread of the virus was more contained than in other countries (Bizri et al., 2020). Additionally, the country’s relatively young population may help to explain the country’s low mortality rate to date (Bizri et al., 2020).

14.4

COVID-19 and Vulnerable Communities

Refugees account for over 30% of Lebanon’s population (Kebede et al., 2020). Hailing from Palestine, Syria, and Iraq, they mostly live in camps or poor suburban areas in close proximity and do not have sufficient access to basic water, sanitation and hygiene services, and infrastructure. These factors have increased refugees’ risk of exposure to infectious and preventable diseases as well as other health issues. With the arrival of the COVID-19 pandemic to Lebanon, citizens were asked to improve their hygiene practices and follow social distancing protocols to slow the spread of the virus. However, implementing these practices in refugee camps— where water is scarce, and people depend on humanitarian organizations for water supplies—proved particularly difficult. Overcrowding and poor sanitation in camps furthermore made physical distancing hard to apply or enforce, exposing refugees to an enormous risk of infection (Reliefweb, 2020). Moreover, in its early stages, the COVID-19 pandemic was accompanied by social stigmatization, especially in refugee communities. Over time, fears of refugees in the general public have been compounded by COVID-19 fears, leading to increased discrimination against these groups. This social stigma associated with COVID-19 has encouraged illnessconcealment, delayed early detection and treatment, increased distrust in local health authorities, and lowered the likelihood of compliance with general guidelines within refugee communities (Guadagno, 2020). Given this context, it was therefore decided that all initiatives targeting refugees—including securing hygiene supplies, implementing a testing and surveillance strategy, and establishing isolation centers within the camps—would be implemented through the more trusted United Nations agencies working in Lebanon, and in collaboration with the government (Khoury et al., 2020). In terms of employment, the COVID-19 crisis added another challenge to Lebanon’s vulnerable workers, particularly Syrian and Palestinian refugees who are employed in the informal economy and tend to accept lower wages and tougher working conditions where hygiene measures are often overlooked (Kebede et al., 2020). During periods of lockdown caused by COVID-19, a large majority of Syrian and Palestinian workers who are paid on a daily basis lost their income without any compensation from the state or their employers. The consequences of this situation have been job losses and increased poverty among this part of the population as well as a heightened risk of contamination. While COVID-19 infection rates within refugee camps remain relatively low compared to those of the general population, especially considering the young average age of most refugees, the death rate is higher than in the general population.

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Much has been said regarding the accuracy of contamination numbers, however, as there has been little concentrated effort to sample the refugees in Lebanon due to the lack of resources and test kits. Also, refugees may refrain from reporting cases due to the lack of awareness or fear of stigma, isolation, and deportation (Kassem & Jaafar, 2020). In light of the above, COVID-19 poses a real threat given that communicable diseases have been historically problematic in refugee populations (Al Munajed & Ekren, 2020), hence containing its spread within such settings is an additional challenge Lebanon continues to face.

14.5

The Role of the Media

Within the current COVID-19 pandemic, social media has the potential, if responsibly and appropriately used, to provide rapid and effective dissemination routes for key information (Chan et al., 2020). In Lebanon, social media and TV channels played a crucial role in raising consciousness among the Lebanese and pushing them to put health priorities in front of political and economic considerations. Awareness campaigns, talk shows hosting various specialists in infectious diseases, and daily figures about contamination in the country and around the world became the focus of the Lebanese public. Relaying this information via social media swayed public opinion in favor of a full lockdown, which was imposed in March 2020, and despite the social and economic sacrifices the lockdown entailed. Similarly, the local media also diffused highly emotional messages from COVID-19 patients, hospital staff, and influencers urging people to “Stay Home” and comply with the lockdown. Furthermore, numerous accounts on social media appeared to publicly “name and shame” the people and institutions breaching health guidelines. During outbreaks, evidence suggests that people struggle with uncertainty and look for sources to fill their needs for information (Mheidly & Fares, 2020). In fact, since the beginning of the COVID-19 pandemic, Lebanese people have been flooded with information from different media outlets, many of which were neither credible nor well-sourced (Bizri et al., 2020). The quick spread of misinformation and fake news increased fear among the Lebanese and created new challenges for the authorities (Bizri et al., 2020). Hence, in a bid to combat misinformation circulating online, the Lebanese Ministry of Information announced in April 2020 a new communications response initiative in partnership with the WHO, UNICEF, and UNDP to flood media and social media with facts and science. This was followed a few months later by the launch of the “Fact Check Lebanon” webpage, whose aim was to verify false news. Despite these initiatives, many rumors continued to circulate on social media. Those rumors included claims that the “real” number of COVID-19 cases was much higher than the figures published by the Ministry of Health, which at the time was controlled by Hezbollah. On one side, accusations of cover-ups became common and conspiracy theories were rampant about the ministry hiding COVID-19 patients coming from overseas—mainly Iran and Africa—in small or remotely located

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hospitals to avoid declaring them. While at a later stage, many rumors spread accusing the government of inflating the number of COVID-19 patients to instill fear among the opposition and subsequently to discourage massive protest demonstrations in the streets against the government.

14.6

Government Mistrust

The Lebanese have for many years shown chronic mistrust in the state and its ruling elite (Kabakian-Khasholian et al., 2020) as a result of social inequalities, rampant corruption within government institutions, and mismanagement of resources. This has translated into a weak application of the law and heightened suspicion from citizens regarding governmental decisions and regulations. For many Lebanese, the state has become the adversary. The adoption of successive oppressive measures as of the October 17, 2019, revolution, which included repressing street protests, silencing the opposition, and manipulating the judiciary system, has deepened the chasm between ruling parties and the people. This situation has had a trickle-down effect on citizens’ perceptions of the handling of the COVID-19 crisis by the government. On one hand, this mistrust reduced peoples’ willingness to follow the rules put in place. Case in point, toward the end of July 2020, despite nearly 5 months of mobilization and the prevailing fatigue of the local population, the number of infected people rose by fivefold compared to the previous month. The government accused the population of neglect and of adopting risky behavior by not social distancing in public spaces; while the people accused the Ministry of Health of inflating the number of positive tests to keep protesters off the streets and to avoid any opposition toward the government. The relation between the government and its citizens worsened and trust further decreased after a hundred COVID-19 tests performed in three clusters were wrongly declared as positive, which led to the renewed circulation of conspiracy theories. Furthermore, controversial decisions by the government, which included opening nightclubs but prohibiting dancing, imposing mask-wearing for people of the same family traveling by car, and forcing companies to pay for their employees’ PCR tests, led the population to adopt a defiant stance and reduce law abidance. As did videos of the caretaker Health Minister Hamad Hassan disregarding social distancing and failing to comply with the lockdown measures on two separate occasions, which added to people’s resentment of the government and its policies. On the other hand, however, this lack of trust in the government may have paradoxically helped reduce the spread of COVID-19. Some experts have argued that Lebanese mistrust in their government’s ability to cope with COVID-19 forced people to be more vigilant and apply auto-discipline due to panic and fear (The Washington Post, 2020). Moreover, years of inefficient governance have conditioned the Lebanese to rely more on themselves and to create and adopt survival mechanisms independently from governing authorities.

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Finally, while dealing with a succession of traumatic events throughout their history, the Lebanese have demonstrated remarkable resilience (DeQuero-Navarro et al., 2020), which has helped them to develop social competency and skills in problem solving (Doron, 2005) necessary for coping with the COVID-19 pandemic.

14.7

Lessons and Conclusion

The propagation of the COVID-19 pandemic has had deep and lasting effects on the world. In Lebanon, the arrival of the SARS-Cov-2 virus coincided with a multitude of crises and accelerated the downfall of the country’s health-care sector, deepened the economic collapse and aggravated divergences between the people and the government. By adopting an aggressive containment strategy early on, Lebanon was able to delay the spread of the virus while increasing the readiness of its healthcare sector. As such, the country was praised internationally for its successful management of the first wave of COVID-19 (Moawad & Andres, 2020). However, these strict lockdown measures had detrimental economic consequences and proved to be unsustainable in the long term. Lebanon was subsequently hit by a second wave of COVID-19, which came in the aftermath of the deadly August 4 explosion, at which point many of Beirut’s hospitals were destroyed or occupied by the victims of the explosion and thus unable to treat COVID-19 patients. Looking forward, one must not neglect the importance of cooperation in overcoming the multicrisis situation that Lebanon faces by implementing strong private– public partnerships in all domains, namely, public health, to increase awareness among the population and preparedness to face other waves of the disease. Partnerships among the Lebanese government, local NGOs and UN agencies have so far helped to successfully contain the spread of COVID-19 in refugee camps, and, as such, can be extended to tackle other challenges. Secondly, for many in Lebanon, religion has served as a source of hope, both for emotional support and in giving a life-sustaining sense during the current crisis. In countries like Lebanon, where religion plays such an important role in society, a need exists to engage religious leaders in the fight against COVID-19 as they are some of the most respected figures in many communities, and their influence on their followers can greatly benefit the efforts against the spread of the virus. The same influence should be utilized to raise awareness and change the attitudes and practices of the community (Hashmi et al., 2020). Thirdly, it appears critical to rebuild trust between the government and the Lebanese through added transparency and accountability within government institutions and reform of the current sectarian system. Since the prime role of a government is the welfare of the population and the advancement of society, there is a need to implement fair and equitable decrees and decisions that can be controlled by local authorities. The failure to act in such a way leads to civil disobedience and reduces citizens’ ability or motivation to comply with the law. In this sense, a participative approach can be adopted by involving citizens in decision-making,

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and in this case, the recommendation of protective measures against COVID-19 may prove to be a better motivator for compliance than enforcement of strict measures. Fourthly, the somewhat novel and mysterious nature of COVID-19 has prompted people to constantly seek information about this virus and its spread. In Lebanon, where official channels of information and traditional media are perceived by the population as subjective and distorted, the alternative source of information is social media, where millions of messages are posted every hour. This reliance on social media has increased the spread of misinformation, which is rarely verified, prompting the WHO to refer to this phenomenon as an “infodemic.” To counter this, Lebanon’s Ministry of Information launched an initiative to flood the Internet with real information, thus helping to dilute the fake news in circulation and allowing citizens access to verified information. Although commendable, this initiative was not as successful as planned and hoped as its implementation was disrupted by a series of technical obstacles. Finally, in a complex and compounded crisis situation, the arrival of the COVID19 pandemic was met with a high level of anxiety by the Lebanon population (Öcal et al., 2020). This reached a tipping point and was further exacerbated by the August 4 explosion, which was felt across the Lebanese capital and left an indelible mark on its people. Despite the historically resilient nature of the Lebanese, who have been brought up to recognize the sounds of war, have faced financial and economic troubles, and have been uprooted numerous times, the events of the past year have left invisible psychological wounds (Middle East Eye, 2020). Therefore, in light of this accumulation of tragedy and trauma, it appears essential to tackle the looming mental health crisis in Lebanon by drawing up a national-level response plan and offering counseling and support to those most in need.

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Öcal, A., Cvetković, V. M., Baytiyeh, H., Tedim, F. M. S., & Zečević, M. (2020). Public reactions to the disaster COVID-19: A comparative study in Italy, Lebanon, Portugal, and Serbia. Geomatics, Natural Hazards and Risk, 11(1), 1864–1885. Reliefweb. (2020). Lebanon: COVID-19 exacerbates already-impossible living situation for Syrian refugees. Retrieved October, 2020, from https://reliefweb.int/report/lebanon/lebanon-covid-19exacerbates-already-impossible-living-situation-syrian-refugees Reuters.com. (2020). Hezbollah asserts role in Lebanon’s coronavirus fight. Retrieved October, 2020, from https://www.reuters.com/article/us-health-coronavirus-lebanon-hezbollah/ hezbollah-asserts-role-in-lebanons-coronavirus-fight-idUSKBN21J537 Shultz, C. J., Rahtz, D. R., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In Handbook of community well-being research (pp. 403–421). Springer. Synaps. (2020). Grand theft Lebanon. Retrieved October, 2020, from https://www.synaps.network/ post/lebanon-finance-economy-ponzi-bankrupt The Washington Post. (2020). Lebanon is in a big mess. But on coronavirus, it’s doing something right. The Washington Post. Retrieved November, 2020, from https://www.washingtonpost. com/world/middle_east/lebanon-is-in-a-big-mess-but-on-coronavirus-its-doing-somethingright/2020/04/21/a024496a-83e0-11ea-81a3-9690c9881111_story.html#click¼https://t.co/ uJDO9ZqDsG Worldometer. (2020). Retrieved November, 2020, from https://worldometer.com

Georges Aoun holds a Ph.D. in commercial strategy from Paris Dauphine University. After working several years as a senior consultant in Europe and North America, he joined the Faculty of business at Saint-Joseph University in Beirut in 1992 as a Marketing Professor and served as Dean of the Faculty for sixteen years. His previous positions at the University include Vice-Rector for research, Director of the Pole for Health technologies and Vice-President of the University Hospital “Hotel-Dieu de France”. He is a member of the editorial board of two journals “Travaux et Jours” and “Proche-Orient: Etudes en management”. He is a member of several academic associations and a Board member of the business incubator Berytech. He has numerous publications in the fields of consumer behavior, ethics and organizational design. Karine Aoun Barakat earned her Ph.D. in Management from Saint Joseph University (USJ) in Beirut. She is currently an Assistant Professor at INSEEC Business School in Paris. Alongside her teaching activities, she has engaged in consultancies and advisory activities for commercial enterprises. Her most recent publications appear in several international journals including: Online Information Review, Environmental Management, Journal of Retailing and Consumer Services, and Journal of Internet Commerce. Her research interests include: consumer behavior in distressed communities, information and communication technology adoption, and social media.

Chapter 15

Loss of Well-Being During COVID-19 Pandemic in Mexico: A Public Policy Analysis Using a Systemic Approach Luis Raúl Rodríguez-Reyes

, Mireya Pasillas, and Keren Camberos

Abstract The loss of well-being due to COVID-19 in Mexico was higher than expected for an integrated, open economy, member of the OECD, and G20, and it was particularly severe on the most vulnerable members of society. Early estimations and surveys indicate that in 2020 Mexico experienced the largest increase in extreme poverty in Latin America and the Caribbean, and faced a large share of distressed, out-of-work people and out-of-business entrepreneurs. On the health front, Mexico exhibits some of the worst mortality indicators due to COVID-19 in the world. This outcome is not an accident but the result of the interaction of elements in a system. In this chapter, the loss of well-being due to COVID-19 in Mexico is studied using a systemic approach as a framework. Results show that some weak key macro factors, a pre-pandemic worsening dynamic due to a set of poorly planned policy actions and reforms, and subpar public policies in the economic and health fronts to fight COVID-19 caused an additional loss of well-being of what could be expected. This analysis is complemented by some lessons and policy recommendations learned from Mexico’s case, which can be applied to improve the response to other negative external shocks that jeopardized the wellbeing of this and other countries and regions. The challenge for Mexico after the first year of COVID-19 is to change its public policy stance to save lives while vaccinating the population and providing significant financial aid to people and businesses during the economic reconstruction after the pandemic. Keywords COVID-19 · Economic hardship · Economic policy · Mexico · Public health · Systemic analysis · Well-being JEL Classification E62 · E65 · G01 · G33 · I18

L. R. Rodríguez-Reyes (*) · M. Pasillas ITESO, Universidad Jesuita de Guadalajara, Tlaquepaque, Jalisco, México e-mail: [email protected]; [email protected] K. Camberos Universidad de Guadalajara, Guadalajara, Jalisco, Mexico e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_15

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Introduction

The emergence of COVID-19 in the last days of 2019 and its rapid spread in the first months of 2020 stressed people, businesses, and governments worldwide, causing thousands of deaths in developed and developing countries at an alarming rate and hindering economic activity. On March 11, 2020, COVID-19 was declared a pandemic by the World Health Organization (WHO). At the time of the announcement, COVID-19 had multiplied by 13 outside China, claiming more than 118,000 infected and 4291 deaths in 114 nations (WHO, 2020). Sadly, this was just the beginning of the tragedy. By the end of April 2021, about 150 million people have been infected by COVID-19 worldwide, and nearly 3.2 million people died from the disease (Johns Hopkins University, 2021). The lack of an effective vaccine or treatment to fight the new illness limited the feasible set of available actions for catalytic institutions, such as governments, businesses, and NGOs, but also generated confusion, fear, and a general loss in well-being among people all over the world. The disease caused economic hardship to communities, as people were afraid of performing otherwise normal economic activities that involve human contact. Nonetheless, the intervention of catalytic institutions had its impact on community well-being, that is, action or inaction from governments, NGOs and businesses created an additional impact in well-being on top of the pandemic, negative or positive. The purpose of this research is to study the loss of well-being due to the arrival of the coronavirus, SARS-CoV-2, in Mexico. The working hypothesis is that this new negative macro factor (COVID-19) interacted with other macro factors (e.g., Population, Economy, Political/Legal, and Infrastructure) and through the intervention of catalytic institutions (mainly government and businesses) produced some determinants (lack of transparency, access to health services, and a lower income) that reduced community well-being, amplifying the damage produced by COVID-19 itself. In this study, the focus will be on the loss of well-being caused by COVID-19 measured by loss of life, quality of care, transparency, economic hardship, and the poverty and inequality endured by Mexico’s population. The approach of this research is systemic, following the framework proposed by Shultz et al. (2017), highlighting the catalytic institutions’ action/inaction, to derive lessons and policy recommendations that can be applied to improve the response to other negative shocks in macro factors that jeopardize the well-being in this and other countries and regions. This manuscript is organized into six sections, including this introduction. In the following section, the setting for the systemic analysis is proposed, with the analysis of key macro factors as they were before the arrival of COVID-19, including the incipient but destructive process of reform that started with a new political regime in 2018. In the third and fourth sections, the loss of well-being related to health care issues and economic reasons is respectively analyzed, as well as system interactions.

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These sections are followed by the sketching of lessons that might be helpful to construct best practices to improve the response to other negative shocks. Finally, the main conclusions are drawn and briefly discussed in the last section.

15.2

Initial Framing of the Macro Systemic Analysis

In this section, the framework to develop the systemic analysis of COVID-19 as an environmental macro factor that disrupts the macro system is set, using a summarized version of the proposal by Shultz et al. (2017). It is important to notice that this research does not pretend to describe the entire system that constitutes Mexico as a country. Rather, it analyzes specific components of the system to evaluate the impact of COVID-19 in its interaction with other macro factors and the performance of catalytic institutions to produce determinants. Therefore, in this section, four crucial macro factors, such as Population, Economy, Political/Legal, and Infrastructure, and their interaction with government policy (catalytic institution), are characterized as they were before the arrival of COVID-19 to Mexico. Mexico’s population reached 129.2 million people in 2017, with a share of 26.7% under 15 and 6.9% over 65 years old; that is, a young population relative to OECD average of 17.9% under 15 and 16.8% over 65 (OECD, 2019a). This could be considered an advantage against COVID-19 since the disease generally produces more severe cases in elderly patients, however, Mexico presented other disadvantages. First, Mexico has a higher population density than the OECD average, which is disadvantageous when a virus is highly contagious. Mexico has 66.5 inhabitants for each Km2, while the OECD average is 35.6 (OECD, 2019a). Furthermore, 80.44% of the population lives in urban areas, with 21.1% of the total population living in México City, its largest metropolis (World Bank, 2020). Second, Mexico’s population is noticeably unhealthy. Among Mexicans 15 years of age and older, 72.5% suffer from being overweight or are obese (BMI > 25); 13.1%, of the adult population has been diagnosed with diabetes. These rates are the second highest and the highest, respectively, of the OECD (2019b). That is, Mexico’s youthful advantage against COVID-19 may be diminished by the relatively unhealthy population. Mexico is the 15th largest economy in the world, producing a GDP per capita of USD19.2 thousand, with a 5-year average economic growth of 2.5%.1 It is wellintegrated with the world economy: Mexico is a member of the OECD and G20, and has signed 13 free-trade agreements with 50 countries (Secretaría de Economía, 2020). Furthermore, concerning macro-financial issues, the central bank (Banco de México) is independent of the government and the Mexican peso is a free-floating currency since 1994, and the second most-traded developing country currency worldwide, just behind the Chinese Renminbi (Bank for International Settlements, 2019). Finally, Mexico’s debt holds the investment grade from three large

1

Numbers as of 2017. GDP per capita in USD PPP (OECD, 2019a).

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international rating agencies. These statistics depict an open and dynamic economy on its way to become a developed economy. Nevertheless, a deeper analysis shows the country has major economic issues—e.g., high informality, poverty—which widely differ among regions, and a weak fiscal system. Mexico’s share of informal workers is 57%, much higher than other comparable economies in the region (Chile 17.5%, Brazil 22.4%, Argentina, and Colombia 35.5%). Poverty and extreme poverty present heterogenous regional patterns. For instance, as a share of the total population, the state of Nuevo León (northern Mexico) has 13.64% and 0.6% of poor and extremely poor inhabitants, while the state of Chiapas (southern Mexico) has a 49.0% and 28.1%. The tax revenue has been persistently low, reaching 16.2% of GDP in 2017, below the Latin America average of 22.4% and the OECD average of 34.2% (OECD, 2019a). These shortcomings depict an economy in need of fiscal and social policy reforms, which involve all catalytic institutions as well as the people. Among political/legal factors, one critical issue is the organization of health care services prior to the pandemic. Mexico’s health care service covers 89.3% of the population, the lowest coverage in the OECD (2019b). Public health care is fragmented into three large sectors, the first two sectors are covered by two institutions, IMSS and ISSSTE, that provide health insurance and health care for the formal private and public workers and their families. The provision of health care for the third sector, informal workers and their families, had two main components before 2020: financing and actual provision of health care. As to financing, “Seguro Popular,” funded by taxpayers, provided insurance against some catastrophic illnesses; in some cases, expenditures were charged to patients, depending on their particular insurance scheme. The actual health care services were offered by a heterogeneous array of public institutions that varied widely in quality, from highquality specialized medical centers to small local clinics run by different national and subnational authorities. Regarding infrastructure, the focus of this analysis is on health resources. Mexico’s public health care sector was and still is in a dire situation. For instance, Mexico’s per capita health spending is the lowest of OECD countries, reporting USD1138, not even one-third of the OECD’s average. As a share of GDP, Mexico spends 5.5% on health, well short of the 8.8% OECD average. In the number of practicing physicians and nurses per 100 thousand people, on aggregate Mexico employs 2.4 and 2.9, respectively. The number of practicing physicians ranks low among OECD countries; the number of nurses is at the bottom. Despite these shortcomings, Mexico provides good-quality primary care—better than the OECD average—however, the quality of secondary care is still lacking. A leading measure of secondary care in the OECD is the 30-day mortality rate per 100 thousand people who suffered an acute myocardial infarction. In this regard, Mexico achieves a 27.5 mortality rate, the worst performance among its peers, and almost four times the OECD average of 6.9 (OECD, 2019b). Looking at the poor state of the reviewed macro factors, before the onset of the pandemic, one likely would have predicted a dire situation when SARS-CoV-2 arrived. A large urban population, young but unhealthy, served by a fragmented

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and underfunded health care system, with low quality on acute secondary care, a weak fiscal system, and wide differences in poverty across regions, is not a foundation for a good perspective. Nonetheless, the situation was going to worsen before the arrival of COVID-19 in Mexico. In addition to some weak macro factors, there was a worsening institutional dynamic. Before the pandemic, Mexico was undergoing profound institutional change, brought by the victory in the July 2018 elections of a new leftist populist president with a proposal for drastic reforms. This process entailed building new institutions to replace established ones developed along more than 30 years of pro-market, liberal administrations. The new government hurriedly dismantled institutions before the new ones were ready to launch. Unfortunately, the appearance and spread of COVID-19 occurred when the destruction phase was underway. For instance, and regarding public health, “Seguro Popular,” the informal workers’ public insurer was dismantled in the early months of 2020, before the new government institution “INSABI” was in full work, which caused disarray in the health care services. Questions were raised about INSABI’s funding, disease coverage, and operative and financial coordination with national and subnational health institutions (Reyes-Morales et al., 2019). Similarly, the process of acquiring pharmaceuticals was disrupted. The new process was centralized and resulted in a shortage of children’s cancer treatments, among other issues (Whelan & Pérez, 2020). This same pattern played out in other areas, including education, economy, infrastructure, and social programs. Therefore, the macro factors of Mexico were subjected to a worsening dynamic in the year before the virus arrived. When COVID-19 started to spread throughout Mexico, some of the key institutions were in the middle of a poorly planned set of institutional and policy changes. One key issue for the worsening was the economy. The new administration had kept its commitment not to raise taxes or public debt, and Mexico was at the start of an economic recession.

15.3

The Loss of Well-Being Related to Health Care Issues

As a result of the high transmissibility of SARS-CoV-2, by most accounts detected near the end of 2019, some few regional cases in China soon became a global pandemic, following air travel routes. On February 27, 2020, and February 28, 2020, three cases were identified in Mexico, with the common factor of a recent trip to Italy, then a hotspot of transmission. By April 30, 2020, the number of patients in Mexico was 19,224, of which 1859 died. If the epidemiological behavior of the first 64 days after inception between Mexico and China is contrasted, the number of confirmed diagnoses in Mexico was 76% lower than in China. However, the fatality rate was 9.67% and 3.66% respectively. Note that the number of tests carried out in Mexico in that period was 0.69 per 1000 inhabitants, while in China was 3 per 1000 inhabitants (Suárez et al., 2020).

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This high case-fatality rate in Mexico continued in the following months. By the end of April 2021, Mexico ranked 15 worldwide in the number of people diagnosed with COVID-19, just above 2.3 million, while ranked third in global deaths from COVID-19, with over 215 thousand deceased. That is, Mexico presented the second highest case-fatality rate in the world (9.2%), just behind Yemen (Johns Hopkins University, 2021). It can be argued that the case-fatality rate may not be the best way to measure the loss of well-being in Mexico due to COVID-19, given that the number of tests per inhabitant performed in the country followed the pattern depicted by Suárez et al. (2020). By the end of April 2021, Mexico performed 0.10 daily tests per thousand people, compared to 2.88 in the USA, 4.8 in Italy, 2.65 in Spain, 3.14 in Chile, and 1.57 in Colombia (Our World in Data, 2021). This could imply an underestimation of the number of cases, thus a biased case-fatality rate. Recognizing the drawbacks in using the case-fatality rate as an indicator of the loss in well-being in the case of Mexico, perhaps the impact of COVID-19 on wellbeing can be better measured using the mortality rate, that is, the number of deaths by 100 thousand inhabitants. In this case, as of the end of April 2021, Mexico was twentieth in the world in mortality rate, reaching 169.25 deaths per 100 thousand inhabitants (Johns Hopkins University, 2021). Nevertheless, the measurement problem in the loss of well-being from COVID-19 via the loss of life does not end there. The mortality indicator is also biased in Mexico, in the sense that the total number of deaths related to COVID-19 is not known, and probably will never be known. Two government policies in Mexico produced biases in the mortality indicator. The first is the scarce number of tests policy, that is, by design, the federal government applied a small number of tests per thousand people. The second was the stay at home until severely symptomatic policy. In this case, people were instructed by health and administrative authorities to stay at home if their symptoms were mild and they were otherwise healthy, and only go to the hospital to seek treatment when their symptoms were severe or they were symptomatic and suffering from some worrying comorbidities (Presidencia de la República, 2020a). Under these two government policies, mild symptomatic or asymptomatic cases were not counted in the statistics because they never were tested, yet many of these infected people died. This practice contributed to the undercounting of the sick and the deceased, which misrepresented indicators such as case-fatality and mortality rates; such bias contributed to a lack of transparency in information, playing down the actual scale, scope, and impact of the illness. Another way to gauge the loss in well-being due to medical reasons may be the excess mortality, which measures how many deaths are registered in countries, regions, and cities on top of what could be expected according to a baseline. In the absence of another event of great mortality, this excess of deaths during 2020 and 2021 can be attributed directly or indirectly to COVID-19, at least on an interim basis. That logic assumes the deaths resulted from undetected COVID-19 cases or other untreated afflictions that lost precedence in the health care sector because of the pandemic. In this way, Mexico exhibits a large excess in mortality reaching 404,430

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thousand deaths between March 31, 2020, and February 27, 2021. Mexico accordingly ranked third highest among all countries with excess deaths, reaching 321 excess deaths per 100 thousand people—ahead of Spain (176), Belgium (161), Britain (183), and the USA (182) (The Economist, 2021). Any of these three indicators exhibit a loss of well-being larger than expected, even considering the macro factors and the worsening dynamic caused by poorly planned reforms. Mexico is still among the top 20 economies in the world and is an open modern economy, financially sound, and constituted as a democracy. Looking for an explanation for the loss of well-being, henceforward, we analyze the intervention of the catalytic institutions. Regarding the federal government health care policies, further to the bias in mortality indicators, the policies of scarce number of tests and stay at home until severely symptomatic caused that most of the recorded mortality refers to people that did not have access to mechanical ventilation. As of October 1, 2020, less than 20% of the patients who died from COVID-19 in Mexico had access to such ventilation in their medical treatment (Secretaría de Salud, 2020). Moreover, these two policies also contributed to the uncontrolled spread of COVID-19, via asymptomatic or mildly symptomatic patients that were not properly identified, advised, and isolated, and to an unbalanced impact biased against poor people, and the indigenous population. The scarce number of tests policy in Mexico produced positivity rates higher than 40% from late April to mid-September 2020, and higher than 50% during the summer of 2020. Positivity rates were persistently high, reaching levels lower than 30% until mid-February 2021 (Our World in Data, 2021). Positivity rates between 40% and 50% mean that many people were/are not being diagnosed or that their diagnosis is too late, but also that poor people do not have options to learn if they are infected. They do not have the resources for private testing. This caused an unbalanced impact on vulnerable groups: the poor and the indigenous populations had a 50% higher chance of dying from COVID-19, on top of an already high mortality rate (United Nations, 2020). Other public policy blunders in health care contributed to an added negative impact of COVID-19 on Mexico’s well-being. For instance, there were failures in recognizing masks as a measure of preventing the transmission of the disease, in providing high-quality care across public hospitals, in protecting health care personal, and in the lack of coordination among authorities in different levels of government. In the matter of masks, despite evidence in other countries that wearing masks helped to control the spread of COVID-19, federal government officials dismissed its utility in many instances (Presidencia de la República, 2020b). It took months and thousands of deaths before the top level of federal government officially recognized the auxiliary use of mask-wearing, and even then, the value and efficacy of wearing masks was dismissed by the president of the country. Regarding the quality of care in public hospitals, one indicator to look at is the mortality of patients that required endotracheal intubation and invasive mechanical ventilation. As of August 13, 2020, the overall mortality of this kind of patient in Mexico was 73.7%; that is, almost three out of four patients who underwent this procedure died. However, there was a major difference across sectors, since this

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procedure presented higher crude mortality in public hospitals compared with private hospitals (Ñamendys-Silva et al., 2020).2 This result is consistent with the low quality of acute health care registered by Mexico in the OECD, previous to the pandemic. One opportunity to correct such a situation could/would have been a strong investment in testing and a more proactive approach to detect and treat patients, which in turn may have precluded the need for mechanical ventilation. Concerning health care workers’ protection, over 70 protests about the lack of personal protective equipment (PPE), the quality of it, and the lack of training and infrastructure erupted among health care personnel (Agren, 2020). This was a generalized problem; a survey among health workers in Mexico revealed that nearly half of them were not issued PPE at work (Pan American Health Organization, 2020). Not surprisingly, the number of deaths among health care personnel observed in Mexico was considerable. According to Amnesty International (2020), 1320 deaths of health care personnel were registered in Mexico as of August 2020, the largest estimated death count in the world, followed by the USA (1077), UK (649), and Brazil (634), although it is acknowledged that numbers are not comparable among countries because of different methodologies and other issues. The same argument is used by the Mexican government in its defense, adding that health care workers in Mexico with COVID-19 had a lower mortality rate than the general population (Agren, 2020). However, data from the Pan American Health Organization (2021) indicates that 47.8% of all health care workers’ deaths due to COVID-19 in the region came from Mexico, which registered 3534 deaths from January 2020 to March 2021, by far the largest number of deaths in the region, which includes hardhit countries with larger populations than Mexico, such as Brazil and the USA. Moreover, when vaccination rollouts started in 2021, the vaccination plan prioritized front-line health care workers, followed by the elderly (60+), and teachers. However, about 71 thousand private-sector doctors, working outside the public health centers, were not considered for early vaccination, because they were not classified as front-line workers. That is, despite doctors’ risk being significantly larger than the general population, they should wait to be vaccinated when their age group was deemed eligible (Reina, 2021). One last issue in government policy is the coordination between national and subnational authorities on the matter of strategy to fight COVID-19. The federal government decided to apply the sentinel model, which relies on information provided by a network of health care units distributed in the territory applying a limited number of tests (100% of severe symptomatic cases and 10% of mild symptomatic cases). Some subnational governments carried out a different strategy. For instance, the State of Jalisco applied an active control model, called Radar Jalisco, early-on during the pandemic (April 17, 2020). This program was built 2

A patient who had endotracheal intubation and invasive mechanical ventilation with access to a private institution faced a 47.9% probability of dying in an ICU or 60.8% outside an ICU, while a similar patient that received care in a public sector hospital faced a 74.2% probability of dying of in an ICU and 75.4% if the procedure occurred outside an ICU [Authors’ calculations based on data published by (Ñamendys-Silva et al., 2020)].

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atop the sentinel model, adding three more sources of information through a wider network of testing, 100% of mild symptomatic cases, active search on health workers, some essential services personnel and at-risk populations, and the incorporation of private health institutions testing (Gobierno de Jalisco, 2020). The added testing produced a significant difference between the national and subnational number of COVID-19 confirmed cases. A visit to their websites, on December 12, 2020, revealed that the federal government reported 45,499 accumulated confirmed cases in Jalisco while the State of Jalisco’s reported 124,661 (CONACYT, 2021; Gobierno de Jalisco, 2020). That is, even with a minor increase in testing, the State of Jalisco found 2.73 cases per one detected by the federal government and the sentinel model. Such discovery enabled a better treatment and isolation of cases that presented mild symptoms or were asymptomatic. This added testing, while still low by international standards, accompanied by other measures—e.g., closing schools a week ahead of the federal mandatory school’s lockdown, the early suspension of sporting events and other large scale events (March 13, 2020), an early 5-day lockdown (March 21st, 2020) and the sustained promotion and enforcement of mask-wearing—played a role in a betterthan-average performance in the loss of well-being, as indicated by the lost of life across Mexican States. Considering comparable data issued by the federal government, the State of Jalisco had the tenth-lowest mortality rate, reaching 141.18 deaths per 100 thousand people, despite being the fourth most populous State and having the third most populated metropolitan area in Mexico. This finding compares favorably with mortality in other States with large populations and large metropolitan areas, such as Mexico City (194.54), Nuevo León (166.59), and the country average (169.37) (CONACYT, 2021). Using the excess mortality as a measure of loss in well-being, as of March 15, 2021, Jalisco reported 36.5% deaths over the expected number of deaths, considering the 2015–2018 baseline. Similar to mortality, the indicator is better than the reported nationally (71.1%), and among other States with large metropolitan areas, such as Mexico City (91.5%) and Nuevo León (50.6%) (Secretaría de Salud, 2021). Three issues regarding government coordination to fight COVID-19 need further discussion. The first issue: more tests, mandatory masks, and early lockdowns were effective for Jalisco; however, similar policies were not as effective for Mexico City. More specifically, despite additional testing and active promotion of mask-wearing, the results were different for Mexico City. This finding is still a matter of further research, but three main differences between the two cases have been found. Firstly, timing—Jalisco started earlier with significant, additional measures, such as the cancelation of massively attended events and additional testing. Secondly, tighter enforcement of mask usage. In Jalisco, mask-wearing was mandatory and sometimes severely enforced; in Mexico City, mask-wearing was suggested, at least during the first months of the pandemic. Thirdly, population density—the number of inhabitants in both states is similar, however, Mexico City is part of a much larger, denser megalopolis.

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The second issue to be discussed is the lack of coordination between national and subnational governments: with at least two sources of information, people often received conflicting messages regarding masks, the severity of the disease, and how best to care for themselves during the pandemic. The conflicting advice moreover was in certain instances part of a partisan political conflict, to attack the policies of the other political party. Ironically and tragically, the only clear beneficiary of this disunity and partisan conflict was the novel coronavirus, which continued, rampant in many parts of Mexico. The third issue: coordinated vaccination rollout. Due to the regulatory framework and the global scarcity of vaccines, the federal government was the only agent that could acquire vaccines in the international market. Thus, the federal government had the required leverage to lead the vaccination rollout, and the general strategy. Although there has been some criticism regarding the strategy, the coordination during the vaccination stage in 2021 among different government entities has been much better than the prevention mechanisms displayed when vaccines were unavailable. Other catalytic institutions also interacted with macro factors to improve wellbeing. For instance, AstraZeneca signed an agreement with the Carlos Slim Foundation, which provided the funding to produce 150 million doses of COVID-19 vaccines in Argentina and Mexico, to be distributed in Latin America, the first few months of 2021. Governments of both countries were integral to negotiations and the agreement. A second example of a successful interaction involved 16 companies and foundations controlled by some of the wealthiest Mexican tycoons and other large public companies. They financed a fully equipped, temporary, 607 beds hospitalization facility, located in Centro Citibanamex, a large convention center in Mexico City. The Nacional University (UNAM) provided technical and medical advice, while the operation was run by the Ministry of Health of Mexico City, starting in late April 2020. Other catalytic institutions also contributed to well-being related to health measures. Businesses generally followed government-issued guidelines, respecting lockdowns, and sanitary measures when open to the public. Sports events continued without spectators—or with a reduced number of spectators—at the stadium or other venues; basic and advanced education continued while relying upon various technologies, including televised lessons; mass and other religious gatherings were suspended; and when restrictions on social distancing were softened, businesses in the service industry adopted sanitary measures. However, as the pandemic lasted longer than expected, there is evidence that some businesses relaxed measures. Two surveys conducted by the Institute of Statistics and Geography Information of the State of Jalisco (IIEG) in July and October 2020 found that 99.4% of restaurants supplied alcohol-based gel to customers for hands sanitization, but other actions were lessened. The percentage of restaurants that increased the frequency of cleaning and disinfection dropped from 93.4% in July to 75.7% in October. Also, the percentage of restaurants that indicated they provided masks to workers fell from 97.4 to 71.5%, and those that limited the number of clients inside the restaurants decreased from 86.8% in July to 66.3% in

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October. Finally, the percentage of these businesses that installed sanitary filters, such as temperature measurement and sanitizing mats declined from 78.8 to 65.6% in the same period (IIEG, 2020). These findings likely revealed fatigue or frustration, as the pandemic has curtailed space and activities that facilitate rest, relaxation, and recreation, thus degrading the sense of well-being among the people. Data compiled by Our World in Data (2021) show several distinctive waves of COVID-19 cases, measured by the rolling 7-day average, peaking in August (nearly 7000), October (over 8000), December 2020 (more than 10,500), and January 2021 (about 17,500). Government measures were bolstered during those periods; however, such measures were relaxed when the number of cases diminished. This approach was problematic because data did not indicate the pandemic was being controlled in any of those instances. The share of positivity in tests was 40% and more from late April 2020 to January 2021, and the number of daily cases did not clearly break the 4000 thresholds until the last days of April 2021. In sum, the conjunction of macro factors, the worsening dynamic brought by a series of poorly planned reforms before COVID-19, and the interaction of some catalytic institutions in the presence of COVID-19, manifested as a mostly uncoordinated and poor effort to preserve the health of people, which had an overall disastrous effect in aggregate well-being indicators.

15.4

The Loss of Well-Being Related to Economic Issues

In addition to the macro factors already described above, the pre-pandemic economic environment in Mexico was subject to the same reform frenzy as the health care sector. These policy changes included the cancelation of USD multi-billion investments, such as a new airport in Mexico City and a new Constellation Brands brewery near the Mexico-USA border and the start of new investments in infrastructure and other projects, including a new refinery, a touristic train service, and a smaller airport on the outskirts of Mexico City. These controversial decisions strained relations between businesspersons and the government, which produced a year-on-year, one-digit drop in fixed capital formation in all pre-pandemic quarters but one, from 4Q-2018 to 1Q-2020, despite the new, large infrastructure government projects. This dynamic in capital formation was part of a general attitude in business that led to subpar performance in the GDP, which stalled in 2019, falling 0.03% in real terms in 2019, but intensifying its downward trend towards the first quarter of 2020, decreasing 1.6% year-on-year, in real terms.3 That is, COVID-19 compounded difficulties for a country already on the brink of a recession. COVID-19 further weakened the economy, in at least two ways. First, the loss in economic activity due to the fear of the disease and the government-enforced

3

Source of data (Instituto Nacional de Estadística y Geografía [INEGI], 2021).

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lockdowns. Second, the disruption of the global supply chain. The aggregate economic impact of COVID-19 as of the first quarter of 2021 can be seen in the official Mexican data. INEGI (2021) data showed a 18.9%, year-on-year, contraction in GDP in the second quarter of 2020, when the first wave of COVID-19 hit the country and the lockdowns were stricter. The economic activity kept falling in real terms during the subsequent quarters, averaging an 8.4% year-on-year drop in real GDP in 2020. In other words, 2020 was the worst year for economic growth in Mexico since the Great Depression. With the start of 2021, the economy was still contracting, which probably relates to the fourth wave of COVID-19 the country faced. In the first quarter of 2021, the GDP fell 3.8%. Nevertheless, some recovery is expected. The International Monetary Fund (IMF, 2021a) estimates 4.3% GDP growth during 2021 and 2.5% growth in 2022. If those expectations are actualized, and considering an average economic growth of 2% in the following years, the level of economic activity before the pandemic would not be reached until 2024. That is equivalent to about a zero growth in the 6-year term of President López Obrador, while the population continues to grow and fiscal requirements also continue to increase due to pension obligations. In terms of employment, the worst month of the pandemic was April 2020, during the nationwide lockdown: nearly 12.5 million people lost their jobs in that month, which is equivalent to the 22% of the jobs registered in the first quarter of 2020. Employment trends improved in the next months, regaining about 9.7 million jobs by October 2020, however, job creation was negative again between November 2020 and January 2021, turning positive on February and March 2021. Nevertheless, not all the jobs lost in April 2020 have been regained. Another measure indicating levels of despair reached during this crisis is the labor market slack, defined as the share of the population that is either unemployed or works fewer hours than needed, or is willing to work but not actively searching for a job. This share of the population grew from the 20% level observed in the first quarter of 2020, reaching 50.5% in April 2020 and 52.9% in May, and then started to slowly decline to 30% in October 2020, staying around that level for several months, and returning to its downward trend in February and March 2021. At the apex of the economic crisis, more than half of Mexico’s willing-to-work population was without a satisfactory source of labor income, and despite some gains in employment, on average, those jobs are more precarious than before the arrival of COVD-19 to Mexico. Moreover, during the first lockdowns job informality rate fell from 55.7% in March to 47.7% in April 2020, that is, the workers of informal businesses were the most affected by unemployment during the first months of the pandemic. It took 6 months for the job informality rate to return to the pre-pandemic level and in March 2021 reached 56.8% (Instituto Mexicano para la Competitividad, 2021). This bleak economic environment—weak macro factors, plus worsening pre-pandemic dynamic, and the necessity of a lockdown to curb COVID-19 transmission—had a profound effect on individual quality of life and community wellbeing. The impact only can be mitigated by the action of catalytic institutions. In this regard, Blackman et al. (2020), who analyze COVID-19 effects and public policy in Latin America and the Caribbean, identify four objectives for governments to face

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COVID-19: save lives, protect the vulnerable people from loss of income, compensate workers, and businesses most damaged by the economic crises, and reduce the systemic risks and possible long-term economic effects. Unfortunately, the Mexican government’s intervention lacked the size, ingenuity, and opportunity to make a significant impact on the loss of economic well-being. According to Cejudo et al. (2020), 21 countries in Latin America and the Caribbean (LAC) created 37 new cash transference programs, seven countries increased the payment size of 17 cash transfer programs, and three countries expanded coverage of three cash transfer programs. Despite being one of the largest economies in the LAC region, Mexico did not do such interventions. Mexico instead advanced the payments on five programs already in place, to provide cash to their beneficiaries. These advances on cash transfers are part of the Mexican government aid structure, which included accelerating tax returns, lending to firms and workers, and providing liquidity support and guarantees by development banks. In sum, budgetary measures amount to 0.4% of GDP in health spending and 0.2% of GDP to support households and firms, while non-budgetary measures amount to 1.2% of GDP. This is the lowest commitment of aid relative to GDP of any of the G20 members or other large middle-income countries in the LAC region. Budgetary and non-budgetary measures as a share of GDP amounted respectively to 3.9% and 2.0% for Argentina, 8.8% and 6.2% for Brazil, 8.2% and 1.8% for Chile, and 4.1% and 5.7% for Colombia (IMF, 2021b). This lack of commitment from the Mexican national government exacerbated the impact of COVID-19, further harming macroeconomic conditions and the wellbeing of people; bringing not only higher levels of poverty, but also a larger inequality gap and the closure of businesses, and a potential downward spiral for many wellness indicators. CONEVAL (2020), for example, identified a real 6.7% drop in the labor income during the third quarter of 2020, compared with the 3Q 2019. This caused a significant increase in in-work-poverty (share of the population with a work income lower than the financial resources necessary for food consumption), which grew from 38.5 to 44.5% during that period. Moreover, Monroy-Gomez-Franco (2020) found the COVID-19 pandemic had a more pronounced negative impact on the economic well-being of the lower income population than the high-income population, who were somewhat shielded because of the nature and requirements of their jobs and their ability and support to work at home, which is a more viable option as income rises.4 COVID-19 was especially harmful to those who already were poor, the absence of government aid deepened their condition of poverty. CEPAL (2020) estimates that the number of people living in poverty in Latin America will increase by 45.5 million in 2020, reaching 230.9 million, equivalent to the 37.3% share of the region’s population. The largest percentage increase in poverty as a share of the population is expected in Argentina (10.8%), Peru

4

This result can also be explained by a rational job hoarding for the hard-to-replace skilled workers described by Petroulakis (2020).

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(9.3%), Brazil (7.7%), and Mexico (7.6%). That is, Mexico’s share of the population living in poverty likely will increase from 41.9 to 49.5%. The number of people in Latin America living in extreme poverty is expected to increase by 28.5 million, reaching 96.2 million people in 2020, equivalent to 15.5% of the population. The country with the largest percentage increase in extreme poverty as a share of the population is expected to be Mexico, with a 6.3% increase; if that estimate is correct, 17.4% of the Mexican population will be living in extreme poverty. In sum, the lack of a decisive intervention from the government delivering relief to people via new cash transfers programs or expansion of existing cash transfers programs that help to offset the loss of income due to the pandemic will generate millions of new poor and extremely poor people. It also will increase inequality as high-income inhabitants were less impacted in their labor income because they have more access to jobs compatible with a home office and/or because their professional skills were in great demand and they accordingly were well compensated financially. Businesses also faced a challenging environment due to the lockdowns, diminishing commercial activity in many sectors, and the lack of financial aid. According to INEGI (2020), 20.81% of the business venues that were active in the last census (May 2019) ceased operations as of September–October 2020; more than 1,010,850 commercial venues were permanently out of business. In the same period, 619,443 new venues opened, usually filling various niches and often in response to the pandemic; however, they were mostly smaller, micro-sized businesses rather than small- and medium-sized enterprises. The business landscape had changed considerably, and it remains precarious. All of this happened in 2020 and early 2021, however, considering the following year’s gloomy economic outlook, the negative impact of COVID-19 on society’s well-being could be worse than seen so far. Government, as the most important catalytic institution, must change its policies, including explicit interventions; it must expedite the pandemic’s end and the well-being of the Mexican people.

15.5

Lessons and Policy Recommendations

The full impact of SARS-CoV-2 on the well-being of Mexican society will be felt for years to come. The fragmented health system, the weak fiscal arrangement, the institutional arrangement, and the population were not prepared to deal with the increasing demand for quality health care and the need for financial aid to alleviate economic loss, nor were adequate policies implemented to minimize the loss of wellbeing for health and economic issues resulting from COVID-19. The outcome has been a higher-than-expected loss for people, families, communities, and the country. There are two types of lessons that can be derived from Mexico’s systemic analysis concerning the COVID-19 epidemic. The first type is the necessity for structural change in key macro factors such as the chronic underinvestment in health care infrastructure, the unification of a health care and social security system that encourages formality in employment and business, new tax laws that allow for a

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better response in crisis to come. All catalytic institutions—government, businesses, NGOs—need to communicate and to cooperate to redress these challenges, but citizens also need to be actively involved in this structural change. There are two specific policy recommendations regarding macro factors, which can help to deliver a better quality of health service, a more inclusive social security system, better public financial practices, and ultimately enhanced well-being. The first is an integrated, universal healthcare system, where access to healthcare is fully guaranteed for the entire population, regardless of employment status. Some studies have addressed proposals for universal health care in Mexico. Muñoz et al. (2012), for example, posited a universal health care plan with the main objectives of improving access to all and reducing avoidable health inequalities, proposing a reorganization process for all health institutions to avoid duplicities of functions making resources more efficient, expanding coverage, increasing funding for the sector, and continuous evaluation processes. The second is to pursue a universal social security system that simultaneously delivers benefits and is financed via general taxation. In this sense, Antón et al. (2013) analyzed the labor market structure in Mexico and showed that informal workers benefit from a set of parallel social programs that provide erratic and incomplete coverage against risks, since access to health care and pensions are not aligned with a rights perspective, and foster tax evasion and incentivize further job informality. The authors proposed a universal social insurance reform based on financing through a uniform value-added tax rate, instead of having a dual scheme where formal workers and firms are obligated to pay contributions. In addition to that, generalized unemployment insurance, regardless of employment status, is also advised. These proposals are long overdue for the people of Mexico and are largest challenges for social policy in the coming years. The second policy lessons that can be derived from Mexico’s case analysis are related to the management of the pandemic. It is clear that the sentinel model is a monitoring tool that allows tracking of the macro transmission of infectious diseases; however, it was not an effective management tool for Mexico. The use of the model should be changed to a generalized testing model that allows the isolation of mild and asymptomatic cases, and the timely care of mild cases. Mapping properly confirmed COVID-19 cases will allow strategic closures of economic activities to avoid crowds instead of a full stop of activities. Moreover, there should be improvements in policy coordination among national and subnational authorities, an improvement in the quality of care for the ill, and an improvement in protective practices for healthcare personnel. Better communication and a unified message about the seriousness of the disease and the recommended practices, based on science and best practices applied by countries that controlled the pandemic are also important, going forward. Likewise, a plan is needed for rapid vaccination to be widely implemented. On the economic front, the burden imposed on workers and firms due to the lack of financial support brought higher unemployment, poverty, inequity, and small business closures, which revealed an unbalanced impact on the most vulnerable. The Mexican government cannot continue to be blind towards the aid needed for the

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many; a change in policy is needed. One way to affect change would be to guarantee job and income protection in case of extreme emergency. For example, developing a basic income for people in distress and granting non-refundable support to small businesses at risk of bankruptcy. Regarding basic income, Gentilini et al. (2020) describe several initiatives that can be the base for a country-wide emergency program. Compare, for instance, Mongolia from 2010 to 2012 and Iran in 2011, which implemented policies for universal basic income (i.e., unconditional, cash, universal, national). In other countries, basic income has been implemented with certain variants, either because it is conditional on eligibility, or focused on a certain group (i.e., not universal), as in India, where it is granted to small farmers. Or in countries that have implemented pilot programs, as in Finland, where 2000 unemployed people were chosen to receive a basic income for more than 2 years. Finally, a reconstruction plan for the economy in the next 2 years must be addressed, focusing on jobs and businesses recovery. There is a need for a program that guarantees non-refundable support for small- and medium-sized businesses, conditioned upon employing workers and keeping them employed. However, such a program may be politically difficult, as it requires agreements between the government and businesspersons, which encourage investment in a time of growing uncertainty.

15.6

Conclusions

The purpose of this study was to analyze the interaction of macro factors and catalytic institutions, and their impact on the well-being resulting from the COVID-19 pandemic, using the systemic framework proposed by (Shultz et al., 2017). The hypothesis was that a new negative macro factor (COVID-19) interacted with other macro factors (population, economy, political/legal, and infrastructure) and through the intervention of catalytic institutions (mainly government and businesses) produced some determinants (lack of transparency and access to health services, and a lower income) that reduced community well-being, amplifying the damage produced by COVID-19 itself. The outcome of the analysis supports the hypothesis, the loss of well-being was amplified by the interaction of macro factors and catalytic institutions in two different moments. The first was before the arrival of the SARS-CoV2 coronavirus to Mexico when a set of poorly planned institutional changes and policies weakened the country’s capacity to fight the effects of the disease on well-being. The second was while the disease ravaged the country when public policy institutions, and the people leading them, lacked the ingenuity, strength, and size to be relevant or more effective in diminishing the impact of COVID-19 on well-being. Moreover, some policy actions and inactions in this second stage further harmed the well-being of many Mexicans, thus exacerbating the crisis. However, not all the damage was due to public policy action/inaction. Prominent among other damaging conditions: Macro factors such as large proportion of citizens

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with comorbidities (e.g., a young but unhealthy population, with a high incidence of obesity and diabetes) rendering that population especially vulnerable to COVID-19; an unequal economy, with regions and people suffering from a high prevalence of poverty and extreme poverty; a large informal sector; and a fragmented health care system with heterogeneous access and quality of care. Nevertheless, these conditions are not an apology for the government’s action/ inaction. These shortcomings have been known for years; unfortunately, and now regrettably, opportunities were missed for more commitment, assertiveness, and ingenuity, all of which were/are needed to fight COVID-19. Instead, Mexico—and the Mexican people—have been subjected to a series of uncoordinated, ineffective policies. The federal government employed the sentinel model, which relies on information provided by a network of healthcare units distributed in the territory applying a limited number of tests. In contrast, some local governments amplified testing, which produced a different count of cases. This lack of coordination also created communication problems by sending different and sometimes conflicting messages to the population. Public policies such as the scarce number of tests policy, and the stay at home until severely symptomatic policy not only produced biased mortality indicators, the data indicates they caused deaths and compounded the crisis: 8 out of 10 deaths occurred without access to mechanical ventilation, and contributed to the uncontrolled spread of COVID-19, via asymptomatic or mildly symptomatic patients that were not properly identified, advised, and insolated, and to an unbalanced impact biased against poor people, and the indigenous population. The overall loss of well-being—perhaps the ultimate loss of well-being—for healthcare reasons can be measured by mortality indicators. Any of the three indicators reviewed depict a somber panorama for Mexico, even considering some bias that may exist. The country (1) presented the second highest case-fatality rate in the world, (2) was twentieth in the world in mortality due to COVID-19, and (3) third in the world with the highest excess mortality. Regarding the economic impact of COVID-19, the size/amount of the aid provided by the Mexican government is significantly smaller than was provided by other comparable countries in the LAC region. This inadequate response did not provide enough cushion to alleviate COVID-19 effects for people and businesses, leaving them mostly on their own, which had an unbalanced impact on the most vulnerable population. As a result of this policy inaction and COVID-19, it is estimated that Mexico will face the largest increase in share of population subjected to extreme poverty, an increase in inequality and working poverty, and a more challenging environment for small enterprises. Finally, what is illuminated via the framework analysis: there is a need to cooperate, and to coordinate catalytic institutions and citizens, to ensure a comprehensive and equitable reconstruction effort, including requisite reforms, and crucially to save lives with different methods, measures, and interventions, from maskwearing, to hygiene, to vaccinations.

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References Agren, D. (2020). Understanding Mexican health worker COVID-19 deaths. The Lancet, 396(10254), 807. https://doi.org/10.1016/s0140-6736(20)31955-3 Amnesty International. (2020, September 3). Global: Amnesty analysis reveals over 7,000 health workers have died from COVID-19. Amnesty International. Retrieved December 10, 2020, from http://www.amnesty.org/. Antón, A., Hernández, F., & Levy, S. (2013). The end of informality in Mexico? Fiscal reform for universal social insurance. Inter-American Development Bank. Bank for International Settlements. (2019). Triennial central bank survey of foreign exchange and over-the-counter (OTC) derivatives markets in 2019. Retrieved September 26, 2020, from http://www.bis.org/ Blackman, A., Ibañez, A., Izquierdo, A., Keefer, P., Moreira, M., Schady, N., & Serebrisky, T. (2020). Public policy to tackle Covid-19. recommendations for Latin America and the Caribbean. Inter-American Development Bank. https://doi.org/10.18235/0002302 Cejudo, G., Michel, C., & de Los Cobos, P. (2020). Policy responses to the pandemic for COVID19 in Latin America and the Caribbean: The use of cash transfer programs and social protection information systems. United Nations Developed Programme—UNDP LAC C19 PDS No. 24. Retrieved from http://www.latinamerica.undp.org/ CEPAL. (2020). Enfrentar los efectos cada vez mayores del COVID-19 para una reactivación con igualdad: nuevas proyecciones. Naciones Unidas CEPAL Informe Especial No.5. Retrieved from http://www.cepal.org/ CONACYT. (2021). Tablero general COVID-19. Consejo Nacional de Ciencia y Tecnología. Retrieved April 30, 2021, from https://datos.covid-19.conacyt.mx/ CONEVAL. (2020). Poverty measurement: ITLP-IS results at the national level. Consejo Nacional de la de la Evaluación de la Política de Desarrollo Social. Retrieved December 15, 2020, from http://www.coneval.org.mx/. Gentilini, U., Grosh, M., Rigolini, J. & Yemtsov, R. (2020). Exploring universal basic income: A guide to navigating concepts, evidence, and practices. World Bank. Retrieved from http:// worldbank.org/ Gobierno de Jalisco. (2020). Plan Jalisco COVID-19. Retrieved December 13, 2020, from http:// coronavirus.jalisco.gob.mx/ IIEG. (2020). Segunda Encuesta a Restaurantes sobre el Uso de Plataformas Digitales. Instituto de Información Estadística y Geográfica de Jalisco. Retrieved December 13, 2020, from http:// iieg.gob.mx/ IMF. (2021a). World economic outlook. International Monetary Fund. Retrieved April 30, 2021, from http://www.imf.org/ IMF. (2021b, April). Fiscal monitor database of country fiscal measures in response to the COVID19 pandemic. International Monetary Fund—Fiscal Affairs Department. Retrieved April 30, 2021, from http://www.imf.org/ INEGI. (2020). Estudio sobre la Demografía de los Negocios (EDN) 2020. Instituto Nacional de Estadística y Geografía. Retrieved December 15, 2020, from http://www.inegi.org.mx/ INEGI. (2021). Banco de Indicadores. Retrieved April 30, 2021, from htts://www.inegi.org.mx Instituto Mexicano para la Competitividad. (2021). Diagnóstico de los cambios en el mercado laboral en tiempos de COVID-19. Monitor de Competitividad. Retrieved April 30, 2021, from http://imco.org.mx/ Johns Hopkins University. (2021). Coronavirus resource center at Johns Hopkins University. Retrieved April 29, 2021, from http://coronavirus.jhu.edu/ Monroy-Gomez-Franco, L. (2020, November). Una crisis desigual. NEXOS. Retrieved December 15, 2020, from http://nexos.com.mx/ Muñoz, O. et al. (2012). Propuesta de un Sistema Nacional de Servicios de Salud. Componente de Salud de una propuesta de Seguridad Social Universal. UNAM-CONEVAL. Ciudad de México.

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Luis Raúl Rodríguez-Reyes is Associate Professor of Finance at ITESO, the Jesuit University of Guadalajara, Mexico. He is a Fellow of the National Research System (SNI/Conacyt) since 2018, awarded the National Researcher Level 1 (2021–2023), and a Participant in the Research Committee at ITESO. Prior to joining academic life and ITESO, he had fourteen years of experience working at private and public financial institutions in Mexico, including directive positions. He was awarded the Ph.D. in Economics at the University of Essex (the United Kingdom, 2005), MSc. in Economics at CIDE (Mexico City, 1998), and a Public Accountant Degree at U.J.E.D (Durango, 1994). He teaches courses in Derivatives, Corporate Finance, International Finance, and Financial Markets and Investments, in undergraduate and graduate levels. His main research interests are Monetary Economics, Financial Economics, and Pensions (http://orcid.org/0000-0003-0568-9356). Mireya Pasillas is a Full Professor of Economics and Financial Engineering at ITESO, the Jesuit University of Guadalajara, Mexico. She also works as Director of Economic Statistical Information in the Institute of Statistics and Geography of the State of Jalisco, Mexico. On several instances over recent years she has worked as principal consultant for national and international institutions, such as the United Nations Development Programme, UN-Habitat, and the Inter-American Development Bank, among others. She was awarded the MSc in Public Financial Policy at the London School of Economics and Political Science (2001–2003) and the BSc. in Economics at CIDE (Mexico City, 2000). She teaches courses in Microeconomics, Time Series Analysis and Financial Engineering at ITESO in undergraduate level. Her main research interests are Public Policy, Social Programs Evaluation, Statistics and Cost Benefit Analysis (http://orcid.org/0000-0002-1049-5348). Keren Camberos is currently pursuing a Ph.D. in Fiscal Studies at the Universidad de Guadalajara, Mexico, with a full scholarship (Conacyt). She was awarded a BSc. in Economics at the Universidad Autónoma de Sinaloa, Mexico, and a MSc. in Finance at UNIVA (Guadalajara, Mexico). She has worked at several national and international financial companies over the years, such as, HSBC, Grupo Bursatil Mexicano and Grupo Financiero Actinver, mainly advising clients on wealth management through financial strategies and portfolio diversification. She also worked in the Jalisco State Congress as an advisor on public finance issues and is currently employed as a collection coordinator at the Jalisco State Comptroller´s Office.

Chapter 16

COVID and New Zealand: An Outlier Case Ben Wooliscroft, Sabeehuddin Hasan, and Alexandra Ganglmair-Wooliscroft

Abstract New Zealand is in an unusual position, surrounded by sea, 3 h flying from the nearest other country (Australia). COVID-19 has been (repeatedly) “eliminated” through a combination of border closure, compulsory Managed Isolation and Quarantine (MIQ) on entry to New Zealand and lockdowns. COVID-19 has also repeatedly emerged, from MIQ into the community, each time resulting in a lockdown for part of the country. The Government has supported and stimulated the economy during lockdowns and the long-term results of that support are currently unknown, though there are worrying signs, particularly around housing affordability. Keywords New Zealand · COVID-19 · Community well-being · Tourism markets · Geographic isolation · Pandemics

16.1

New Zealand

New Zealand’s population has recently topped five million. Its landmass is approximately 90% that of Italy, population 60 million. New Zealand is made up of two major islands, imaginatively named the North Island and South Island, and a number of small islands with resident populations (Stewart Island and the Chatham Islands are the largest). At least, on average, social distancing is no problem in New Zealand. The cultural norm of lightly populated countries/cities is the distance that people stand from each other and the space people are given on footpaths.

B. Wooliscroft (*) Auckland University of Technology, Auckland, New Zealand e-mail: [email protected] S. Hasan University of Otago, Dunedin, New Zealand e-mail: [email protected] A. Ganglmair-Wooliscroft Massey University, Auckland, New Zealand e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_16

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At the center of New Zealand’s values is the concept of fairness (analogous to America’s use of freedom as a key value) (Fischer, 2012). The concept of fairness appears in government documents, speeches, and consulting reports on New Zealand. It is central to New Zealanders’ understanding of and interpretation of the world around them. That central value has colored the interpretation of the response to COVID. New Zealand has one city with more than a million inhabitants, Auckland (population 1.8 million). Auckland is the major gateway to the world with the busiest international airport and the country’s major freight port. It is the preferred destination of most immigrants to New Zealand and the economic engine room of the country (though other regions may disagree). Even in this most populous city, New Zealanders keep their distance, relative to large cities overseas. New Zealand is an outlier, having spent most of the last year and a quarter, since COVID first arrived in the country, without significant restrictions. During lockdowns, there have been severe restrictions and at lower levels of restrictions, large gatherings have been banned. But, most of the last year has seen unrestricted gatherings, unrestricted domestic travel, and life being “normal,” except for the absence of international tourists and students—both of whom are important to the New Zealand economy. Recent, in May, travel bubbles with Australia and the Cook Islands have seen some international travel without isolation or quarantine. The travel bubble with Australia has been off and on as Australia struggles with community outbreaks of COVID. Since COVID arrived in New Zealand, there have been 2668 cases (as of May 22, 2021) within the New Zealand borders, or 543 cases per million of population. Most of those cases have presented in Managed Isolation and Quarantine (MIQ), not in the community. Taking those MIQ cases from the total leaves 673 community cases, or 137 cases per million of population. In contrast, Germany, which has managed COVID well by international standards, has had 44,002 cases of COVID per million of the population (also as of May 22, 2021). Germany has suffered 87,385 deaths (1053/million population) versus New Zealand’s 26 COVID-related deaths (5/million population). New Zealand’s COVID experience is hard to describe as anything other than an outlier. New Zealand has remained a flourishing society during COVID, with some considerable stress (Shultz et al., 2017). The costs of locking down the border to defend against COVID have not fallen evenly and have impacted income inequality and a number of key markets (see Fig. 2: Shultz et al., 2017, p. 49). Auckland has been the major site of MIQ, hosted in large hotels, mainly in the center of the city. The wisdom of placing these facilities in densely populated areas has been called into question each time the virus has escaped into the community and the whole city of Auckland has been locked down, costing the local economy millions. Like much of the world there was in New Zealand a near-instant shortage of toilet paper and flour, amongst other items. Perceptions of speculation and postponement were changed very quickly in the unknown situation of a pandemic lockdown (Alderson, 2006). In reality, there was not a shortage of flour, but there

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was a shortage of small packs of flour. Demand had shifted from industrial use to domestic use and the required sorts and packaging capacity was not available.

Table 16.1 COVID-19 Timeline for New Zealand (New Zealand Government, 2021) February 28, 2020 14th March 19th March 21st March 23rd of March 25th March 27th April 11th May 13th May 8th June 11th August 12th August

30th August 21st September 23rd September 7th October February 14, 2021 17th February 22nd February 28th February 7th March 12th March

The first case of COVID-19 was reported in New Zealand Anyone entering New Zealand must self-isolate for 14 days, except those arriving from the Pacific (COVID free) All indoor gatherings of 100 people or more are canceled. Borders are closed to all except New Zealand citizens and permanent residents The Government announces the four-tier Alert level system and places the country at level 2 The Prime Minister announces an immediate shift to level 3 with level 4 to start in 48 h. New Zealand is under hard lockdown At level 4 the entire country goes into self-isolation and a state of national emergency is declared New Zealand moves to level 3 Prime Minister announces plan to move to level 2 New Zealand moves to level 2 The Ministry of Health reports that there are no more active cases of COVID-19 in New Zealand (except in MIQ) and New Zealand moves to level 1 Four new cases of COVID-19 in the Auckland community Auckland moves to level 3, all businesses except supermarkets and pharmacies close. Non-contact pickup of food and other goods allowed from some other retailers. The rest of New Zealand moves to level 2 Auckland moves to level 2 with additional restrictions on travel and gatherings All New Zealand except Auckland moves to level 1 Auckland moves to level 2 without additional restrictions on travel and gatherings All of New Zealand is at level 1 Three new cases in the community. Auckland moves to level 3 with the rest of the country moving to level 2 Auckland moves to level 2 and the rest of New Zealand moves to level 1 Auckland moves to level 1 Auckland moves to level 3, with the rest of the country moving to level 2 Auckland moves to level 2, with the rest of New Zealand moving to level 1 Auckland joins the rest of New Zealand at level 1

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The History of COVID-Free New Zealand: Lucky and Good

New Zealand was late in receiving our first confirmed COVID infection. The timeline of COVID in New Zealand is presented in Table 16.1. The New Zealand government introduced a four-tier level of COVID Alerts, with attendant restrictions (see Table 16.2). The New Zealand Government response, with the goal of elimination of COVID 19 from New Zealand, was based on two pillars; (1) go early and go hard, (2) be kind. The Prime Minister repeated a mantra of the country being a team of five million and that we should all “be kind,” as exemplified in Fig. 16.1. The first pillar is reflected in the decision to go to a full (level 4) lockdown starting March 25, 2020, when New Zealand had only 52 cases of COVID-19. Subsequent lockdowns of Auckland have occurred with only a handful of cases in the community. The second pillar can be seen in New Zealanders’ compliance with government orders, though isolated exceptions have caused severe concern and some cases of community transmission—including holding prayer meetings during a lockdown. With the exception of the first lockdown, which was signaled 48 h ahead, lockdowns have been swift, generally less than 24 h from the time of announcement. Borders were closed, and remain so, and any New Zealand citizen or permanent resident returning to New Zealand is required to spend a minimum of 14 days in Managed Isolation and Quarantine (MIQ). Initially, MIQ was managed by the Ministry of Health using security companies and hotel employees. MIQ is now Table 16.2 COVID alert levels in New Zealand: key attributes Level 1 The border is closed. Life is relatively normal, but citizens must wear masks on public transport and commercial planes. Scanning locations on entry to businesses strongly encouraged.

Level 2 No more than 100 people at social gatherings. Social distancing required at work

Level 3 Stay home if you can. Children should learn at home if possible. If tested for COVID, you must self-isolate until you receive results. You must stay within your family bubble. 2 m distance in public, 1 m in shops or workplaces. Gatherings of up to 10 people for weddings and funerals. Public venues must close (libraries, food courts, gyms, pools, playgrounds, and markets). Payment must be contactless. Movement between regions may be restricted.

Level 4 People must stay home in their bubble other than for essential personal movement. Safe recreation is allowed in the local area. Travel is severely restricted. All gatherings are canceled and all public venues closed. Businesses are closed except essential services. Educational facilities are closed. (New Zealand Government, 2020)

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Fig. 16.1 New Zealand Government Poster (https:// covid19.govt.nz/assets/ resources/posters/COVID-1 9_poster_be-kind-business. pdf)

under the control of the New Zealand Army with support from the New Zealand Police. There has been some controversy about exceptions being made for non-citizen/ permanent residents of New Zealand for entertainers (touring musical acts, comedians, actors for films being shot in New Zealand, etc.) and those involved in America’s Cup sailing regatta, including sponsors, the necessity of whose immediate location is questionable at best. The number of these exceptions being allowed into New Zealand and its MIQ facilities while New Zealand citizens/permanent residents are unable to return to visit sick or dying relatives, etc. has been a regular feature of the news media. The capacity of MIQ has been insufficient for the demand. The Government’s decision to pursue a strategy of elimination, rather than suppression, has been arguably more successful than anyone might have hoped. We have been helped by our geographic isolation and spread-out population, and there has been a share of good luck along the way (Kieran, 2021, online). The first and most comprehensive lockdown of New Zealand occurred on March 25th and ran until the April 27th. The preparatory levels were put in place on March 21st. During level 4 the Government severely restricted retail activities and work, other than at home (see Table 16.2). All businesses except supermarkets, petrol stations, and pharmacies were closed at level 4. Since that national lockdown,

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Auckland has had three lockdowns (see Table 16.1) while the rest of the country has remained at a lower level. While the Government’s response has so far been successful, New Zealand has been lucky, particularly in the last three Auckland lockdowns where very little community transmission occurred even with community cases with more infectious varieties of COVID-19 and people with confirmed COVID infections having visited work and gyms while waiting for test results. The economic stimulus package the New Zealand Government committed around the pandemic is massive. New Zealand’s Gross domestic product in 2020 was $322 billion (Stats New Zealand, 2021). During the first year of the COVID pandemic, the New Zealand Government committed $62 billion to the COVID-19 Response and Recovery Fund, far in excess of any previous stimulus package (Kieran, 2021). This chapter considers the impact of COVID and the New Zealand Government’s responses to a number of markets: Food and fast-moving consumer goods (FMCG), Labor, Housing, Tourism including America’s Cup, International Education and Medical Supply chains.

16.2.1 Essential Retail Only: Creating a Monopoly for Supermarkets The NZ Government closed “non-essential” retailers during the first nationwide level 4 lockdown. It surprised many to find that essential retailers were supermarkets, petrol stations, and pharmacies, not butchers, bakeries, fruit and vegetable shops or farmers’ markets. The Government closed many essential retailers. New Zealand’s retail food market has for decades been dominated by two companies: Foodstuffs (North and South Islands) and Woolworths NZ (formerly Progressive), each representing multiple brands. These two companies dominate the sales of food to consumers in New Zealand. They provide food producers with little choice and squeeze prices. Increasingly in the last decade producers in New Zealand sought alternative channels to sell their perishable food. Farmers’ markets (www.farmersmarkets. org.nz) have brought over a thousand food producers closer to consumers and freed them from the power imbalance of selling into supermarkets. Consumers have, in recent years, increasingly sought alternative and traditional food distribution; farmers’ markets, artisan butchers, bakeries, specialist greengrocers, and speciality food shops. Consumers report social and environmental sustainability as a key reason for this shift. Our research (Wooliscroft et al., 2014) demonstrated that choices regarding food are important to New Zealanders’ expression of their ethics and frequently involve non-supermarket purchasing. Prior to COVID, 50,000 New Zealanders shopped at farmers’ markets every week (Chamberlin, 2012). Other consumers require specific specialist shops to satisfy their dietary, or religious, requirements; Halal butchers, organic food, etc.

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The New Zealand government, quite correctly, sought to protect New Zealanders from the spread of COVID-19. Most shops were closed and only “essential” retailers are allowed to remain open—supermarkets and dairies, with very restrictive customer rules. Many butchers, green grocers, etc. purchased extra stock as they anticipated the country going into lockdown, only to be barred from selling that stock. They were forced to close with no way of selling their goods as online purchasing was originally not allowed. The New Zealand government privileged supermarkets in three ways: 1. They were allowed to remain open while most other food suppliers were not. 2. They were allowed to continue to sell non-essential items (hardware, clothing, and toys are found on supermarket shelves and for the next month nowhere else) while their competition is closed. Wine shops have all been closed, while supermarkets continue to be allowed to sell wine. 3. They were allowed to deliver food while other food suppliers were not. Many small food suppliers put in place plans to deliver, as a service to their loyal customers and to help their businesses survive. Some of these suppliers stocked up on raw ingredients to allow for these delivery services, believing their businesses, as many of their customers do, to be essential services on the same level as supermarkets. In other countries (Canada, for example) delivery services mobilized to bring cooked food and groceries to people locked down at home. In New Zealand that opportunity was reserved for supermarkets and supermarket-like food delivery services (e.g., Myfoodbag.co.nz). Other countries, recognizing the important place farmers’ markets have in society (connecting producers and consumers directly), allowed farmers’ markets to continue with restrictions on the density of people around the stalls. The only reason that the supermarkets should be privileged as they were is if they had higher standards of safety than the smaller competitors. No evidence was given that supermarkets have a higher safety standard. The supermarket is of course a low service/self-service environment where contact between customers and sellers is minimal. But the food needs to get on the shelves, fruit and vegetables are open to handling and being sneezed upon, bulk is broken and food is wrapped in store. The fact that food sold through the supermarket goes through so many hands compared to the farmers’ market, the bakery, the butcher, etc. would suggest only an increased opportunity for contamination. What would the situation look like if instead of banning shops, except supermarkets, the government had stopped the supply of non-essential items, inside and outside supermarkets? Supermarkets would not be able to sell wine and beer, or liquor shops would remain open. Butchers, bakeries, and greengrocers would remain open, along with farmers’ markets stalls (selling essential items only). Many of these smaller businesses planned safe ways to continue to serve their customers. Would the citizens of New Zealand have faced more risk of infection? Instead of queueing outside and inside supermarkets customers would have been spread among more retailers, decreasing crowds.

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What did the New Zealand food market look like post lockdown? During the, estimated, 4 weeks of the level 4 lockdown all food retailers will pay rent, many will top up staff wages and two dominant companies will sell almost 100% of the food in New Zealand. It is almost the definition of “super profits” that have been given to the supermarkets for the duration. There is no doubt that the market is distorted during the lockdown and that this distortion will have a medium to long-term impact.

16.2.2 The Labor Market and Wage Subsidies: The Good, the Bad, and the Ugly In response to the lockdown and suspension of the ability to work away from home, the New Zealand Government provided a wages subsidy at the rate of $585/week for any staff normally working over 20 h and $350 for any staff working less than 20 h a week (Work and Income New Zealand, 2021). The subsidy was intended for businesses that saw a drop in turnover due to COVID and the lockdown. It certainly contributed to firms being able to maintain employment during a business downturn. Many large businesses signed up and received the subsidy. Coca-Cola Amatil New Zealand received over $7 million of wages subsidy. One of New Zealand’s largest construction companies received over $30 million in wage subsidies and then paid over $70 million in dividends—in effect tax payers’ money was being transferred to shareholders. Included was a national courier company, who then deducted the subsidy from payments made to couriers, leading to a net reduction in income. Some supermarkets, having been handed a near monopoly, also applied for the wages subsidy. When this came to public attention the applications were withdrawn.

16.2.2.1

Unemployed Through COVID: “Unlucky”/Lucky Job Losses

After three quarters of a year affected by COVID, the December 2020 unemployment rate was expected to be high, around 6%, but when the Government released the statistic it was 4.9% (Statistics New Zealand, 2021). The Government’s wage subsidy had worked. But each lockdown had seen some degree of subsidy for wages and many businesses had not yet been exposed to the post-subsidy reality of COVID-19. There is little doubt that many more businesses will fail, taking with them employee’s jobs, as the full economic impact of COVID rolls through New Zealand. The New Zealand Government introduced a special category of job seeker benefit (unemployment benefit) for those who lost their jobs through COVID, available for 6 months. That rate ($490/week) was considerably higher than the standard job seeker benefit ($250/week) (Radio New Zealand, 2020b). The difference has been described as “unfair and discriminatory” (Radio New Zealand, 2020b, online) by beneficiary advocates. Was this special benefit rate a recognition that normal benefits

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were not sufficient to live on? The difference certainly clashed with New Zealanders’ innate expectations of fairness (Manatū Taonga Ministry for Culture and Heritage, 2021).

16.2.3 Tourism in New Zealand New Zealand’s borders have now been closed for a year, to all except returning citizens or permanent residents and “essential workers,” including Russian crews to go on New Zealand owned fishing boats, America’s Cup sailors and support workers (including nannies for families of support workers), film stars, sponsors of America’s Cup and entertainers (The Wiggles, a children’s entertainment group, being one controversial essential worker group). From being New Zealand’s biggest export industry, Tourism became the source of much of the country’s unemployment as the number of people visiting tourist destinations plunged. Tourism was directed to focus on the domestic market, but locals are not prepared to pay the prices that international tourists have, and reluctant discounting was required from accommodation and experience businesses. Some businesses have simply closed, intending to re-open when high-paying international tourists return. Areas like the lower West Coast of the South Island famous for the Franz Joseph and Fox Glaciers have been especially hard hit, with many people forced to leave towns in search of work. “The local chief fire officer reports that where he previously had 11 [volunteer] firefighters, there are now four, placing the service in jeopardy. Most businesses have laid off 80% of their staff” (Mills, 2021, online). For the year ended March 2019: • Total tourism expenditure was $40.9 billion. • International tourism expenditure is $17.2 billion, which contributed 20.4% of New Zealand’s total exports of goods and services. • Tourism generated a direct contribution to gross domestic product (GDP) of $16.2 billion, or 5.8% of GDP. Tourism is our biggest export industry, contributing to 21% of foreign exchange earnings. • 229,566 people were directly employed in tourism (8.4% of the total number of people employed in New Zealand), an increase of 3.9% from the previous year. • (Stats New Zealand, 2019, online) From 410,778 overseas tourist arrivals in January 2020, the New Zealand inbound tourist market collapsed to under 2000 by April. Closed borders in April (at time of writing the borders are still closed) meant that the only people who were allowed to enter New Zealand were citizens of New Zealand and foreign nationals holding permanent residence visas. Exceptions were made by a senior Minister of the Government for a small number of people including actors in major movies being made in New Zealand and the crews and families of America’s Cup challengers.

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America’s Cup 2021

With significant (around $250 million) government and local government backing the New Zealand defence of America’s Cup was scheduled for early 2021, with an expectation of large numbers of high spending tourists. The new AC75 class (foiling monohull 75 ft yachts) promising high speeds and remarkable maneuverability promised a spectacle for viewers in person and around the world. COVID restrictions prevented the pre-America’s Cup regattas planned around the world in the lead-up to the Cup. There was a degree of social unease when in spite of a closed border, America’s Cup sailors and support staff were considered to be essential workers and allowed into New Zealand. At the same time capacity in Managed Isolation and Quarantine facilities was insufficient to accommodate New Zealand citizens wanting to return to New Zealand. The Prada Cup was sailed in early 2021, with three contenders seeking the right to challenge the Cup Holders, New Zealand. COVID lockdowns led to some races being held on courses further from shore to avoid the public congregating on shore and watching the races. The usual large flotilla of powerboats and spectator yachts was still present. All that occurred with these changes was an increase in the cost of watching a government-subsidized sporting event, with the rich still able to view in person and those without access to a boat watching at home on the television.

16.2.4 International Education in New Zealand The eight universities in New Zealand have been heavily encouraged by Government to cater to international students. Providing education to international students, including high schools and other training institutions, has resulted in “$5.1 billion was comprised of $4.8 billion from international students visiting New Zealand and $0.3 billion from education and training goods and services delivered offshore” (Education New Zealand, 2018, online). Recently, well over 100,000 international students have studied in New Zealand each year until COVID-19. International education is New Zealand’s fourth-largest export earner and it has underwritten the finances of New Zealand’s universities, until COVID-19. With few international students coming in 2020 and effectively none in 2021, the pipeline of international students is dry and universities are suffering severely curtailed budgets. The Government has increased the number of domestic students that it will partfund to go to university, but the fees associated with domestic students are much lower than the income the same number of international students would have brought in. At the same time that the Government reneged on its promise to fund 2 years of fee-free university study, and in response to COVID, they have funded

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free trades apprenticeships—training that competes with universities for limited domestic students.

16.2.5 COVID and the New Zealand Housing Market New Zealanders have an unusually high expectation of home ownership. In the 1990s home ownership peaked at 74% of New Zealanders living in their own home (Statistics New Zealand, 2020). That figure has now fallen to 64.5% in 2018 (the last census) and is likely to be lower now, as high house price to income ratios continue to increase. One of the first Government responses to the COVID pandemic was to negotiate mortgage holidays with banks in New Zealand. Mortgage holders could take a holiday from paying their mortgage, but the interest would continue to accrue on their debt. “More than 240,000 mortgage payments have been missed since April—worth about $2.2 billion. This is in addition to more than 83,000 mortgage deferral requests lodged since the end of March, 13 percent of all mortgages” (Corlett, 2020, online). After an initial 6-month mortgage holiday, the Government extended the scheme to a full year (Rosanes, 2020). The pain of paying the mortgage was been delayed again while interest has continued to accrue. There is considerable concern about the affordability of housing in New Zealand (indices in brackets) and “The median markets of Australia (6.9), New Zealand (8.6) and China [Hong Kong] (20.8) are severely unaffordable” (Cox & Pavletich, 2019, p. 2). The affordability indices are calculated by house price to income ratio. “Auckland has been severely unaffordable in all 16 Demographia surveys” (Cox & Pavletich, 2019, p. 20). It is now the fourth least affordable city in the world. In order to keep the New Zealand economy out of recession, Reserve Bank interest rates were cut and mortgage rates have dropped to 2.49% (for a 1-year term). This lower cost of borrowing has led to an increase in demand and higher house prices as those who do not own a house rush to get on the property ladder. The lure of capital gains has, in part, driven the fear of missing out. New Zealanders should prepare for at least another year of rapidly rising house prices as the market runs “red hot” thanks to ultra low interest rates, a rapid recovery from the COVID-19 pandemic and changes to the tax system, a leading economist has said. After the latest figures showed house prices rose at their fastest monthly rate for 16 years in November, Westpac’s chief economist for New Zealand thinks there is much more to come and that prices could rise by 12.2% next year. Median prices have already risen 20% this year, according to the Real Estate Institute of New Zealand, taking the median national price from $605,000 in October 2019 to a new record high of $725,000 in October 2020. The median price in Auckland is now above $1 m. (Farrer, 2020, online)

In spite of Government attempts to cool the housing market, the senior economist for the Government’s own bank—Kiwibank—says “We are forecasting annual house price growth will peak at 25 per cent across the country in the June quarter. And house price growth is still expected to remain in double-digit territory by the

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end of 2021, eroding some of the changes made to help first-home buyers” (Stock, 2021, online). One thought-provoking analysis indicates that given the rise in house prices during the COVID-19 pandemic, those who work (on the median wage) while not owning a house have lost $54.59 for each hour that they worked in the first year of the pandemic (Blue, 2021). The economic course through COVID has been two speed—increased wealth for those who own a home and lost opportunity to buy a house for those that do not. Rents are also highly likely to increase due to Government policies, a second blow to those not on the property ladder.

16.2.6 Primary Industries and COVID New Zealand is a farming country, providing milk, fruit, vegetables, beef, and lamb for export. With a large coastline and a 200-mile economic zone, it is also heavily involved in fishing and exporting fish. Much of that is harvested, processed, milked by migrant workers in New Zealand on temporary visas. The Pacific Islands serve as the source of much of this labor and the opportunity to undertake work is positioned as part of New Zealand’s support for the Islands. When the 2020/2021 harvest season (Southern hemisphere summer is December through February) arrived without open borders for Pacific Island workers, orchardists and farmers were quick to point out their problems (Kissun, 2020). Our food would rot on the trees and in the fields (1 News, 2020). Commentators added to the calls for Pacific Island workers being allowed into New Zealand to harvest (Nagar, 2020a, 2020b). The Government bowed to pressure and allowed 2000 workers to come to New Zealand, via MIQ at the employer’s expense, but they must be paid at least the living wage (NZ$22.10/h) including while in MIQ. New Zealand workers were quick to notice that the living wage requirement did not apply to New Zealanders working alongside the Pacific Island workers in the same fields and orchards (Satherley & Prendergast, 2020). Is it any wonder that unemployed New Zealanders had been reluctant to take on fruit and vegetable harvesting? Fishing vessels working for New Zealand organizations are frequently crewed by overseas sailors. The COVID-19 pandemic exposed this exporting of “New Zealand jobs” and Russian and Ukrainian fishermen were judged to be essential workers, taking more MIQ places and in more than one case bringing COVID-19 into the country.

16.2.7 Medical Supply Chains New Zealand sits at the end of many supply chains, including medical equipment and medicines. The size of the New Zealand market does not make it attractive.

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New Zealand also has a single national drug buying agency, Pharmac, charged with negotiating the cheapest drugs for its citizens, frequently generic drugs. This single purchaser model has seen resistance from drug companies who expect a free market and an opportunity to exploit their brand value. Direct to consumer advertisements for medicine are allowed in New Zealand and a number of companies have used this to encourage patients to request branded drugs from their doctors instead of generics that would normally be supplied. New Zealand’s position in the global medical supply chain is evident in the availability of vaccines for COVID. By the end of May 2021 under half a million doses have been administered. Only 153,000 people have received two doses of the vaccine, required for ‘full’ coverage against the virus. It is not expected that the majority of the population will have the opportunity to be vaccinated until the end of the year.

16.3

The Impact of COVID on the NZ Economy and Markets: Into the Great Unknown

We do not know what the impact of COVID on the New Zealand economy will be in the medium to long term. As of March 2021, unemployment has remained low, those who own houses have seen their paper worth increase considerably and there is an eerie confidence in the economy. Will New Zealand continue to be blessed by good luck keeping COVID out of the country and allowing the economy to operate, domestically, as normal? Will COVID escape in the community? Or, will the economic fundamentals currently propped up by near “free” lending collapse? Only time will tell. The Government announced its intention to fund “shovel ready projects” related to infrastructure and building. Planned University buildings with foundations dug and the University budget in tatters because of the absence of international students were not approved in this scheme. An additional NZ$ 3 billion has been allocated by the government to the costs of administering the closed border and Managed Isolation and Quarantine (MIQ) but capacity remains insufficient for demand. The economy is still being heavily stimulated with the Reserve Bank lending banks money at 0.25%. Mortgage rates are currently 2.49% and most home purchasers are heavily indebted (Pullar-Strecker, 2021a). The chief economist of a major bank, Sharon Zollner, has calculated that a 1% increase in interest rates would lead to 5% of the discretionary income of Aucklanders, and 3% of the discretionary income of the rest of the country, being required to cover those debt servicing costs (Pullar-Strecker, 2021b). In June 2020, 6000 businesses were reported as being in danger of closing (Shaw, 2020). September saw 10000 businesses reported as being likely to close (Radio New Zealand, 2020a). In March 2021, as the government support for

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COVID-affected businesses was removed, business closure statistics started to roll in. “In September through to November last year, 16,234 businesses closed permanently, compared to 7154 in the same period in 2019. That is an increase of 127 per cent” (Edmunds, 2021, online). Only time will tell what the total cost to the New Zealand economy of COVID 19 will be. Continuing to stimulate the economy with approximately 20% of GDP per annum is not sustainable. The effect of the New Zealand Government giving a monopoly on the supply of food to two supermarket chains on alternative food distribution networks has not been finalized, but it has definitely stressed those alternative networks, frequently beyond breaking point. New Zealand is an outlier. The New Zealand Government moved early and hard and was able to eliminate (repeatedly) COVID-19 from the community, helped in no small part by good luck. Repeated infections escaping MIQ, heavy subsidies and major stimuli have avoided some problems but exacerbated others, particularly wealth inequality associated with home ownership and rampantly increasing house prices.

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Kieran, G. (2021, March 31). Economic forecasting’s spectacular covid failure. Website. Retrieved from https://www.stuff.co.nz/business/opinion-analysis/300250426/economic-forecastingsspectacular-covid-failure Kissun, S. (2020, October 20). Vege crops at risk of rotting. Website. Retrieved from https://www. ruralnewsgroup.co.nz/rural-news/rural-general-news/vege-crops-at-risk-of-rotting Manatū Taonga Ministry for Culture and Heritage. (2021, April 22). The fair society. Entry in the online. Encyclopedia of New Zealand. Retrieved from https://teara.govt.nz/en/political-values/ page-4 Mills, L. (2021, February 5). O’connor, mbie officials hear glacier towns’ pleas. Website. Retrieved from https://www.odt.co.nz/regions/west-coast/o’connor-mbie-officials-hear-glaciertowns’-pleas Nagar, S. (2020a, November 25). NZ needs a plan to help migrant workers pick fruit and veg, or prices will soar and farms go bust. Website. Retrieved from https://theconversation.com/nzneeds-a-plan-to-help-migrant-workers-pick-fruit-and-veg-or-prices-will-soar-and-farms-gobust-150447 Nagar, S. (2020b, November 25). Nz urgently needs to find workers to avoid a picking season disaster. Website. Retrieved from https://thespinoff.co.nz/business/25-11-2020/nz-urgentlyneeds-to-find-workers-to-avoid-a-picking-season-disaster/ New Zealand Government. (2020, December 15). About the alert system. Website. Retrieved from https://covid19.govt.nz/alert-system/about-the-alert-system/ New Zealand Government. (2021, January). History of the covid-19 alert system. Retrieved March 15, 2021, from https://covid19.govt.nz/alert-system/history-of-the-covid-19-alert-system/ Pullar-Strecker, T. (2021a , March 4). Adrian Orr frets over soaring asset prices as ASB warns more people low on cash. Stuff.co.nz. Online. Retrieved from https://www.stuff.co.nz/busi ness/124430525/adrian-orr-frets-over-soaring-asset-prices-as-asb-warns-more-people-low-oncash Pullar-Strecker, T. (2021b, March). ‘Gale force’ economic warning: What 1% rise inmortgage rates would mean. Stuff.co.nz. Online. Radio New Zealand. (2020a, September 2). Covid-19 could mean 10,000 businesses fail in2021— Retail nz. Website. Retrieved from https://www.rnz.co.nz/news/business/425053/covid-19could-mean-10-000-businesses-fail-in-2021-retail-nz Radio New Zealand. (2020b, May). Welfare advocates not happy with covid-19 unemployment benefit. Online. Retrieved from https://www.rnz.co.nz/news/national/417531/welfare-advo cates-not-happy-with-covid-19-unemployment-benefit Rosanes, M. (2020, August 19). Reserve bank extendes mortgage holiday scheme. Website. Retrieved from https://www.nzadviseronline.co.nz/news/reserve-bank-extends-mortgage-holi day-scheme-272917.aspx Satherley, D., & Prendergast, E. (2020, November 28). Unions question why local fruit-pickers haven’t been offered living wage, like foreigners. Website. Retrieved from https://www. newshub.co.nz/home/politics/2020/11/unions-question-why-local-fruit-pickers-haven-t-beenoffered-living-wage-like-foreigners.html Shaw, A. (2020, June 4). Covid 19 coronavirus: More than 6000 businesses at risk of closing— Report. Website. Retrieved from https://www.nzherald.co.nz/business/covid-19-coronavirusmore-than-6000-businesses-at-report/V7PZHFM4A754KI55KEBCTR26SY/ Shultz, C. J., Rahtz, D. R., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In Handbook of community well-being research (pp. 403–421). Springer. Statistics New Zealand. (2020, December). Home ownership rate lowest in almost 70 years (Tech. Rep.). New Zealand Government. Retrieved from https://www.stats.govt.nz/news/ homeownership-rate-lowest-in-almost-70-years Statistics New Zealand. (2021). Unemployment (webpage). Statistics New Zealand. Retrieved from https://www.stats.govt.nz/indicators/unemployment-rate

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Stats New Zealand. (2019, December). Tourism satellite account (Tech. Rep.). Statistics New Zealand. Retrieved from https://www.stats.govt.nz/information-releases/tourism-satelliteaccount-2019 Stats New Zealand. (2021, March 18). Gross domestic product (gdp). Website. Retrieved from https://www.stats.govt.nz/indicators/gross-domestic-product-gdp Stock, R. (2021, March 29). Kiwibank forecasts house price growth of 25 per cent, with rent hikes possible. Website. Retrieved from https://www.stuff.co.nz/business/124686399/kiwibankforecasts-house-price-growth-of-25-per-cent-with-rent-hikes-possible Wooliscroft, B., Ganglmair-Wooliscroft, A., & Noone, A. (2014). A hierarchy of ethical behavior: The case of New Zealand. Journal of Macromarketing, 34(1), 57–72. https://doi.org/10.1177/ 0276146713508560 Work and Income New Zealand. (2021). Payment rates and processing times for COVID-19 Resurgence Wage Subsidy (Webpage). Work and Income New Zealand. Retrieved from https://www.workandincome.govt.nz/covid-19/resurgence-wage-subsidy/payment-rates-andprocessing-times.html

Ben Wooliscroft is a Professor of Macromarketing and the Associate Dean Research for the Faculty of Business, Economics and Law, Auckland University of Technology, Auckland New Zealand. He is the current President of the Macromarketing Society and an Associate Editor of the Journal of Macromarketing. His research is centered around macromarketing, with research streams in systems, sustainability, marketing history, brands, quality of life and sustainability transitions. Sabeehuddin Hasan holds Ph.D. in Marketing from University of Otago, Dunedin, New Zealand. His research interests include ethical consumption and quantitative techniques. Sabeeh also has a Bachelor’s degree in Computer Science and is a professional programmer with many years of software development experience in different multi-national software houses. He has developed desktop and web-based applications for international clients in Java related technologies. Alexandra Ganglmair-Wooliscroft is a Senior Lecturer in the Business School, Massey University Auckland, New Zealand. Her research focuses on the wider impacts of (sustainable) consumption, and consumption’s impact on well-being and quality of life. Alexandra’s research has appeared in the Journal of Business Research, Journal of Happiness Studies, Journal of Sustainable Tourism and the Journal of Macromarketing, among others. She is an Associate Editor of the Journal of Macromarketing and Vice President Conferences of the Macromarketing Society Inc.

Chapter 17

Rwanda Galvanizes Healthcare Readiness, Citizen Support, and Technology to Flatten the Coronavirus Curve in the Land of a Thousand Hills June N. P. Francis and Lama Mugabo

Abstract Rwanda has experienced one of the lowest rates of COVID-19 infection globally, ranking seventh on a composite measure, despite being a poor, landlocked country. This chapter draws on the framework of Shultz et al. (The handbook of community well-being (pp. 403–422). Dordrecht: Springer, 2017) to interrogate the lessons learned, and the factors contributing to, Rwanda’s successful intervention against the spread of COVID-19. Our analysis shows that Rwanda’s “catalytic institutions” were ready to provide healthcare, quickly deploying strategies learned from the experience of previous outbreaks of infectious diseases, notably Ebola in 2018. The initial response was rapid, coordinated, and scientifically informed; supportive social programs were put in place, with deep community involvement, alongside innovation and trust in the government and state communications. Rwanda’s success illustrates the need to decolonize knowledge production and policy dissemination. As policy makers sought models to emulate in the face of this pandemic, few were looking to a small, landlocked African country. They consequently missed a major opportunity to emulate its life-saving strategies. Keywords Consumer well-being · Quality-of-life · Consumer behavior · Digital transformation · BRICS · Rwanda · COVID-19

17.1

Introduction

Rwanda is a densely populated, landlocked African country of 13.2 million, with an 83% rural population, sandwiched between Tanzania to the east, and the Democratic Republic of the Congo (DRC) to the west, Uganda to the north, and Burundi to the

J. N. P. Francis (*) Simons Fraser University, Burnaby, BC, Canada e-mail: [email protected] L. Mugabo Building Bridges with Rwanda, Vancouver, VC, Canada © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_17

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south. The 1994 Rwandan genocide against the Tutsi, which saw the slaughter of up to a million people in 100 days, brought Rwanda to the world’s attention. Rwanda now de-emphasizes the ethnic descriptors that seeded the genocide, but for clarity, the ethnic group historically known as the Hutus account for 84% of the population, the Tutsi make up 15%, and the Twa account for 1% of the population. Rwanda is ranked seventh in the world on the COVID Performance Index as of March 31, 2021, using a composite measure that includes case counts, deaths, and testing (Lowy Institute, 2021). This chapter presents a case study on the lessons learned regarding Rwanda’s remarkable management of the COVID-19 pandemic and the factors that led to this outcome. The chapter draws on the framework of Shultz et al. (2017), aiming to explain the factors that have contributed to community well-being, which in the case of COVID-19 can be understood as protection from the pandemic. In the Shultz et al. framework, macro-factors, such as geography and environment, political and legal systems, infrastructure, technology, and the educational system are all seen as foundational for communities to flourish. These factors on their own are not considered to be determinative. Collaborations among business, government, and civil institutions are argued to be “catalytic” in linking macro- to micro-factors and achieving “good management.” The effects of such management include enabling communities to create marketing systems capable of delivering a range of goods and services, leading to a higher quality of life. However, given the colonial history of Rwanda and the calls for historicizing marketing research, we will first critique the framework from a decolonial perspective that challenges the geopolitics of knowledge production. As Mignolo facetiously noted, “as we know: the first world has knowledge, the third world has culture; Native Americans have wisdom, Anglo Americans have science” (p. 160). Hence, the secondary goal of this chapter is to adopt a decolonial perspective to highlight the geopolitics of knowledge production and dissemination. Rwanda’s achievement should be understood with critical reference to the initial warnings at the start of the pandemic that African countries would experience dire consequences. It was predicted that 83,000–190,000 people in Africa could die of COVID-19, with 29–44 million expected to be infected in the first year. The pandemic was expected to overwhelm the available medical capacity in much of Africa, with an estimated 3.6–5.5 million COVID-19 hospitalizations, of which 82,000–167,000 would be severe cases requiring oxygen (World Health Organization Africa, 2020). However, a year after the pandemic, the continent has actually seen a much lower infection rate of four million cases, and although there have been 106,000 deaths, it is important to note that 40% of cases and just under half of these deaths occurred in South Africa alone (Statista, 2021). It is widely recognized that COVID-19 shines a revealing light on systemic vulnerabilities across countries and within societies. As the world shifts from evaluating the impact of COVID-19 to the rollout of vaccinations, global inequalities have only been exacerbated. As of April 29, 2021, “83 percent of shots that have gone into arms worldwide have been administered in high- and upper-middleincome countries. Only 0.2 percent of doses have been administered in low-income countries” (Holder, 2021a, 2021b).

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The pandemic, then, has laid bare a range of differing global responses and impacts. This provides us with an unprecedented opportunity to better understand how and why some countries and communities have remained resilient in light of the pandemic while others have fared disproportionately worse. As Europe opened its borders in summer 2020 to foreign countries, many were surprised that Rwanda was one of the countries allowed to enter while many others, including the United States, were barred based on their COVID-19 prevalence (European Council, 2020). Rwanda also became the first African country to vaccinate against COVID-19, using the Pfizer vaccine (Reuters, 2021a, 2021b). The government has also put in place a COVID-19 recovery plan, with Rwanda aiming to vaccinate at least 60% of the population by 2022 (Sabiiti, 2021a, 2021b). Beyond being an exemplar of best practice in the face of a global pandemic, Rwanda also provides an opportunity for us to interrogate the colonial legacy of knowledge production and dissemination. The quickly generated, negative prognostications were based on a deeply colonial approach that essentialized the African continent while making sweeping generalizations regarding the supposed inferiority of its public health system and related measures. This had significant consequences. For, it robbed the world of the possibility of emulating the successful strategies that non-Western countries deployed while overemphasizing strategies utilized by hegemonic countries. The chapter unfolds as follows. First, we briefly discuss the framework of Shultz et al. (2017), which has guided the study. Drawing on this framework, we discuss selected macro-factors relevant in Rwanda, before highlighting relevant responses to the pandemic made by “catalytic institutions” (Shultz et al., 2017). With this in place, we discuss what lessons policy makers can learn from Rwanda’s response to COVID-19, situating this within the broader debate surrounding decolonizing knowledge, and we propose some amendments to the Schultz et al. framework in response, regarding how we measure “quality of life.”

17.2

Conceptual Framework

Shultz et al. highlight that what is important for promoting the quality of life involves a link between macro- and micro-factors being “recognized, understood, valued, and deftly managed in the form of ‘Best Practices” (2017, p. 412). Macro-factors either bolster or degrade depending upon how well these factors are (mis)managed. Collaborations by business, government, and civil institutions are seen as catalytic in linking macro- to micro-factors and achieving “good management.” Enabling communities to create marketing systems capable of delivering a range of goods and services is seen as pivotal to a high quality of life, where citizens/consumers are both the ultimate arbiters and the beneficiaries. We shall begin by asking the overarching question as to whether a framework developed within a Eurocentric academy that ignores the present effects of colonialism can serve as a helpful starting point, given that:

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The marketplace cannot be fully understood without historicizing marketing within the context of the enduring effects of the transatlantic slave trade, the institution of slavery, and colonization. . .Hence there is a need for historical (including critical) analyses that explicitly situate racism, markets, and marketing in these historical and broader contexts.

Coloniality must be contended with, given that it is an: Invisible power structure that sustains colonial relations of exploitation and domination long after the end of direct colonialism. Thus, coloniality survives colonialism and is maintained alive in what gets accepted as common sense, in the self-image of peoples, and in aspirations of self.

The Shultz et al. framework acknowledges a range of nonmarket factors in quality of life but ultimately argues that flourishing societies need “clear evidence of positive physical, economic, environmental, and social well-being” (p. 407). They argue that in the case of societies that have experienced (e.g., subsistence agriculture or protracted civil war) that very few would insist that such communities are flourishing. We beg to differ. We argue instead that using a decolonial perspective allows us to imagine flourishing societies primarily through interrogation of power, community agency, and harmony. Decolonial perspectives, for example, the notion of vivir bien (VB) in the Bolivian constitution, is based on an Indigenous perspective of well-being that “represents a legal and an epistemological shift that radically contests the dominant Western paradigm of modernity/coloniality.” This notion of well-being specifically rejects its applicability where there is inequality—that is to say, any conception of well-being that is framed as living better than others—instead of seeking a reciprocal respectful and harmonious balance that brings into focus all living communities including humans, nature, and respect for identity and cultural diversity. This notion of well-being rejects constant material improvement as a relevant measure given its high cost both to society and the environment. In its place, human interdependence is identified as the primary mode to improve quality of life, as found in “communal practices of solidarity, support, and mutual attention to the well-being of others.” Analogously, in an African context, Wissing and Fadiji have shown that embeddedness in strong social ties allows people to realize their potential despite personal hardships, thus challenging market-oriented conceptions of well-being. Decoloniality interrogates the specificities of social relations and argues for promoting the agency of communities. The Shultz et al. framework acknowledges the importance of engaged citizens—however, it sees them merely as stakeholders to be engaged rather than as active agents in their determination. Communities that are not flourishing are seen as primarily having deficits in access to the marketplace—for example, insofar as they lack capital or market literacy. But as Beninger and Francis argue, communities have forms of capital that are often subject to harm by the marketplace. Consequently, it is not engagement per se that is immediately relevant but, instead, the need to develop. As Kaunda et al. put it: Decolonial participatory approaches requiring that ordinary people adjudicate over the issues that concern them, that they organize themselves and decide their fate, including by operating from their own meaning of concepts such as development, democracy, and human rights.

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Therefore, we propose to expand upon the Shultz et al. framework to explicitly (1) interrogate coloniality, (2) reject a conception of well-being as mediated by the availability of goods and services, and (3) adopt a decolonial perspective that emphasizes the centrality of intra-community perspectives. Our analysis is also mindful of interpreting the COVID response from a specifically Rwandan perspective to ensure our insights will not be filtered to fit the Western gaze. In the following section, we interrogate the relevant macro-factors in coming to understand Rwanda’s COVID-19 response.

17.3

Rwanda: Macro-factors

17.3.1 History Matters The Shultz et al. framework acknowledges a range of influential macro-factors but nowhere is one of the most defining features of modern history incorporated—that is, the effects of colonization. In a now-famous quotation, we are encouraged when studying Rwanda that “instead of seeing history exclusively through the genocide . . . one can only understand the genocide through an understanding of Rwanda’s history.” Likewise, contextualizing Rwanda’s COVID-19 response also starts with its history, given how the genocide contextualizes present-day Rwanda. Rwanda’s history is rooted in centuries of rule by a Tutsi-dominated monarchy. However, although Rwandan history has been highly politicized with different actors accused of using history for their political gain, there is consensus that historically, distinctions between ethnic groups were not rigidly defined: Ethnicity was important to social process . . . but . . . [was] not primordial; [the ethnicities] were contextually created, they altered over time, and they evolved differently in different places and contexts. Therefore, ethnic groups cannot be seen as internally homogeneous, externally distinct, and constantly in confrontation with other such groups.

For example, in spite of Tutsi hegemony, with the accumulation of cattle and therefore wealth, Hutu peasants could become members of the ruling class. But this changed during European colonization, which entrenched and codified ethnic divisions and mobilized discrimination for colonial gain. Rwanda’s colonial period began with German colonization in 1894, before sovereignty was passed to Belgium by the League of Nations in the aftermath of World War I. Rwanda became independent in 1962. Both colonial powers, however, strategically sidelined the influence of indigenous leadership and instead privileged and coopted local leaders who would administer and enforce local rule. In a practice common to European colonization, race was deployed as a category to distinguish the conquered from the conqueror—local elites were racialized, afforded a colonial education, and given access to privileges. These elites were put in command of the administration apparatus and thus given access to the power this provided over other groups.

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In the case of Rwanda, the existing monarchy was sidelined, and control was achieved through privileging the colonial powers’ choice of local elites over other groups. Colonial governance exacerbated and exploited ethnic differences by widening and entrenching the fault lines of ethnic tension. These fault lines were not immutable before colonization: For example, a century ago in some areas of western Rwanda, people identified by local kin-group and residence. In other areas there were political identities reaching beyond the kin group, but there was no broad social category uniting all as Hutu; in fact, the very term ‘Hutu’ was meaningless.

Crucially, identity cards were introduced in 1933, during the Belgian administration, serving to further entrench the ethnic divisions that began under the German colonization, which had first racialized the population by ethnic group. These cards included ethnic identification, determined solely by the Belgian colonizer, and were required for travel outside of the region. Underlying these racial categorizations was the European myth that the “Hamitic race” was considered superior to or more advanced than other races in Africa. It was claimed that the “Hamites” were descended from Europe and it was assumed that all significant achievements in African history were down to their work. To categorize people, tests (including height and nose width) were used to make it official policy that the Batutsi (Tutsis) were the “European under a black skin”, and they were to be given preferential treatment in the appointment of local political authorities. The long-term effect was that a superior French education and opportunities were afforded to Tutsis. These colonial powers celebrated the Tutsi, essentializing them as the aristocrats exhibiting more “European” physical features, while the Hutus were stereotyped as darker and less European. This was to change after Rwanda’s independence. Hutus rose to power and dominated Rwandan politics until the aftermath of the genocide. The “Tutsi now became those considered ‘out of place’, inferior creatures in a newly regained natural order of Hutu homogeneity and majority control over the state.” The Rwandan Civil War, culminating in the genocide against the Tutsi, is clearly the pivotal moment in modern Rwandan history. Rwanda’s current president played a significant role in the liberation of Rwanda by the RPF, and after taking power, formed a government of national unity. Following the liberation of the country and the ensuing liberation war, Rwanda looked for ways to rebuild a new society. The “official” justice system had been decimated and civil society was on the cusp of disintegration. Rwanda had been abandoned by most of the international community and thus sought to rebuild itself on its own terms. Many intuitions and norms were reimagined with egalitarian aims explicitly stated, as in, e.g., the Gacaca system of justice that that was implemented in post-genocide Rwanda as a national system of reconciliation. To unite the country under a Rwandan identity following the genocide, the government sought to remove ethnicity from the national identification card. The government saw it as important to officially clarify that Rwandans were one people, sharing a culture, language, and traditional beliefs. According to the Rwandan oral

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historian, JDD Nsanzabera, King Cyilima II Rujugira (1675–1708) created the three groups as a mechanism of nation building. No one was born Hutu, Tutsi, or Twa. Tutsi was the highest level of economic achievement. To be a Tutsi, one had to have plenty of cows and had to make available one’s intellect and physical strength to fight for the country in case of a war. Most importantly, though, a Tutsi’s role was to help Hutus build their wealth, become patriotic and prepare him to put his/her life on the line fighting for his/her country. As a primarily social identity, then, one could fall from grace and lose one’s social standing: one could go from Tutsi to Hutu to Twa (Nsanzabera, 2018). To de-escalate the persistence of ethnic tensions, referring to ethnicity was officially banned from public life and punishable by law. And while it would be an oversimplification to assert that simply banning ethnic divisions is the same as achieving harmony, the ban itself did represent an important shift in public life. Rwanda adopted a new constitution in 2003 that committed to equity, stating in its preamble that the country was: Resolved to fight the ideology of genocide and all its manifestations and to eradicate ethnic, regional and other forms of divisions. . . .[and] resolved to build a State governed by the rule of law, based on respect for fundamental human rights, pluralistic democracy, equitable power sharing, tolerance and resolution of issues through dialogue.

Rwanda also instituted measures in its constitution to address gender inequality, granting at least 30% of posts in decision-making organizations to women. Women now comprise 61% of Rwandan members of parliament and Rwanda ranks ninth in the world in gender equality (World Economic Forum, 2020). It is clear that Rwanda chose to decolonize its society, attending to social cohesion, social inequality, and harmony as a primary condition for flourishing creating the conditions for economic, health, and other changes. However, as will be shown below, while there are improvements in these macro-factors, Rwanda has “little or no margin for administrative error or systemic shocks” (Shultz et al., 2017, p. 407) yet the country has flourished from the perspective of COVID-19.

17.3.2 Economics Matters If the political context in Rwanda is best understood through its ethnic history, then the economic context for its COVID-19 response begins in earnest with the government’s 2000 launch of Vision 2020, an ambitious development plan to move the country from its “Heavily Poor and Indebted Countries” classification to a middleincome economy in 20 years. When the coronavirus erupted in late 2019, Rwanda was enjoying an economic boom and anticipating reaching most of the development goals of Vision 2020. Economic growth exceeded 10% in 2019 and this strong growth was expected through 2020. Rwanda has moreover been assessed to be a moderately open economy, ranking 47 of 148 countries on the Index of Economic Freedom (The Heritage Foundation, 2021).

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The Rwandan economy relies heavily on returns from its investment in tourism. With the pandemic having disrupted the international flow of travel, goods, and services, Rwandan exports and tourism have taken a strong hit. Despite the EU lifting its travel advisory to Rwanda because of its successful management of the coronavirus pandemic, tourists are not traveling. The country is already feeling the fiscal pressures of this and has a mounting balance of payments. These global factors could negatively impact Rwanda’s provision of public health services not only with respect to COVID-19 but also the provision of other essential health services, given that healthcare workers and fiscal resources have been redirected to the emergency response to the pandemic.

17.3.3 Social Context Matters Under Vision 2020, Rwanda has achieved significant improvements in living standards. World Bank indices have shown a substantial two-thirds decline in child mortality and almost a universal enrollment in primary school education as of July 2020. World Bank national aggregate measures have also indicated significant improvements in social indicators: poverty has declined from 77% in 2001 to 55% in 2017 and there has been a dramatic increase in life expectancy from 29 in the mid-1990s to 69 in 2019. Using the Gini index, which measures inequality, one can see a similar decline, from 0.52 in 2006 to 0.43 in 2017 (World Bank, 2020). At the same time, however, we contend that such indicators should also reflect local conceptions of well-being and poverty, as these may not align with colonially rooted international measures such as those published by the World Bank. Research in Rwanda itself indicates that the critical variables identified by local communities include “land; livestock; employment; health; housing; infrastructure; social relations and sharing; and autonomy over land use and investment decisions”. With such variables in mind, a more nuanced picture emerges when these are evaluated: some rural Rwandans, e.g., can be seen as not benefitting to the same degree as others. What appears to be critical, however, is the emphasis placed by rural Rwandans on nonmaterial social and political factors, such as the quality of social relations and levels of autonomy for people to make their own decisions. To illustrate, consider Umuganda, a system of community participation were once every month, villagers contribute their time and labor to address a range of community needs, including repairing infrastructure and discussing community issues. This system was able to fill a shortage of classrooms after the Rwandan government abolished school fees in 2003, in an attempt to increase access to education. Over 2 years—2009 and 2010— 6000 new classrooms and close to 15,000 new latrines were constructed.

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17.3.4 Democratic Institutions In the aftermath of the genocide, Rwanda faced a challenge: how could the need for security and social cohesion be reconciled with constitutionally guaranteed democratic institutions? Commitment to such institutions is mentioned in the Constitution of Rwanda, stating in Article 10 that Rwanda is “building a State governed by the rule of law, a pluralistic democratic Government.” While elections have remained free, promises of democratic institutions remain elusive as the government of Kagame has been accused of authoritarianism and repressing opposition and dissent. The Economist Intelligence Unit (2021) ranked Rwanda 131 out of 167 countries in its 2020 Democracy Index Report. However, as Kritz has claimed, “the Rwandan people seemed to have expressed their preference for national security over democratic ideals” (2019, p. 154). In a 2015 vote that was roundly criticized by the international media, Rwanda almost unanimously voted to amend Article 101 of the 2003 Constitution, allowing President Kagame to be eligible to serve a third 7-year term, followed by two additional 5-year terms, such that he is now eligible to be President until 2034.

17.3.5 Trust in Public Communications Given some of the undeniably dangerous effects of mass media in Rwandan history—in particular, radio was essential for inciting violence during the genocide—we might expect trust in mass media to be low: Looking back to Rwanda, it is crystal clear to me that for the most part, the local media in the country, in particular the extremist radio station Radio Télévision Libre des Mille Collines (RTLM), were literally part of the genocide. The génocidaires used the media like a weapon. The haunting image of killers with a machete in one hand and a radio in the other never leaves you.

The role that hegemonic powers and strategic priorities play in media coverage meant that the international media also failed Rwanda: The net effect for Rwanda was that as for the international media, I think we need to ask ourselves, did the lack of attention and understanding by the international media actually contribute to the genocide? Did the decision to ignore Rwanda border on complicity, by letting this atrocity go largely underreported?

Rwanda implemented media reforms in law in 2013 and the Rwanda Media Barometer was introduced to assess the state of media development in Rwanda and address any existing gaps. The 2013 established self-regulation converted the state broadcaster into a public broadcaster (Rwanda Broadcasting Agency) with an independent board, among other reforms. The latest multi-index composite barometer report indicates that Rwanda’s media sector performance has improved from 60.7% in 2013 to 72.4% in 2018 (Rwanda Media Barometer, 2019).

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Such changes appear to be well-received by the Rwandan public: As a whole, the findings from our sample highlight strong trust in local media, especially state-run media. This finding is surprising, given our sample of young, relatively educated adults with access to multiple media sources—a group one might expect to be more skeptical—and speaks to the overall high levels of public trust in the media in Rwanda.

The authors contend that this reflects high levels of trust in the government of President Kagame: In short: Kagame played a key role in ending the genocide and ushering the nation into a period of peace and development, thus, the public trusts him . . . that trust seems to have translated into public trust in the news media, and especially trust in public news outlets. At least on the surface, citizens trust Kagame. Critics have suggested that his tight rein prohibits dissent, thus, citizens are fearful to speak out against the ruling party. . . This study cannot conclude whether the loyalty that citizens show to Kagame is authentic but based on the results . . . the trust appears widespread.

The above analysis makes clear the heavy toll that colonization took on Rwanda’s social cohesion leading to one of the greatest tragedies in human history. We contend that in rebuilding its society, Rwanda’s emphases on social cohesion, gender equity, trust, and community governance are the glue that, as will be shown below, allowed for its catalytic institutions to effectively respond to the COVID-19 threat.

17.4

Catalytic Institutions and the COVID-19 Response

As covered in the following section, Rwanda’s COVID-19 ongoing responses reflect its healthcare readiness, a cross-sector collaborative approach, detailed plans that were implemented in a timely effective manner and the combination of leading technology and traditional approaches that all pivoted on strong community inclusion and support.

17.4.1 Building an Effective, Decentralized Healthcare System Vision 2020 is committed to building a robust healthcare system that guaranteed universal access across Rwanda. The data shows that much progress has been made. In 1994, the country had only 96 medical doctors, or, in other terms, one doctor for every 63,000 patients. Many doctors had fled Rwanda before the genocide; many others were killed. Today, there are 1350 doctors and 9551 nurses in Rwanda, averaging 8919, 1261, and 552 people per doctor, nurse, and hospital bed, respectively. These are notable improvements, although Rwanda still compares somewhat unfavorably (except for beds) to the averages for sub-Saharan Africa of 5000, 1000, and 833, respectively, and global averages of 666, 294, and 370. Rwanda has

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fulfilled the Abuja declaration of allocating 15% of the government budget to health and has an almost universal healthcare system, with approximately 90% coverage— the vast majority (84%) are covered through public insurance as of June 2017 (Republic of Rwanda, Ministry of Health, 2018). Crucially, there are 45,000 community health workers (CHW) who operate out of hundreds of decentralized health centers and health posts, providing the population access to the health system in their communities. The CHW are critical to providing equitable access to the healthcare system, and they are elected at community gatherings by members of their own villages. The CHW perform several functions in maternal health, primary care for malaria, pneumonia, diarrhea, family planning, and immunization. CHW visit people’s homes and answer questions, using a holistic approach to build trust with local communities. As one CHW reports: “in our village, we do monthly cooking demonstrations. Every woman contributes 100 francs [USD $0.03] at each gathering and brings other food items . . . we teach them how to make healthy meals. . . This has helped to enhance our role in the community.” They are key to the country’s high rates of success in curing tuberculosis and keeping people with AIDS on antiretroviral drugs. Rwanda’s response to COVID-19 more broadly has reflected this expertise gained from handling the Ebola crisis, a range of infectious diseases including treating HIV/AIDS, tuberculosis, and malaria, among others. For example, in 2018, when Rwanda saw cases of Ebola escalate across the border in neighboring DRC, “Rwanda took a proactive approach by sending a team of health professionals to study Ebola in the neighboring town of Goma. They went to learn about Ebola transmission and developed mitigation strategies,” explained Dr. Sabin Nsanzimana, director general of the Rwanda Biomedical Centre.1 No cases of Ebola were recorded in Rwanda.

17.4.2 Community Support Taking cues from its Ebola response, Rwanda was the first African nation to implement full lockdown a week after its first case was reported in March 2020. A major factor that made the system in Rwanda effective in comparison to the rest of Africa was that Rwanda had: . . .formulated a social protective plan for the delivery of free food to at least 20,000 households in the capital Kigali . . . The door-to-door delivery is meant to mitigate the impact of a lockdown implemented on March 21 by the government, aimed at limiting the spread of the Covid-19 pandemic. (AUDA-NEPAD, 2020)

Announcing the social protective plan, President Kagame noted, “we know that this is not an easy period for most Rwandans, whose livelihoods have been interrupted across the country. But we ask you to be patient. Although we are 1

Faustin Gasaza, personal communication, October 20, 2020.

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making good progress, we cannot afford to relax yet” (Kagire, 2020). Food distribution was facilitated through Ubudehe, a socio-economic stratification system whereby poor Rwandans are supported with social protection schemes. Bethany Hedt, a statistician at Harvard Medical School, has worked in Rwanda for the past decade. She noted that, in 2020, the low-income country reported only around 100 deaths from COVID-19 out of a population of 13 million: It’s clear to me, at least, that [the low death-rate has been achieved] because the government had very clear and decisive control measures . . . When news of COVID hit, they imposed a strict curfew, and the Rwandan population really listened. There was limited travel outside the home without documentation. The police would stop you and check. Schools were closed. There were no weddings or funerals. And then, as the numbers decreased, the government played a very good game of whack-a-mole. They have a really strong data center, and anywhere they see an outbreak they do strict control at the local level.2

Cross-border movement was identified as a significant risk to Ebola transmission, and during the Ebola crisis of 2019, borders and nonessential business were closed, alongside the imposition of restrictions on nonessential travel between cities and public transportation.

17.5

Implementing a Cross-Sectoral Collaborative Approach

In the case of Ebola, once the World Health Organization issued an Ebola alert, the Rwandan Ministry of Health (MOH) activated the National Rapid Response Team, a task force established to deal with the crisis. The task force reflects the collaboration of the government through the MOH with the Rwanda Bio-Medical Centre, the Rwanda Centre for Disease Control (CDC), and internationally, the WHO and Rwanda Red Cross Society (IFC, 2019). With this task force in place, Rwanda implemented a National Preparedness Plan that included border screening, the training of healthcare workers in disease detection, a communications strategy, a vaccination strategy, ensured health facilities were equipped, and used simulation and scenario planning to prepare for uncertainty. The Ebola Treatment Center was also set up and strategies for self-isolation were established in areas of high priority (Lindmeier, 2019). On March 3, 2020, Rwanda set up a national COVID-19 Task Force to coordinate the implementation of a preparedness and response plan just in time for the first case. The task force was led by the Prime Minister and convened a multidisciplinary team, drawing on their joint expertise to assess Rwanda’s preparedness and strengthen the national response to the pandemic. Some 500 professionals from a range of sectors were tasked with coordinating activities to contain the coronavirus. The crisis was

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https://www.newyorker.com/magazine/2021/03/01/why-does-the-pandemic-seem-to-be-hittingsome-countries-harder-than-others

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framed as a war that everyone had a duty to fight: “there are many sectors involved, the leadership is highly supportive of the action. So, when you see for example medical professionals, police, army, and other partners, they are all working together in a coordinated manner” (Tasamba, 2020a, 2020b). Rwanda was able to draw on the expertise of some key health institutions, notably the Rwanda Biomedical Center (RBC). The RBC, the most prestigious medical body in the country, was created in 2011 through a merger of 14 key health institutions and implements the healthcare policies and programs of the MOH. The RBC is primarily responsible for conducting scientific research, providing diagnostic services, and implementing innovative health interventions to protect the nation against diseases and other health threats.

17.5.1 Border Screening and Controls In the summer of 2019, during the Ebola epidemic, the government installed thermal cameras at high-risk entry points to reinforce Ebola surveillance (Xinhua, 2019). Similarly, during COVID, the government has continued to follow this protocol and has swiftly installed thermal imaging cameras to screen people arriving through land and air borders. Rwanda closed the borders between neighboring countries for the movement of people, but importantly put in place measures to allow the facilitation of trade. Prior experience had shown that transport workers were an important source of infectious disease spreading—therefore, protocols were implemented specifically geared toward these workers. Specific clearance guidance was issued on the Rwanda trade information portal, including the implementation of an online system for clearance of paperwork that avoided physical contact, thus enabling work from home for many workers while trade continued (Uwamariya, 2020). However, despite these measures, Rwanda experienced a sharp increase in COVID-19 cases from cross-border truck drivers delivering essential goods resulting in development of detailed protocols for preventing transmission and for testing cargo transport workers at the borders (Uwamariya, 2020). Specifically, in mid-2020, a one-stop clearance and facilitation station was established at Kiyanzi Dry Port to pull together all the various agencies required to facilitate trade in one location while also putting in place specific protocols for truck drivers: Drivers are tested for Covid-19 at the border, they are provided with facemasks and briefed about the sanitary measures such as practicing social distancing and washing hands, then they proceed to clear their goods at the newly established Kiyanzi station where their trucks are decontaminated by a team from the Rwanda Biomedical Center (RBC) and then proceeded to offload cargo at the warehousing facilities. Trucks carrying relief goods, transit goods, fuel and perishable goods are expedited, and escorted up to the final destination free of charge. This is to make sure that truck drivers only stop at designated points to minimize the risks of physical contact with the community along

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the routes. This is in line with the EAC joint statement that stipulates that truck drivers should only stop at designated stop overs (Uwamariya, 2020).

Since these measures were put in place, there has been a significant decrease in cases of COVID-19 traceable to truck drivers (Uwamariya, 2020). Moreover, given that Rwanda also has significant experience testing HIV/AIDS patients, much of the medical infrastructure was already available: “the main machines we are using for COVID testing are the HIV machines that were (already) there. We are using the same structure, same people, same infrastructure and laboratory diagnostics, but applying it to COVID testing” (Beaubien, 2020).

17.5.2 Contact Trancing By mid-March 2020, Rwanda had set up a contact tracing system and implemented testing for all staff policing border areas, as well as those working in public spaces, such as banks and bars. By the end of April 2020, 29,395 citizens had been tested for COVID-19, with prevalence at 0.7%. The nation’s community health network has enabled the government—with help from the private sector—to identify communities in need of extra support. “I graduated from medical school at the end of the year and in March I was appointed to support the healthcare team that was fighting the virus spread in the country,” says Dr. Fred Gisa, a general practitioner. “My first assignment,” he continues, “was at the Kigali International Airport, interviewing people who arrived in the country, administering COVID-19 tests and examining the results. Towards the end of March 2020, I was assigned to join the Rwanda Biomedical Centre team to do a ‘contact and tracing’, using mobile phones. We worked closely with people who work in the sex trade industry and used their phone contacts by tracing customers they had been in contact with. The information was kept confidential and only used the number to notify customers that they might have been infected with the coronavirus.”3 The nation’s community health network has enabled the government, with help from the private sector, to identify populations in need of extra support. As Dr. Gisa explained: We worked very closely with women who worked in the sex industry. Those who tested positive, we asked them to share with us telephone numbers of their clients. We followed up with the clients to notify them that they might have been infected with the coronavirus. This was carried out privately with no one else knowing. The objective was to control the spread of the virus, not law enforcement.4

This practice helped the government control the spread of the virus. Meanwhile, testing continued both in the capital city of Kigali and across the country. Rwanda 3 4

Dr Fred Gisa, personal communication, October 10, 2020. Dr Fred Gisa, personal communication, October 10, 2020.

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has identified contact tracing as a critical step to reducing contamination within its communities. Contact tracing is a critical part of controlling the spread of the coronavirus. In Rwanda, contact tracing involves: A COVID-19 sample [being] collected and analyzed at identified satellite sample collection sites. The results may take up to 6hrs. If the test is positive, the individual is placed in isolation of the index case. Process of contact tracing in country: Step 1—COVID-19 case investigators identify all clinical. Step 2—Use of memory history to recall all possible contacts during the window period, (2 days to 14 days). Step 3—Development of a roster of close contact and anyone who was in touch with the index case within the period of time and space (within 1 m). Step 4—An active contact follow-up is therefore initiated by the command post to monitor on daily basis, any sign leading to possible. This step includes also communicating to household members any progress of the index case and the plan for screening all rosters identified in step (2). Completion of step 4 with travel history to rule out any additional contact during travel history.5

17.5.3 Pool Testing The ability to test every citizen for the coronavirus amidst supply shortages is a challenge shared by every country. However, researchers in Rwanda have created pool testing in response, an innovative approach: “instead of testing every person— which would require millions of tests—[Rwanda has] turned to a different strategy: pooled testing, a strategy that efficiently tests in region of low virus incidence” (Mutesa, 2020). “[Rwanda is] using an algorithm to refine the process of pooled testing” (Ssuuna, 2020). This method tests batches of people at the same time, which provides significant cost savings, reduces turnaround time, catches asymptomatic people earlier, thus providing a quicker picture of the trajectory of the disease (Mutesa, 2020). Although pool testing has been around for some time, the novel algorithm for COVID-19 was developed by Wilfred Ndifon, a mathematical epidemiologist who is director of research at the African Institute for the Mathematical Sciences Global Network in Rwanda. The process requires normal laboratory work, but the algorithm is essential for saving resources since it can calculate batches of people—between 20 and 50—with an extremely low failure rate of 0.001%. Laboratories test on a 24/7 basis and have added a few drive-through mass-testing sites (Ssuuna, 2020). The key has been to test every potential COVID-19 case. In addition to setting up drive-in testing sessions, people can be tested randomly as they walk in the neighborhood. Across the continent, we hear allegations of countries faking their test record. So, how does Rwanda ensure accuracy of testing? Faustin Gasaza, Ambassador at Abbott in Rwanda, explains, “when someone is tested, authorities who are in charge of administering the test come to visit the person tested with the results,

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Dr. Fred Gisa, personal communication, October 10, 2020.

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positive or negative. This record is kept for future cross reference and evaluation. There is no incentive to fake the results.”

17.5.4 Mass Mobilization Beyond building trust between the government and the population, a major challenge remains: how do you explain complex information, such as the infectivity of COVID-19, to the population, so that citizens will understand and support the requisite public health measures? Similarly, how do you manage any conspiracy theories that arise? Drawing on their experience with Ebola (UNICEF, 2019), Rwanda prepared a detailed COVID-19 standard operating procedure document (SOS) and a Risk Communication and Community Engagement team was created to provide coordinated COVID-19 information. The purpose of the team is thus to foster confidence and mitigate misinformation (Republic of Rwanda, Ministry of Health, 2020). The SOS detailed proactive engagement and communication strategies for informing the public, as well as a disinformation mitigation strategy. With these strategies in place, ongoing communications have utilized a diverse range of approaches (Rwanda Biomedical Centre, 2020). While the government has used the traditional media—e.g., television and radio—social media has also played a significant role, with official daily updates released on Twitter, often by the Prime Minister. The government has mobilized the public through a decentralized system of communications, beginning at the level of individual villages, including through schools, health centers, and service providers—and through community influencers including religious authorities, the CHW, and alternative medicine providers. CHW were integral both because of their knowledge and the trust they had built in their communities over the years. A toll-free hotline was also put in place so that Rwandans could access information and contact health authorities, alongside a national WhatsApp number. Clear community guidelines and proactive strategies were put in place to identify and address possible miscommunication and develop trust in official communications. Misinformation was promptly corrected on Twitter.6 Guidelines indicated that spokespeople and media relations were to refrain from lying to the media, refrain from saying “no comment,” and indeed, that there were to be no “off the record” comments. Moreover, there has been a stated commitment to provide prompt responses without speculating and to remain calm (Ministry of Health, 2020, p. 37). Proactive strategies for managing misinformation and rumors have included monitoring public perceptions and misinformation and the preparation of a rumor mitigation strategy along with relevant guidelines and a monitoring tool to assess and monitor potentially misleading rumors.

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https://twitter.com/UrugwiroVillage/status/1370008076489789440

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Initially, the police and local defense agents were tasked to ensure that the population was following the COVID-19 protocols. Following complaints of excessive force, however, the government pivoted its public engagement approach to recruiting youth volunteers: Youth are trained by the national police on large crowd management, ethics and discipline on how best to contribute to public order. The youth volunteers work under the aegis of the City of Kigali with work jackets, face masks, and are facilitated with resources for food, communication and transport. (Rwanda National Police, 2020)

In explaining the impact, Damascene Irakoze, a Kigali resident, said the volunteers’ work has amplified guidelines about the virus: Those volunteers explain health guidelines politely and in a language everybody understands. Their message is perfect reminder even to those who don’t have time to listen to radio or follow through other media platforms. It would be out of ignorance to waste time arguing with them. (Tasamba, 2020a, 2020b)

17.6

Technology and Innovation

17.6.1 Internet and Mobile Connectivity In its Vision 2020 document, the Rwandan government saw technology as an economic tool and thus invested in fiber optic Internet connectivity, further allowing for mass mobilization in response to COVID-19. Rwandan government data indicates that more than 90% of populated areas have broadband coverage and 60% of the population has access to an internet subscription (RURA, 2021). External sources, however, report much lower levels, with only 31.4% accessing broadband, but mobile connections are estimated to be at 74% (Digital 2021: Rwanda, 2021). Social media statistics indicate that 41.73%, 38.5%, 13.3% of the population use Facebook, Twitter, and Pinterest, respectively (Statcounter, 2021). Although Rwanda has download speeds that put it in the mid-range relative to other countries, heavy Internet usage during COVID-19 has put significant pressure on the system, which has resulted in lower speeds (Freedom House, 2020). Rwanda was the first African country to manufacture smartphones, manufacturing The Mara X (Uwiringiyimana, 2019).

17.6.2 Drones In 2017, Rwanda became the first country in the world to use drones to deliver blood and other essential medical supplies, the result of a collaboration between the Silicon Valley company, Zipline, and the Rwandan government (The New Times, 2017). Since then, drones have been used in different sectors including larvicide spraying,

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facilitating the distribution of medicines for chronic patients during lockdown, assessing the topography in agriculture, and taking pictures to promote tourism to the country (Mbabazi, 2021). During the pandemic, the directives to stay at home, wash one’s hands, wear a mask, and respect physical distancing were unheeded by some citizens owing to a lack of access from community awareness teams and their messages. As time went on, the police began to use drones to broadcast relevant information to remote communities. These were deployed to complement communications via radio, television, health workers, and other community leaders by bringing educational messages directly to residents through engagement by air. But not only were the drones used to spread messages, they were also equipped with cameras. The recorded footage allowed law enforcement officers and local authorities to closely monitor areas, which required intervention or evacuation. Without such methods, it would have taken much longer to identify such cases and organize accordingly (ADF, 2020).

17.6.3 Robots To reduce the risk for healthcare practitioners who interact with infectious patients on a daily basis, the Rwandan government partnered with UNDP and Belgium to procure five robots to administer tests, collect data and serve food and medicine (Duncan, 2020). “We tend to imagine robots as a tool for the future but to the contrary, we have access to the technology right now. We should use it to meet our needs, today,” explained Dr. Nsanzimana of the Rwanda Biomedical Centre. “The robots we acquired through UNDP have helped us ease the stress to our medical staff. The good thing is that opening this technology to students in elementary school will unleash new solutions to meet the challenges of tomorrow.”7 Given the success of this program, the Rwandan government has acquired three more robots to disinfect treatment centers: “each of the disinfectant robots can disinfect up to 15 rooms over an eight-hour shift. According to the ministry, they are expected to improve infection prevention control in treatment centers and other areas due to their speed and efficiency” (Tasamba, 2021).

17.7

Lessons Learned: COVID-19 Strategy

Looking back on the recent history of Rwanda, particularly the complete collapse of its society amidst a devastating genocide against the Tutsis some 27 years ago, this success in the face of the pandemic can only be celebrated as a remarkable

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Dr. Fabien Nsanzimana, personal communication, June 22, 2020.

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achievement. This small landlocked African country led the world in demonstrating an effective strategy against COVID-19. Of course, this did not emerge out of nowhere, but was built on the work of strengthening institutions and social cohesion over the past three decades. Rwanda’s preparation for COVID-19 started well before the pandemic actually hit. Rwanda has significantly invested in improving its healthcare system—and this has been critical to its success. The country parlayed its experience from controlling other infectious diseases into a preparedness strategy that was successfully deployed. With a robust public health system that includes universal healthcare, the government conducted a massive public health sensitization campaign. It also provided public washing stations with water and soap, enforced wearing face masks, put in place social distancing protocols and conducted a massive test-and-trace operation. Such positive results have made Rwanda a model that other sub-Saharan African countries emulate. According to the World Health Organization, “investment in emergency preparedness and health system strengthening has helped Rwanda confront the COVID19 crisis effectively, control the emergence of the virus and protect the health of its population. All-of-government collaboration, led by the country’s president, and adherence to WHO guidance and the fundamentals of outbreak control, from testing and contact tracing to wide use of public health measures, have been the hallmarks of Rwanda’s response” (World Health Organization, 2020). Rwanda responded to its earliest cases with a swift implementation of a lockdown, including at its borders, and also quickly put in place measures to support compliance. Food support for the poor, border controls, testing and contact racing were all critical elements. Although massive investment has been required—estimated at 3.3% of GDP (IMF, 2020)—all of these efforts were supported by a mass mobilization campaign with credible transparent information and proactively mitigating misinformation. The Rwandan government’s embrace of technology from pool testing to using drones and robots has also shown the value of combining traditional approaches with the use of technology. However, perhaps the most critical factor was trust in the Kagame government. As Claire Akamanzi, CEO of the Rwanda Development Board, said in an interview with CNN on July 20, 2020, the three key interventions that have made Rwanda successful against containing the coronavirus were “1) utilizing the trust that the government has built with the population on previous community engagement in promoting best cases against the spread of malaria and HIV/AIDS. The population trust that the government has their best interest at heart. 2) Increasing our contact tracing capacity, using the infrastructure we have across the country. We have built a contract-testing system of over 190,000 staff, who trace contacts all over the country. 3) Increase testing. We started testing 300 persons a day and now we are testing more than 5,000 a day.” Community engagement, involvement, and commitment—as shown in the mass involvement of youths volunteering and the guidance provided by community leaders—were all critical to Rwanda’s success. The networks of support from CHW in a decentralized healthcare strategy were able to galvanize the community

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and provide support that was trusted at the community level, essential for a country with a large rural population. Rwanda’s ability to curb the pandemic also bodes well for the country’s postpandemic recovery, indicating the importance of pandemic strategy for economic recovery. As Sabiiti writes: “[according] to the outlook report Rwanda which had a 0.2% growth in 2020 will recover to a 5.7% this year and 6.8% which is relatively close to the earlier 8% growth before the pandemic” (Sabiiti, 2021a, 2021b).

17.8

Framing the Shultz et al. Framework in the Rwanda Setting

In the Shultz et al. framework, macro-factors are seen as foundational for communities to flourish. Despite limited absolute levels in almost all the macro-factors identified, Rwanda was still able to mobilize the resources they do have available. What stands out as a critical factor, and why their success was achievable, appears to be the trust that has been built up between the citizenry and the government. What is clear is that despite relative poverty and limited resources, Rwanda was able to accomplish what even wealthy countries could not. Certainly, in the case of COVID19, the absolute levels of the relevant macro-factors appear to be far less important than the way in which these were mobilized and the support these measures received from the public. Rwanda has seen remarkable progress and has been referred to as “the most significant example of human development of the past 20 years”. Alongside international praise, however, President Paul Kagame has simultaneously been criticized for being “among Africa’s most repressive leaders”, who operates a country that has been used as an example of “developmental authoritarianism”—that is, “[a] nominally democratic [government] that provide[s] significant public works and services while exerting control over nearly every facet of society.” What the Kagame government has achieved is political stability and this has paved the way for long-term economic development programs. The country could not have achieved what it achieved in the last 27 years had it remained politically unstable. The same cannot be said for its southern neighbor. On the eve of the global COVID-19 outbreak, Burundi was struggling to manage a three-pronged crisis: (1) a political nightmare in the midst of a presidential election, (2) refugees disbursing to all neighboring countries, and (3) a major public health crisis exacerbated by the global pandemic. Under these circumstances, it was virtually impossible for Burundi to formulate a unified national strategy to mitigate the onslaught of a virus that does not discriminate on the basis of color, gender, creed, economic standing, or nationality. While Rwanda was putting in place a well-coordinated strategy, other neighbors and countries around the world resorted to misinformation. Our case study indicates that Rwanda’s catalytic institutions and collaboration were indeed crucial in helping to explain its success in curbing the COVID-19

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pandemic. However, what our case study also reveals is that the catalytic institutions in Rwanda may have been effective for reasons that would not be predicted by the framework. For example, the Kagame government’s hold on the economy and levers of power do not support the traditional definition of democratic governments. Yet it was indeed this ability to harness all levers of government and to achieve both citizen and cross-sector compliance that helped Rwanda succeed in curbing the pandemic’s worst effects. Likewise, it would have been difficult to predict that a society that had experienced such disintegration would be able to create the kind of social support necessary to comply with the common good and public health orders that were required. Therefore, the COVID-19 pandemic compels us to ask a difficult question: should the right of the individual precede the right of the collective during a major world crisis? Rwanda’s successes shed light on the ways in which its government has been able to draw on its intentional investment in building its healthcare infrastructure. In particular, Rwanda has been able to draw on culturally specific, Afrocentric approaches that had already been tested in prior situations, such as the Ebola outbreak in the region. Its ability to quickly communicate with its citizens, combined with citizens’ own readiness to cooperate with public service announcements, has also had a significant impact. Finally, Rwanda was able to combine traditional approaches with high-tech solutions efficiently and effectively, based on relationships within Rwanda and across the international community. The conclusion from Shultz et al. that, “flourishing communities have wellfunctioning marketing systems that have legal and accounting transparencies, with traceable behaviors” (2017, p. 414) could not be supported in the context of Rwanda’s COVID achievements. Rwanda can by no means be seen as having a “well-functioning market system.” Yet, within the context of COVID-19, it is hard not to conclude that Rwanda is a flourishing society. Consequently, Rwanda’s success challenges the idea that the marketplace is a critical factor in a flourishing society. In fact, what the Rwandan case instead suggests, is that consistent with decoloniality’s emphasis, social cohesion, harmony, and a deep commitment to and trust in one’s community and institutions are instead what is critical. Flourishing can exist despite deep hardships.

17.9

Decoloniality, Postcoloniality, and the Discourse Surrounding COVID-19

Perhaps there are two more issues that we need to consider in the context of flourishing and community well-being. Firstly, the instinctive approach taken by international organizations and so-called “developed countries,” to draw on modernist notions to essentialize and homogenize the African continent, without recognizing variations across countries, means that there was no serious attempt to understand the unique differences in Africa. Traditionally, when major pandemics

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such as smallpox, tuberculosis, HIV/AIDS, and Ebola exploded, the world was accustomed to turning eyes to industrialized countries to lead the way. So-called “developing nations” took note and learned from their best practices. The second was to underestimate the strengths of the specific healthcare systems of African countries and other institutional and macro-environmental factors. This is consistent with the longstanding tendencies to value and privilege the approach of developed Western countries and underestimate the strength, capacity, and assets that non-Western and underdeveloped countries—particularly African countries— possess. As Shahjahan puts it: “[the] Eurocentric version of modernity, fashioned from the imperial history of Europe, in fact, relies on silencing this darker narrative of coloniality. The triumphal March of modernity necessitates the eradication of non-European modes of life, economy, and political organization, in the name of developing capitalist economy and market democracy.” This case lay’s bare the danger of this approach.

17.10

A Final Update

By February 2021, Rwandans had been under strict lockdown for 11 months straight. Public health protocol measures were slightly relaxed and international visitors were again welcomed to Rwanda, to participate in a series of international competitions; the African Basketball League tournament, tour du Rwanda Cycling competition, and weddings were allowed to take place as positive cases numbers swelled. In May, the Nyirangongo Volcano erupted in the nearest Democratic Republic of Congo and Rwanda opened its borders and allowed in hundreds of Congolese in distress who were tested and provided with personal protective equipment and accommodations (Ilunga, 2021). These factors exacerbated by the arrival of highly infectious delta variant of COVID-19 resulted in a substantial increase in infections and death with Rwanda reporting an average of 913 new infections each day, representing 65% of the peak with the highest daily average reported on July 22 and 75,462 infections and 876 coronavirus-related deaths, reported in the country since the pandemic began (Reuters, 2021a, 2021b). These numbers were up from just over 19,000 cases and 265 deaths as of February 2021. As cases of coronavirus continued to rise, the government reinstituted new lockdown measures on July 17, 2021, and implemented its food relief program to vulnerable households in the lockdown areas (OCHA, 2021). Rates have begun declining in response to these measures with the average number of new infections falling to 26% of its previous peak as of August 10, 2021. Rwanda has administered 854,194 vaccines (August 9, 2021), equivalent to only 3.4% of its population being fully vaccinated (World Health Organization, 2021a, 2021b), due to the lack of availability of vaccines. African vaccinations rates remain abysmal, with the region recording the slowest vaccination rate of any continent, with 5.4 doses compared to 90 per 100 people in Europe as of August 9, 2021 (Holder, 2021a, 2021b), given the targeting of

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vaccinations for high-income countries and amid calls for vaccinations to be manufactured on the continent to serve the needs of Africans. President Kagame challenged the international community to level the playing field and allow Africa to make its own vaccines: “The African continent has to be an equal partner with the rest of the world when it comes to manufacturing vaccines instead of waiting for them from other places where they are currently being manufactured.” (Ashimwe, 2021). Rwanda is being considered, along South Africa and Senegal as three key African countries where a regional vaccine manufacturing hub could be set up. South Africa recently reached agreement for a regional manufacturing hub to boost vaccine production (World Health Organization, 2021a, 2021b).

References ADF. (2020, September 30). Rwandan drones take to air with COVID-19 messages. Retrieved from adf-magazine.com: https://adf-magazine.com/2020/09/rwandan-drones-take-to-air-with-covid19-messages/ Ashimwe, E. (2021, June 21). Kagame calls for Africa to be equal partner in vaccine making. Retrieved August 10, 2021, from The New Times: https://allafrica.com/view/group/main/main/ id/00078460.html AUDA-NEPAD. (2020, April 20). Rwanda to deliver free food to 20 000 households during coronavirus lockdown. Retrieved from nepad.org: https://www.nepad.org/news/rwandadeliver-free-food-20-000-households-during-coronavirus-lockdown#:~:text¼Rwanda%20has %20formulated%20a%20social,of%20the%20Covid%2D19%20pandemic Beaubien, J. (2020, July 15). Why Rwanda is doing better than Ohio when it comes to controlling COVID-19. Retrieved from npr.org: https://www.npr.org/sections/goatsandsoda/2020/07/15/ 889802561/a-covid-19-success-story-in-rwanda-free-testing-robot-caregivers Digital 2021: Rwanda. (2021, April 30). Retrieved from https://datareportal.com: https:// datareportal.com/reports/digital-2021-rwanda Duncan, M. (2020, June 5). Rwandan medical workers deploy robots to minimise coronavirus risk. Retrieved from weforum.org: https://www.weforum.org/agenda/2020/06/rwandan-medicalworkers-robots-coronavirus-covid19-risk/ European Council. (2020, June 30). Council agrees to start lifting travel restrictions for residents of some third countries. Retrieved from consilium.europa.: https://www.consilium.europa.eu/en/ press/press-releases/2020/06/30/council-agrees-to-start-lifting-travel-restrictions-for-residentsof-some-third-countries/ Freedom House. (2020, May 31). Freedom on the Net 2020. Retrieved from freedomhouse.org: https://freedomhouse.org/country/rwanda/freedom-net/2020 Holder, J. (2021a, April 29). Tracking coronavirus vaccinations around the World. Retrieved from nytimes.com: https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker. html Holder, J. (2021b, August 10). Tracking coronavirus vaccinations around the world. Retrieved August 10, 2021, from New York Times: https://www.nytimes.com/interactive/2021/world/ covid-vaccinations-tracker.html IFC. (2019, September 27). Emergency plan of action final report. Ebola Preparedness. Retrieved from reliefweb.int: https://reliefweb.int/sites/reliefweb.int/files/resources/MDRRW01 7dfr_0.pdf Ilunga, P. (2021, May 23). Congo-Kinshasa: Rwanda opens borders to hundreds fleeing DRC volcanic eruption. Retrieved from Allafrica.com: https://allafrica.com/stories/202105230003. html

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IMF. (2020, October). IMF country report no. 20/285. Retrieved from imf.org: https://www.imf. org/~/media/Files/Publications/CR/2020/English/1RWAEA2020004.ashx Kagire, E. (2020, March 29). Rwanda: How COVID-19 relief distribution will work. Retrieved from ktpress: https://www.ktpress.rw/2020/03/rwanda-how-covid-19-relief-distribution-will-work/ Lindmeier, C. (2019, July 24). WHO applauds Rwanda’s Ebola preparedness efforts. Retrieved from who.int: https://www.who.int/news/item/24-07-2019-who-applauds-rwanda-s-ebola-pre paredness-efforts Lowy Institute. (2021, March). Covid performance index. Retrieved from Lawyinstitute.org: https:// interactives.lowyinstitute.org/features/covid-performance/ Mbabazi, D. (2021, April 26). How drones are fighting Rwanda’s war on malaria. Retrieved from newtimes.co.rw: https://www.newtimes.co.rw/news/how-drones-are-fighting-rwandas-warmalaria Ministry of Health. (2020, March). Standard operating procedure for preparedness and response to coronavirus disease (Covid 19) outbreak. Retrieved from rbc.gov.rw: https://rbc.gov.rw/ fileadmin/user_upload/annoucement/SOP%20for%20preparedness%20and%20response%20to %20Covid-19.pdf Mutesa, L. (2020, July 2). Rwanda’s COVID-19 pool testing: A savvy option where there’s low viral prevalence. Retrieved from theconversation.com: https://theconversation.com/rwandascovid-19-pool-testing-a-savvy-option-where-theres-low-viral-prevalence-141704 Nsanzabera, J. (2018, December 10). Waguke Imyumvire (C. Barore, Interviewer). OCHA. (2021, July 31). Rwanda key message update: Reinstated COVID-19 restrictions reducing incomes for poor urban households. Retrieved August 10, 2021, from Reliefweb: https:// reliefweb.int/report/rwanda/rwanda-key-message-update-reinstated-covid-19-restrictions-reduc ing-incomes-poor-urban Republic of Rwanda, Ministry of Health. (2018). Fourth health sector strategic plan. Retrieved from npgti.com: http://npngti.com/wp-content/uploads/2018/06/Rwanda_Nat-Health-SectorPlan_2018-2024.pdf Republic of Rwanda, Ministry of Health. (2020). Coronavirus disease 2019, national preparedness and response plan. Republic of Rwanda, Ministry of Health. Retrieved from moh.gov.rw: https://moh.gov.rw/fileadmin/user_upload/Publication/Coronavirus%20Disease%202019%2C %20National%20Preparedness%20and%20Response%20Plan.pdf Reuters. (2021a, August 19). Reuters covid tracker. Retrieved from Reuters.com: https://graphics. reuters.com/world-coronavirus-tracker-and-maps/countries-and-territories/rwanda/ Reuters. (2021b, March 5). Rwanda becomes first African nation to use Pfizer COVID-19 vaccine. Retrieved from usnews.com: https://www.usnews.com/news/world/articles/2021-03-05/ rwanda-becomes-first-african-nation-to-use-pfizer-covid-19-vaccine RURA. (2021). Annual report 2019-2020. Retrieved from rura.rw: https://rura.rw/fileadmin/docs/ report/RURA_ANNUAL_REPORT_2019-2020.pdf Rwanda Biomedical Centre. (2020). Standard operating Procedure for preparedness and response to Covid-19. Rwanda Ministry of Health. Rwanda Media Barometer. (2019). Retrieved from rgb.rw: https://rgb.rw/fileadmin/Publications/ Rwanda_Media_Balometer-all/RWANDA_MEDIA_BAROMETER_2018.pdf Rwanda National Police. (2020, May 15). COVID-19: Youth volunteers in mass campaign against Coronavirus. Retrieved from police.gov.rw: https://police.gov.rw/media-archives/news-detail/? tx_news_pi1%5Bnews%5D¼15150&cHash¼e335ddbc17f8d8b4ff717322528b2701 Sabiiti, D. (2021a, April 26). Rwanda among countries in good economic recovery trend—IMF report. Retrieved from ktpress.rw: https://www.ktpress.rw/2021/04/rwanda-among-countriesin-good-economic-recovery-trend-imf-report/ Sabiiti, D. (2021b, April 23). Rwanda gets $30 M to boost COVID-19 vaccination plans. Retrieved from ktpress.com: https://www.ktpress.rw/2021/04/rwanda-gets-30-m-to-boost-covid-19-vacci nation-plans/

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Shultz, C., Rahtz, D., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), The handbook of community well-being (pp. 403–422). Springer. Ssuuna, I. (2020, August 13). Limited COVID-19 testing? Researchers in Rwanda have an idea. Retrieved from washingtonpost.com: https://www.washingtonpost.com/world/africa/limitedcovid-19-testing-researchers-in-rwanda-have-an-idea/2020/08/13/288adc4a-dd34-11ea-b4f1-2 5b762cdbbf4_story.html Statcounter. (2021, April). Social media stats in Rwanda. Retrieved from gs.statcounter: https://gs. statcounter.com/social-media-stats/all/rwanda statista. (2021, March 21). Number of coronavirus (COVID-19) deaths in the African continent. Retrieved from statista.com: https://www.statista.com/statistics/1170530/coronavirus-deathsin-africa/ Tasamba, J. (2020a, April 22). Rwanda uses Ebola experience to combat COVID-19. Retrieved from aa.com: https://www.aa.com.tr/en/africa/rwanda-uses-ebola-experience-to-combat-covid19/1813902 Tasamba, J. (2020b, June 6). Rwandan youth volunteers helping fight against COVID-19. Retrieved from aa.com.tr: https://www.aa.com.tr/en/africa/rwandan-youth-volunteers-helping-fightagainst-covid-19/1867456 Tasamba, J. (2021, February 9). Rwanda: Robots to disinfect COVID-19 treatment centers. Retrieved from aa.com.tr: https://www.aa.com.tr/en/africa/rwanda-robots-to-disinfect-covid-1 9-treatment-centers/2139445 The Economist Intelligence Unit. (2021). Democracy index 2020 in sickness and in health? Retrieved from eiu.com: https://www.eiu.com/n/campaigns/democracy-index-2020/#:~: text¼Democracy%20Index%202020%3A%20In%20sickness,lives%20from%20a%20novel% 20coronavirus The Heritage Foundation. (2021, May). heritage.org. Retrieved from 2021 Index of Economic Freedom: https://www.heritage.org/index/ranking The New Times. (2017, September 7). Rwanda’s Medical Drone Delivery System wins prestigious global award. Retrieved from newtimes.co: https://www.newtimes.co.rw/section/read/219147 UNICEF. (2019, September 20). unicef.org. Retrieved from UNICEF Rwanda Ebola Situation Report: https://www.unicef.org/rwanda/sites/unicef.org.rwanda/files/2019-09/Ebola-SitRepUNICEF-Rwanda-Sept-2019.pdf Uwamariya, R. P. (2020, September 21). Managing trade Facilitation in pandemic times: The experience of Rwanda at the Kiyanzi Dry Port. Retrieved from unctad.org: https://unctad.org/ news/managing-trade-facilitation-pandemic-times-experience-rwanda-kiyanzi-dry-port Uwiringiyimana, C. (2019, October 7). Rwanda launches first ‘Made in Africa’ smartphones. Retrieved from reuters.com: https://www.reuters.com/article/us-rwanda-telecoms-idUSKBN1 WM1TN World Bank. (2020, July 30). The World Bank in Rwanda. Retrieved from worldbank.org: https:// www.worldbank.org/en/country/rwanda/overview World Economic Forum. (2020). Global gender gap report 2020. Retrieved from weforum.org: https://www.weforum.org/reports/gender-gap-2020-report-100-years-pay-equality World Health Organization. (2020, October 25). World Health Organization on Twitter. Retrieved from twitter.com: https://twitter.com/WHO/status/1320462338550628353 World Health Organization. (2021a, August 10). New consortium working to boost vaccine production in South Africa. Retrieved August 10, 2021, from Reliefweb: https://www.who. int/news/item/30-07-2021-new-consortium-working-to-boost-vaccine-production-in-southafrica World Health Organization. (2021b, August 10). World health emergency dashboard. Retrieved August 10, 2021, from https://covid19.who.int/region/: https://covid19.who.int/region/afro/ country/rw World Health Organization Africa. (2020, May 7). New WHO estimates: Up to 190 000 people could die of COVID-19 in Africa if not controlled. Retrieved from afro.who.int: https://www. afro.who.int/news/new-who-estimates-190-000-people-could-die-covid-19-africa-if-notcontrolled

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Xinhua. (2019, July 30). Rwanda installs thermal cameras at entry points for Ebola surveillance. Retrieved from xinhuanet.com: http://www.xinhuanet.com/english/2019-07/31/c_138270 578.htm

June N. P. Francis (LLB, MBA, Ph.D.) is the Co-Founder of The Co-Laboratorio Project, Director of the Institute for Diaspora Research and Engagement (IDRE) at Simon Fraser University where she also serves as a Special Advisor to the President on Anti-racism and is an Associate Professor in the Beedie School of Business (Beedie). She Chairs The Hogan’s Alley Society’s Board of Directors, a non-profit whose mission is to advance the well-being of people of African Descent. Her research and practice focus on diversity, interculturality, leadership, non-traditional intellectual property law and anti-racist and decolonial practices. June’s contributions have been recognized by Beedie, the Province of British Columbia, The National Congress of Black Women, The City of Vancouver, and she received the 2021 Rosemary Brown Award for work on gender equality. June advises nationally and internationally on racial equity initiatives and is a thought leader, giving frequent public and media appearances. Lama Mugabo , BA, MA, Chair, Building Bridges with Rwanda (BBR), holds a BA in Communications (SFU) and MA in Community and Regional Planning (UBC). A Community Planner with a passion for sustainable development in Rwanda, Lama is the founding director of Building Bridges with Rwanda (BBR); a non-profit organization that creates a platform for collaboration between international volunteers and Rwandan counterparts who are rebuilding their society after the 1994 genocide. Lama led the Gashora Integrated Community Development initiative that hosted 500+ international volunteers from eight different nations. International volunteers and Rwandans worked on food security, nutrition and wellness activities. In 2019, BBR joined hands with Simon Fraser University’s Institute for Diaspora Research and Engagement (IDRE), to launch the Remember Rwanda 25 Legacy Project, designed to engage audiences in gaining a deeper understanding of Rwanda development model. Lama is a frequent speaker on social and economic justice issues in the media.

Chapter 18

COVID-19 Pandemic, Catalytic Institutions, and Consumer Well-Being: Evidence from Russia Alexander Krasnikov, Vera Rebiazina, and Svetlana Berezka

Abstract The purpose of this chapter is to examine changes in the well-being of Russian consumers, caused by the COVID-19 pandemic. Building upon both micromarketing and macromarketing perspectives, the authors identify key topics in studies of consumer behavior during the worldwide spread of a novel and deadly coronavirus and examine changes in behaviors in relation to individual and community well-being in Russia. These topics are further examined using data collected during the outbreak of COVID-19 to compare changes in individual and community well-being across Russia, Brazil, China, India, and South Africa. Finally, the authors examine how Russian consumers adjust their behaviors during lockdown. The results shed light on changes to consumer behavior patterns caused by global pandemic in a transitional economy, with implications for health-and-well-being management in Russia and potentially other transitional economies distressed by future health crises. Keywords Consumer well-being · Quality-of-life · Consumer behavior · Digital transformation · BRICS · Russia · COVID-19

18.1

Introduction

The purpose of this chapter is to substantiate tenets of the well-being and quality-oflife (QOL) literature by providing evidence of how Russian consumers and catalytic institutions (government authorities, businesses, NGOs, and industry associations) respond to the COVID-19 pandemic. Lacking prior macromarketing research on how marketing systems in Russia and other transitional economies respond to a new A. Krasnikov (*) Marketing Department, Quinlan School of Business, Loyola University of Chicago, Chicago, IL, USA e-mail: [email protected] V. Rebiazina · S. Berezka Marketing Department, Graduate School of Business, HSE University, Moscow, Russia e-mail: [email protected]; [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_18

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and deadly virus, SARS-CoV-2, we aim to provide a thorough analysis of individual and community well-being using QOL indicators at different stages of pandemic in Russia. We draw on the framework that outlines continuum between flourishing and distressed states of communities, groups, societies, and countries (Shultz et al., 2017). The conceptual distinction between these antitheses is rooted in the ability of community to satisfy and fulfill developmental needs of its members (Sirgy, 2011). Obviously, if a community is distressed then it lacks capacity to provide for basic or lower-order needs (health, safety, housing, and environment); its residents will struggle to sustain livelihood and may be adversely affected even by minor mishaps. Alternatively, flourishing communities play a significant role in satisfying basic pre-potent needs and also empower its members to achieve higherorder social, esteem, esthetic, and actualization needs (Sirgy, 2011). The transition between distressed and flourishing states may be described using QOL indicators, which help policy makers develop and assess the impact of programs at various levels ranging from individual and household to regions and societies (Hagerty et al., 2001). However, Shultz et al. (2017) note that QOL indices are quite heterogenous because they capture needs, inputs, throughputs, and outcomes at various levels of analysis using objective or subjective measures. Consequently, we adopt a systemic and systematic approach (Shultz et al., 2017) and apply multiple approaches to discern key QOL variables that describe changes in consumer well-being in Russia during the COVID-19 pandemic. We begin by outlining key turns of events during the pandemic in Russia— starting with the detection of the first case back in January 2020 and rounding up with the announcement of mass vaccination and release of mournful statistics a year later. In doing so, we outline key macro factors that affect catalytic institutions and marketing systems and may explain commonalities in the COVID-19 pandemic responses in other regions and countries. Next, we review how COVID-induced changes in marketing systems push communities towards a distressed state. Third, we adopt scientometric method to identify key topics in studies of consumer reactions to the COVID-19 pandemic and identify several variables that capture changes in individual and community well-being. Fourth, we compare these metrics in Russia, Brazil, China, India, and South Africa, which are commonly used as frame of reference for comparison of policies and performance of the large transitional economies. Such review allows us to understand consumer reactions and changes in QOL at the wake of pandemic. Fifth, we examine the performance of Russian catalytic institutions during pandemic and examine how authorities, businesses, and Non-Government Organizations (NGOs) cooperate and adapt in order to withstand pandemic. Sixth, we use follow-up survey and measure adaptation of Russian consumers at later stages of pandemic and propose potential explanations for observed behaviors based on QOL theory. Finally, we offer recommendations to policy makers on the implementation of QOL-based programs to fight pandemic and restore individual and community well-being in Russia and other transitional economies.

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369

Timeline of the COVID-19 Pandemic in Russia

The first cases of the COVID-19 infection were reported in December 2019 in Wuhan, China, and on March 11, 2020 the World Health Organization (WHO) declared the COVID-19 outbreak as a pandemic (WHO, 2020). In Russia, COVID19 cases were detected for the first time on January 31, 2020, in Chinese citizens visiting the Tyumen region and Zabaykalsky Krai (TASS, 2020). The first case of a Russian citizen infected with COVID-19 was recorded on March 1, 2020—this patient arrived from Italy (Interfax, 2020a). Four days later Sergei Sobyanin, the mayor of Moscow, declared the state of high alert due to the threat of coronavirus disease in Moscow. On March 26, 2020, Moscow mayor’s office declared selfisolation for seniors and high health risk groups. Starting March 30, 2020, 14 largest regions (including Moscow) declared lockdown (Interfax, 2020b). The high alert state was declared due to COVID-19 in all Russian regions, and the government imposed some restrictions on entering the country. Despite that, all Russian regional governments had significant freedom in decisions on the scope and timing of policies based on their estimates of threats. For example, Khabarovsky Krai (bordering China) was the first region to announce protective measures, while Republic of Sakha did not have any confirmed cases until later, due to remote location and control over few gateways connecting Sakha with the rest of country. Table 18.1 reports key statistics on pandemic for the 20 largest Russian regions and intensity of protective measures (e.g., closures, social distancing, work from home, remote learning, stopping transportation) implemented by regional governments. As follows from Table 18.1, the number of policies (and consequently COVID morbidity) varied significantly among Russian regions: the most measures were implemented in St-Petersburg (28), Khanti-Mansy (27), and Stavropol (26); the least in Saratov region (9) (Table 18.1). Overall, Table 18.1 illustrates one major point: the decisions of regional authorities regarding restrictions were determined not only by the spread of disease but also by the level and availability of healthcare in that region. While the largest regions (Moscow and St-Petersburg) had the highest number of diseased (22,003 and 9043), the overall mortality was lower than in less developed but heavily populated Krasnodar Krai (2% mortality in Moscow and 3.9%—in Krasnodar). All universities and colleges in Russia switched to online teaching from March 17, 2020. Furthermore, the Russian Ministry of Education announced 2 weeks of school break to give teachers and school administrations time to transition classes to online teaching, and from April 6, 2020, elementary and secondary schools were assigned to work remotely (Ministry of Education of the Russian Federation, 2020). Rapid growth of COVID cases in Russia in March–April forced authorities to implement massive testing and COVID diagnostics initiatives and to introduce changes in the healthcare system, which resembles the model favored in Soviet era. As of January 30, 2021, 101.5 million tests for detecting COVID-19 were administered in the Russian Federation. At the same time, a total of 3,832,080 cases of infection were detected making Russia (population 146.2 million) the fifth

1,229,824 1,315,643 741,404 3,466,369 2,491,036 2,421,895 2,803,573 3,179,532 5,675,462 1,012,512

Population 20,368,942 5,398,064 3,202,946 4,310,681 4,197,821 2,324,205 2,866,255 1,136,535 2,391,193 1,674,676 1 7 5 14 4 4 6 14 17 12

Confirmed cases on 03/31/2020 1226 No data 11 24 2 6 No Data 7 2 No Data

Source: Compiled by authors based on data from ConsultantPlus 2020

Region Moscow St. Petersburg Nizhny Novgorod Region Sverdlovsk Region Rostov Region Voronezh Region Krasnoyarsk Krai Arkhangelsk Region Irkutsk Region Khanty-Mansi Autonomous Okrug Ulyanovsk Region Khabarovsk Krai Murmansk Region Chelyabinsk Region Volgograd Region Saratov Region Stavropol Krai Samara Region Krasnodar Krai Kaliningrad Region 41,333 41,292 40,959 40,652 40,640 40,449 39,891 37,157 31,562 21,916

Confirmed cases 1,081,783 307,392 79,177 66,359 59,488 54,008 52.920 48,503 45,780 45,463

Table 18.1 COVID policies implemented in the 20 largest regions, Russian Federation

37,853 37,330 36,776 27,907 38,708 34,836 35,793 34,256 22,083 19,727

Patients recovered 893,180 193,417 71,455 58,816 49,196 48,644 48,700 40,154 40,459 41,958 539 228 758 675 552 492 870 754 1257 211

Confirmed COVID-19 deaths 22,003 9043 1954 1855 2397 1396 2060 458 1452 629 18 16 21 12 14 9 26 19 11 11

Number of COVID policies 20 28 16 17 18 16 12 17 23 27

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largest country in terms of confirmed cases. Furthermore, Russia was ranked as eighth based on COVID-caused mortality; however, there are reports that death rate due COVID in Russia may be higher than reported statistics (Talmazan, 2021). Western media raised concerns that Russian COVID statistics might be understated since Russian Healthcare Ministry used a different approach to calculate COVID mortality than did other countries (Levresse, 2020). Next, Moscow was the first Russian city to transform existing medical facilities into hospitals treating only patients with COVID-19. The large dwellings around the country (such as the exhibition center in St-Petersburg) have been repurposed for COVID. Moreover, the Russian government announced an ambitious plan to build 16 new hospitals across the country. Each new hospital has an area of 115,000 m2, between 60 and 200 beds, and was built quickly, between 40 and 56 days. To contain or eliminate the SARS-CoV-2 virus, several research centers in Russia started exploration and development as early as January 2020. The initial, earlystage results were available 2 months later (Ria.ru, 2020a). The first vaccine registered in Russia was Gam-Kovid-Vak (Sputnik V) developed by Gamaleya National Center of Epidemiology and Microbiology. The vaccination campaign in Russia started on December 5, 2020 and initially was open to educators, health care professionals, and social workers (Protsenko, 2020). Starting January 18, 2021, all healthy Russian citizens were invited to get the Sputnik V vaccine. Importantly, Gam-Kovid-Vak (Sputnik V) is not the only vaccine against COVID-19 created in Russia—three more vaccines are being developed by Russian research centers (Stopcoronavirus.rf, 2020): EpiVacCorona—a vaccine by the State Research Center of Virology and Biotechnology Vector; “Koviak” by the Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of Russian Academy of Sciences, and a vaccine by the Saint-Petersburg Research Institute of Vaccines and Serums. As of February 2021, the Russian government was contracting Sputnik V as a preferred vaccine for inoculation in a couple dozen countries, and Russia was supposed to become the first country to complete vaccination of its entire population by June 2021 (Meyer, 2020). It is expected that vaccination campaign will eventually improve the epidemiological situation in Russia and contribute to the gradual opening of the Russian economy.

18.3

Background

The expanding epidemic of acute respiratory syndrome (COVID-19) in humans had profound and long-lasting effects on the economic and sociopolitical environment around the world. Market actors nested in previously established marketing systems have found themselves in a dramatic situation of supply shock resulting from contagion containment measures with restrained demand and mobility (BénassyQuéré et al., 2020). The distress caused by the COVID-19 pandemic had jolted existing supply chains and reduced the ability of communities around the world to satisfy both basic and higher-order needs (Sirgy, 2011). Furthermore, the COVID-19

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pandemic has changed the way consumers live, work, and shop, which has led to massive dislocation among businesses (especially small and medium enterprises) and has jeopardized business models of companies around the world (Bartik et al., 2020). The distress caused by pandemic overturned existing marketing systems as they could not adapt to lockdowns, protective policies, decreased mobility, and diminished participation in social and economic exchanges. Mass closures and layoffs became the “norm” in many industries, and struggling companies are trying new business models and strategic choices to create offerings that are aligned with changing consumer needs (Sheresheva, 2020). Economies clearly will not emerge unscathed and the daily routines and lifestyles of consumers will shift to accommodate continued social distancing while treatment and vaccine options are being considered (Euromonitor, 2021a). Businesses and consumers around the world must be prepared that some of their rights will be suspended by governments while authorities try to develop new policies and regulations during confinement (Mastropietro et al., 2020). Nonetheless, businesses in various industries face increased competition and uncertain demand, which are largely driven by the deep changes in consumer well-being and QOL (Baum & Hai, 2020). Several important changes in consumer lifestyles and habits were identified, such as reducing activity in dining out or other social occasions, spending more time at home, and socializing virtually (Euromonitor, 2021a). In the after-COVID-19 world, consumers can take a more “digital” approach to social interaction and work, meaning virtual participation as part of their daily routine. Online shopping habits have become more permanent in consumers’ minds; in the latest survey, nearly three-quarters of respondents agree that the shift to e-commerce will be permanent and 45% now expect the decline of in-store shopping to be permanent compared to 28% in April 2020 (Euromonitor, 2021a). In this regard, retailers have adopted new technologies, including contactless payments, digital touchpoints, and virtual changing rooms while also re-configuring store layouts to create space for social distancing and sanitizing stations to keep consumers, as well as employees, safe (Euromonitor, 2021a). To provide a comprehensive framework for analysis of changes in well-being and quality of life in Russia, the authors conducted scientometric analysis of research agenda on consumer well-being in the COVID-19 pandemic. Using VOSviewer Software1 the authors identified clusters for the related keywords and visualized co-occurrence networks. The publications were selected from Web of Science (WoS, webofknowledge.com, 18.01.2021) with the search terms, including “coronavirus,” “COVID-19,” “consumer behavior,” and “well-being” as well as their combinations. The search returned 1099 publications authored by 2082 authors, among whom only 31 used keywords at least ten times. The selected research publications were grouped into six thematic clusters, which may be used to identify broad research themes (Fig. 18.1; Table 18.2).

1

http://www.vosviewer.com

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Fig. 18.1 Bibliometric network for research on consumer’s well-being during COVID-19 pandemic. Source: Authors’ analysis with VOSviewer (N ¼ 1099 papers indexed in Web of Science, keyword frequency 10)

The cluster 1 addresses epidemiological issues and patient’s well-being: SARSCoV-2, social distancing, and COVID-19. The cluster 2 captures mental well-being: mental health, coping with psychological distress, and resilience. The cluster 3 captures indicators related to overall health, physical activity, and the effects of social isolation. The cluster 4 focuses on psychological well-being during the lockdown and how households have to adjust their lifestyles. The cluster 5 narrows down to the psychological consequences such as stress, anxiety, and depression. Finally, the cluster 6 captures quality of life and quarantine (Fig. 18.1). Importantly, the evaluations of individual well-being may vary between regions and affected by national cultures and other country variables. Comparably, Vindegaard and Benros (2020) summarized 43 studies measuring mental health in public workers and general public during pandemic and found similar immediate concerns and signs of ill-being, such as increased depression/depressive symptoms, anxiety, psychological distress, and poor sleep quality. In summary, using insights from bibliometric networks (Fig. 18.1), we identified the commonly studied effects of pandemic on well-being and QOL. Psychological

374 Table 18.2 Thematic clusters for research on consumer’s well-being during COVID-19 pandemic

A. Krasnikov et al. Thematic cluster Cluster 1

Cluster 2

Cluster 3

Cluster 4

Cluster 5

Cluster 6

Keyword COVID-19 Pandemic SARS-COV-2 Social distancing Burnedout Mental health Stress COVID-19 pandemic Resilience Psychological distress Coping Risk perception Well-being Physical activity Public health Loneliness Health Education Older adults Social isolation Students Lockdown Psychological well-being Children Adolescents Anxiety Depression Social media Quarantine Quality of life Subjective well-being

Frequency 522 121 39 15 11 121 50 33 25 18 16 10 105 25 21 17 14 11 10 10 10 33 16 14 10 77 53 11 29 17 10

Source: Authors’ analysis with VOSviewer (N ¼ 1099 papers indexed in Web of Science, keyword frequency 10)

well-being and changes in daily routines emerged as the most common themes in this line of research. Consequently, we proceeded with the analysis of psychological well-being, protective behaviors, and perceptions of COVID policies in Russia and other transitional countries.

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QOL Indicators at the Wake of the COVID-19 Pandemic in BRICS

Sheth (2011) identified five key characteristics of transitional markets, which differentiate them from the developed economies—market heterogeneity, sociopolitical governance, chronic shortage of resources, unbranded competition, and inadequate infrastructure—all of which have impact on responses to the COVID-19 pandemic at individual, firm, and country levels. Each country implemented different measures to prevent the COVID-19 pandemic spread. In this regard, consumer data collected by Fetzer et al. (2020) in the wake of pandemic in March–April 2020 provide unique insights on how individuals adjust their behaviors based on recommendations and measures that were introduced by governments to stop the spread of COVID-19. Using these data, the consumer responses were analyzed and compared across BRICS countries (Table 18.3). The comparison of preventive behaviors across five countries reveals that Russia has the lowest score on five preventive behaviors (Panel A, Table 18.3). Indeed, only 58.7% Russian respondents prefer to stay home as compared 86.3% in Indian and Table 18.3 Preventive behaviors and perceptions of COVID measures by BRICS customers

Survey Item Russia Brazil Panel A. Individual preventive behaviors (%) Staying home 58.7 80.3 Avoiding social 84.1 88.3 gatherings Maintaining social 47.9 65.7 distance Monitoring symptoms 83.5 95.6 Washing hands more 83.7 92.7 frequently Panel B. Perceptions of COVID measures (%) Insufficient government 82.4 81.2 reaction Insufficient public 70.4 75.2 response Do not trust government 80.8 83.5 to take care of its citizens Social distancing is 82.2 89.9 effective Panel C. Mental health (Z-score) Anxiety 0.273 0.122 Depression 0.262 0.132 Number of respondents 3399 11,589

China, including Hong Kong

India

South Africa

82.6 92.6

86.3 93.2

79.1 90.0

72.4

72.2

76.0

93.7 85.9

92.1 90.5

93.8 94.0

22.5

44.8

27.9

15.8

74.9

74.6

20.5

30.3

35.2

94.1

91.7

79.2

0.731 0.320 512

0.077 0.312 992

0.077 0.265 548

Source: Calculated by authors using data from Fetzer et al. (2020)

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82.6% in China. Less than half (47.9%) of Russians comply with social distancing— contrary to 76% respondents from South Africa and 72.4% in China. Furthermore, other protective measures, such as avoiding social gatherings, checking symptoms, and washing hands were adopted by a majority of Russian respondents with scores of 84.1%, 83.5%, and 83.7%, respectively. Overall, lower adoption of protective measures may be explained by relatively low rate of spread of infection, protective policies by Russian health authorities, and pivoting containment measures in large metropolitan areas (Moscow, St-Petersburg, Kazan, etc.). Although Russian authorities quickly reacted to pandemic threats; 82.4% survey respondents found these measures to be inadequate, while similar sentiment was expressed only by 22.5% and 27.9% of interviewees in China and South Africa, respectively (Panel B, Table 18.3). Moreover, a majority Russian informants believed that public response was insufficient (70.4%). Similar patterns emerge in three other countries (India, Brazil, and South Africa), which may be attributed to lack of accurate information at the wake of pandemic. Next, distrust in the Russian government’s action-responses was expressed in 80.8% of answers—the only higher disbelief was recorded for Brazil (83.5% respondents). Finally, a majority in BRICS agreed that social distancing is an effective protective mechanism against spread of disease (Panel B, Table 18.3). Third, we estimated scores for mental health using worries battery to measure anxiety (Fetzer et al., 2020) and PHQ scale—for depression (Kroenke et al., 2001). The scores were standardized across BRICS countries (cf. Fetzer et al., 2020) (Panel C, Table 18.3). The mean anxiety score among Russian respondents is lower as contrasted to scores in India, South Africa, and Brazil; the anxiety values are the lowest among Chinese. Next, the values for depression in Russian respondents are lower than average across five countries (0.262), yet is higher than in groups from China, India, and South Africa (Panel C, Table 18.3). Potential explanation for lower worries and depression scores in the Russian sample may be attributed to the early intervention (remote learning, work from home, curfews, etc.) introduced by Russian authorities early during pandemic as well as quarantine measures by regional governments.

18.5

Engagement of Russian Non-government and Non-profit Organizations During Pandemic

The COVID-19 pandemic caused significant changes in marketing systems around the globe. In the context of health disaster, catalytic institutions may induce changes in markets and social environments at early stages, even without government regulations or persuasion campaigns. Moreover, higher engagement of socially active entities, such as Non-Government Organizations (NGOs), faith-based organizations (e.g., Russian Orthodox Church), trade associations, citizen-stakeholders, and volunteers may help to conform marketing systems to abide new health

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measures when they are adopted (Durante et al., 2020). In this regard, the contributions of these types of catalytic institutions in Russia to handling the COVID-19 crisis deserve attention. According to ROSSTAT (2019), the total number of NGOs in Russia was 90,835 in 2018. Despite the different areas of activity of NGOs, as well as the different goals of these organizations, many of them were able to switch focus, to fight the COVID-19 pandemic and support the most vulnerable segments of the population during pandemic. During the first wave of the COVID-19 pandemic, Russian NGOs contributed in the following ways (Korneeva et al., 2021): • Providing assistance and supporting vulnerable groups (e.g., delivery of food, essentials, and medications) • Psychological counseling • Information and communication • Legal advice • Assisting larger NGOs and other community groups Korneeva et al. (2021) captured a growing trend that NGOs help to facilitate interaction and joint efforts of local authorities, businesses, and citizens in helping disadvantaged population and elderly affected by the COVID-19 pandemic. For example, volunteers from the children hospice “Dom s Mayakom” in Moscow region helped patients to visit patients’ homes during quarantine. Many Russians also struggle with mandatory self-isolation, leading to higher anxiety and concerns about themselves and loved ones. NGOs, providing psychological assistance had to expand existing services and offer new services (e.g., COVID hotlines). Consequently, the Russian government responded to the growing volunteerism into fighting the COVID-19 pandemic and provided grant-funding for 2 billion RUR to almost 900 non-profits (Ria.ru, 2020b). Amid the spread of coronavirus infection, Russian NGOs are actively engaged in helping those in need and are changing the ways they operate. First, such organizations had to adjust conveyance of services (e.g., home delivery of food and other necessary goods) to the most vulnerable people—lonely pensioners, families in difficult life situations, people with disabilities, large families, and low-income families, homeless, and imprisoned population. In this regard, growing volunteer movement to help affected people in self-isolation with daily chores illustrate this new trend. Second, across Russia there is growing evidence that NGOs actively cooperate with both local governments and various businesses ranging from local small and medium enterprises to large corporations, such as Mail.ru, X5 Retail, and Nornickel (Korneeva et al., 2021). Specifically, local authorities assist NGOs by providing access to infrastructure (e.g., medical emergency vehicles and dwellings) and companies—by supplying necessary goods (food rations by X5 Retail), networks (mobile networks by Yandex), and resources (grants issued by Sady Pridonia company), which are distributed by NGOs. Third, NGOs and non-profits in Russia are also supporting frontline health workers, including doctors, nurses and other medical personnel who are providing care to COVID patients. Multiple public and private initiatives (e.g., “Sozvesdie Dobra”) aim to help regional hospitals in various ways, such as adding new beds in hospitals, delivery of hot meals to doctors and

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nurses, purchase of medical supplies and personal protective equipment (Asi.org.ru, 2020). Finally, non-profit organizations may serve as trustworthy and important sources of information about health and pandemic, which improve the overall community response to disaster. For example, Russian non-profit fund “Ne Naprasno” initiated COVID online service www.defeatcovid.ru, whereby people and doctors can access relevant information about the diagnosis, treatment, and prevention of coronavirus infection in St-Petersburg. Similarly, Moscow FemFest team organized a series of webinars on safety and well-being during isolation for women, combining work, childcare, and household chores. However, the pandemic caused a surge of fake news about coronavirus in social media and traditional news outlets. In this regard, the authorities’ attempts to engage Russian non-profits to policing media (Ncpti.su, 2020) may negatively affect NGOs’ legitimacy and public trust in these institutions because an authoritative state might take advantage of the hardship and challenges faced by these catalytic institutions (Chernova, 2020). Despite that concern, the experience gained by non-profit organizations during the pandemic will have a positive impact on the development of the NGO ecosystem in Russia, going forward; that is, it would/could strengthen relations and mutual trust with local decision-makers, create new forms of cooperation with business and entrepreneurs, and grow new coalitions of non-profit organizations. Russian NGOs may grow through civic mobilization, volunteer movement, and by increasing grassroots initiatives. The contribution of Russian NGOs to the fight against coronavirus will increase confidence in the non-profit sector on the part of the state, business, and society.

18.6

Role of Industry Associations in Fighting the COVID-19 Pandemic

Self-regulation by industry associations in Russia represents a collective action to create best practices and diffuse hygienic norms during the COVID-19 pandemic, without the intrusion of the state. Such institutions help to shape existing marketing systems and promote responsible conduct by market players. Standards, which were introduced by trade associations in four industries (e-commerce, retail, fitness, and movie theaters) illustrate how self-organized regulation assists businesses to withstand a pandemic and to lay a foundation for functioning in a post-COVID period (Table 8.4). The guidance from industry associations highlights not only safe employee-customer interaction (e.g., contactless delivery or cashless payments in e-commerce and retail) but also provides health protocols to secure employee wellness (e.g., increasing frequency of health checks in fitness clubs and workplace disinfections in cinemas). Moreover, associations undertook additional efforts (e.g., “Fitness Control” initiative) to engage clients to receive positive and responsible customer experience (e.g., using personal protective equipment while exercising in fitness club) (Table 18.4). Overall, these examples demonstrate how business

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Table 18.4 Changes in marketing systems during the COVID pandemic Marketing system E-commerce

Market players The Association of E-Commerce Companies is a non-profit organization that unites the largest representatives in the field of e-commerce Members of the association: Re: Store, Mi Store, Wildberries, Yandex Go, M. Video, Eldorado, OZON, Yandex. Shop, Supermarket, Perekrestok, O’stin, GILLETTE, BRAUN

Cinema

Association of Cinema Owners. The Association unites representatives of small and medium-sized businesses working in the audiovisual technology segment, including in the field of cinema screening Members of the association: Cinema Star, Cinema 5, Caro, Moschino, Kinomax, Cinema Mirage, Cinema Madagascar

Retail

The Association of Retail Companies (AORC) is a non-profit association that includes 24 federal retail chains of Russia, representing 30% of the retail market of the Russian Federation Members of the association: Leroy Merlin, Billa, Magnit, Metro, OBI

Fitness and health

Association of Operators of the Fitness Industry. The purpose of the association is to represent and protect the business interests of fitness market participants, to ensure a dialogue between the industry and the government, to develop the fitness services market

Proposed policies 1. Contactless delivery 2. Employees, working in area of issuing online orders and couriers work only in protective masks and gloves 3. Reduction of the product line at the points of order’s delivery 4. Reduction of the cash payments, encouraging customers to switch to prepaid orders and/or contactless forms of payment 5. Floor marking to maintain social distance in order pick-up points 6. Placement of sanitizers or similar disinfectants at the entrance to the points of delivery of orders or in the store 1. Monitoring the health status of employees 2. Providing employees with personal protective equipment 3. Reducing employees’ contacts, sanitary treatment of office 4. Online ticket sales, implementation of contactless payment 5. Marking space between ticket offices and cinema kiosks 6. Floor marking to maintain social distance in movie theaters 7. Increasing the intervals between sessions 1. Development and implementation of regulations for trade enterprises during the pandemic 2. Consumers are actively informed about the measures applied against COVID-19 3. Corporate procedures for monitoring the adoption of recommendations of Rospotrebnadzor (health regulator) and the AORC regulations 4. Checklist for the implementation of Rospotrebnadzor recommendations 1. Health protocol for fitness clubs has been developed and adopted by several regions in the Russian Federation as the main document regulating the work of fitnesses during the COVID-19 pandemic 2. Launching of the “Fitness Control” (continued)

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Table 18.4 (continued) Marketing system

Market players

Proposed policies

Members of the association: World Class, Alex Fitness, Territory of Fitness, Orange Fitness, World Gym

service 3. Establishing coordination committee between fitness businesses and regional health authorities

catalytic institutions in Russia are compelled to diffuse new practices and provide a common good by establishing standard code(s) of conduct.

18.7

Digital Transformation of Russian Consumers

As an historic natural disaster, the COVID-19 pandemic has affected every aspect of consumers’ lives—biological, environmental, social, and economic—and substantially changed everyday consumption behavior (Van Bavel et al., 2020). Baker (2009) also notes that frameworks for studying disasters should also incorporate market mechanisms that provide consumption choices and solutions to customer needs and wants. Notably, degree and speed of consumer adaptation to stress caused by disaster indicates resilience (Reich et al., 2010); the lack of such adjustment leads to vulnerability defined as a state of powerlessness, dependence, and reduced capacity of individuals and communities to act in their own interests and satisfy needs (Hill & Sharma, 2020). Within a growing body of research examining consumer behavior during the COVID-19 pandemic, multiple studies reveal that consumers learn to adapt quickly; they improvise to overcome constraints imposed by lockdowns and social distancing (Brodeur et al., 2020; Donthu & Gustafsson, 2020). Unusual purchases (Laato et al., 2020), stockpiling (Sheth, 2020), and changing social identity (Kirk & Rifkin, 2020) illustrate various coping mechanisms to reduce anxiety caused by sheltering, remote working and learning, closures, shortages, and other restrictions necessitated by pandemic. To maintain social connections, the use of mediating technologies has grown exponentially, resulting in more consumers adopting a “digital” approach to social interaction and virtual participation as a part of their daily routines.

18.8

Methods

To assess the adaptation of Russian consumers to the pandemic, the authors conducted a survey of participants of the Russian National Educational Platform “Open Education.” The data collection (April 17–October 17, 2020) corresponds to the timing when major policy interventions (social distancing, mandatory use of

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Table 18.5 Latent constructs and indicators from the Survey of Russian consumers (N ¼ 956) Latent variables 1. Personal protective behavior

2. Concerns about hygiene 3. Packaging preferences 4. Buying behavior

5. Anxiety

Indicators I did not attend social gatherings I did not use public transport I kept distance of 1.5–2 m to other people I stayed at home Car sharing has no hygiene risks Taxi has no hygiene risks Clothes rentals have no hygiene risks I prefer brand packaged products to bulk products I prefer products with an additional layer of packaging I prefer packaging with an extra layer I shop grocery products online more often than before I shop clothes online more often than before I order ready-to-eat food online more often than before I am stressed about leaving my home I am nervous when I meet difficulties buying personal protective equipment (e.g., masks, gloves) I am nervous when I think about current circumstances

masks, restrictions on transportation and travel, etc.) were implemented by Russian health authorities. Unlike the survey by Fetzer et al. (2020), which was administered over a short period at the wake of pandemic, our study examines behaviors over a longer time and allowed us to track adaptation to restrictions necessitated by such a deadly virus. A total of 956 respondents from 67 regions of the Russian Federation participated in the survey, the response rate was about 15.8%. Most respondents (48.5%) reportedly live in the largest cities (Moscow, Vladivostok, St. Petersburg, etc.). 77.8% respondents are females, 20.3%—males. A majority (81.3%) was between 18 and 25 years. The questionnaire included items pertaining to personal behaviors, anxiety, hygiene and health concerns, and buying behavior. All reported items were measured using 7-point Likert scale. An exploratory factor analysis using 15 survey items revealed five factors that describe consumer responses to new conditions: (1) personal protective behavior, (2) concerns about personal hygiene, (3) packaging preferences, (4) buying behavior, and (5) anxiety. Cronbach’s Alpha for each of the factors was larger than 0.7. The model also demonstrated good fit (GFI ¼ 0.975; Chi-square ¼ 173.38, d. f. ¼ 92; TLI ¼ 0.973; CFI ¼ 0.979; RMSEA ¼ 0.033). Table 18.5 illustrates how survey items were used to form latent constructs.

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Findings

Cluster analysis of the factor solution suggested three clusters (Table 18.6). The first cluster (339 respondents) demonstrates the highest level of anxiety (mean 4.6) among the three clusters (Panel A, Table 18.6). Respondents in this cluster strictly followed social distancing and self-isolation recommendations (mean 6.0) and rated packaging as important (mean 4.8). Their preference for online shopping for any type of goods is much stricter (mean 5.1) in comparison with other clusters. The second cluster (274 respondents) has the lowest level of anxiety (mean 3.1). They have fewer hygiene concerns (mean 2.5) among the clusters and an average preference to shop online. The third cluster (233 respondents) experienced higher level of anxiety (mean 3.4) than the second cluster; however, respondents in this cluster were much more concerned about hygiene (mean 4.7) (Panel A, Table 18.6). Nevertheless, they were less likely to switch to online shopping. The clusters did not differ with respect to age, gender, and other demographic characteristics; however, compared to the Clusters 1 and 2, respondents in the third cluster were more likely to live in towns with population of less than half million. Next, Kirk and Rifkin (2020) identify three adaptation mechanisms to the restrictions imposed by pandemic: maintaining social connectedness in a time of social distancing, coping by doing-it-yourself, and changing views about brands and companies. In particular, such adaptation depends on access to online tools that provide a gateway to socializing and human interaction. As such, we examined the role of online tools in four activities (shopping, fitness, education, and entertainment), which were most affected by lockdown. Customers self-reported whether Table 18.6 Cluster analysis of personal behaviors for the Russian customers (N ¼ 846) Item Panel A. Cluster profiles F1. Personal protective behavior F2. Concerns about hygiene F3. Packaging preferences F4. Buying behavior F5. Anxiety Cluster size Panel B. Adoption of online tools Shop grocery online Shop clothes online Order ready-to-eat food Do fitness with an instructor online Do fitness with video or mobile apps Attend free online courses Buy online courses Use free entertaining services Buy entertaining services

Cluster 1

Cluster 2

Cluster 3

6.0 4.2 4.8 5.1 4.6 339

5.0 2.5 3.3 3.3 3.1 274

5.3 4.7 3.4 2.6 3.4 233

5.3 5.2 4.9 3.4 4.7 5.6 4.5 5.4 4.7

3.0 3.3 3.5 2.7 3.8 4.8 3.7 5.0 4.0

2.1 2.8 2.9 2.5 3.9 5.2 3.5 4.9 3.7

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they started to use online and digital tools more (less or the same) often than before the pandemic. Panel B, Table 18.6 shows the average values for each cluster. Several observations emerge from comparison of the usage of digital tools in the three clusters. First, Cluster 1 represents the most active users of such tools for each type of activity. Such reactions may be explained by the desire to minimize social contacts and adhere to the distancing recommendations without sacrificing convenient services. Interestingly, users in the first cluster reported an increase in consumption of both free and paid services. The difference between this and the other two clusters is becoming more apparent in comparison shopping behaviors (groceries, cloths, and food delivery) (Panel B, Table 18.6). The low levels of adoption of online buying in Cluster 3 may be attributed to the higher concerns about hygiene and overall lower scores on buying behavior (mean 2.6) (Panel A, Table 18.6). Moreover, Cluster 3 had the lowest scores for paid online services, including shopping—attributed perhaps to lower purchasing power—which declined further during pandemic. However, users in all clusters exhibit similar high preferences for free online content (online courses and entertainment), which suggests that online platforms may attract more customers by targeting free materials and services to all online users. Interestingly, respondents in Cluster 3 had lower scores for every online activity than did users in Cluster 2; the only exceptions were for exercise apps and videos (3.9 in Cluster 3 v. 3.8 in Cluster 2) and free online courses (5.2 in Cluster 3 v. 4.8 in Cluster 2) (Panel B, Table 18.6). Overall, adoption of free services may be driven by different considerations in three clusters: concerns for hygiene in Clusters 1 and 3 and low anxiety (and potentially boredom) for Cluster 2. Finally, all three clusters reported that their preference for payment methods had changed from cash to card payment, including online payment at the website or application. In summary, observed results suggest various adaptive mechanisms in Russian customers, who may be affected differently by pandemic restrictions.

18.10

Conclusion and Lessons Learned

In this chapter, we examine the impact of the COVID-19 pandemic on Russian consumers, businesses, NGOs, governments and society at large. Using a conceptual framework distinguishing flourishing versus distressed communities, rooted in the well-being and quality-of-life (QOL) literature (Shultz et al., 2017), we conceptualize pandemic as a stressor that jolted Russian—and many other—societies towards a distressed state. Furthermore, answering a research call to examine community wellbeing across the globe both systemically and systematically (Shultz et al., 2017), we adopt different qualitative and quantitative methods to provide an overview of the pandemic timeline in Russia and (re)actions of catalytic institutions and consumers to SARS-CoV-2 and COVID-19. We did so by applying scientometric analysis to understand the composition of current research on pandemic in social sciences; discerning key QOL indicators for studying effects of pandemic; comparing key metrics for mental health, preventive behaviors, and attitudes towards proposed

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COVID policies in BRICS countries using insights from a study of personal behaviors at the wake of pandemic (Fetzer et al., 2020); identifying key trends in the responses of Russian NGOs and similar institutions, and capturing adaptation of Russian consumers in April-October 2020. We reviewed and integrated information and salient ideas from different disciplines to illustrate how Russian market actors respond, adapt, change, and survive during health disaster. Our approach will help to guide researchers to select and measure QOL concepts, which are most relevant to understanding societal response to the COVID-19 pandemic and other crises. The state of distress can be measured by using QOL indicators for mental health, health behaviors, and perceptions of COVID policies. The analysis of Russian consumers during the early stages of pandemic revealed lowest frequency of protective behaviors; highest distrust to authorities and COVID policies, and low damage to mental states compared to other emerging economies. Such a distinction helps to outline potential reasons for observed changes in well-being. First, individuals will feel more pressure to change daily routines and adopt health precautions when access to quality healthcare is limited. In this regard, some observers report that Russia was able to alleviate the coronavirus outbreak because of a large number of hospital beds, which were inherited from the Soviet health system, and which may be quickly transitioned for patients suffering from COVID-19 (Levresse, 2020). Second, the low trust towards proposed policies may be explained by the authoritarian tendencies of the Russian state, in which authorities are routinely engaged in self-serving propaganda campaigns that increase wariness and suspicion, especially during disasters (Prabhala & Ling, 2021). However, such reactions are not unique to Russia or other transitional countries—similar skepticism towards health policies and social distancing closely coincided with political views and media preferences among US consumers (Simonov et al., 2020). Collectively, these findings suggest that policy makers and stakeholders should monitor well-being during pandemic using a diverse set of indicators to capture a broader spectrum of human reactions. Next, we examine how NGOs, businesses, authorities, and industry associations in Russia shape the complex networks of economic and social exchanges during the pandemic. As previously noted, the political, social, and cultural structure in Russia greatly determines reactions of catalytic institutions during the COVID-19 pandemic. This chapter also aims to contribute to the ongoing debate in Russia regarding whether, or to what degree, the authorities and NGOs need to cooperate (or should cooperate) during disaster (Chernova, 2020). Indeed, a traditional suspicion between Russian authoritative state and civil society temporarily dissipated when these institutions faced the pandemic. In this regard, allocation of federal grants and subsidies for social NGOs actively involved in fighting the coronavirus as well as amendments in Tax Code protecting donations to charitable causes provide cautionary optimism for the Russian post-COVID social landscape (Rozhanovskaya, 2020). This study also contributes to the research on consumer journey under environmentally-imposed constraints (Hamilton et al., 2019), which suggests different stages of consumer response and adaptation to limitations on behavior—ranging from ignoring to reacting and building resilience. In this regard, Kirk and Rifkin (2020) argue that at the later stages of pandemic consumers learn to cope by exerting

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control in other domains and adopting new behaviors. In our second study of Russian consumers, we estimated that 40% of respondents increased the use of new online tools and channels for common daily activities. This finding corresponds to the industry reports that consumers became more digitally engaged during the pandemic (Euromonitor, 2021b). Accordingly, policy makers should plan investments in the infrastructure, software, media, and networks that accommodate increasing demands for online services and digital tools. The materials (e.g., figure and tables) shared in this chapter ultimately are intended to facilitate and provide analysis of the changes in Russian society using a community well-being and QOL framework outlined in Shultz et al. (2017). Multiple perspectives, examples, and measures applied in the Russian context—all help to test and further develop QOL theory. Such method helps to create a holistic view about macro factors that help communities to become more resilient, adapt to new environmental conditions, and ultimately to flourish. During the time when many nations are struggling with pandemic and its socioeconomic outcomes, Russia offers several important lessons, which may be extended to other nations, as well. First, the resilient response to the health crisis may be attributed to the ability to quickly channel resources to the healthcare system. The additional hospital capacity served as a buffer to rapid spread of SARS-CoV-2 in Russia. Though it is not very efficient to run empty hospitals, other countries might consider an emergency-related system based directly in the country, which would allow to avoid not only healthcare system crisis, but to lower the stress level in a community. Moreover, ability to provide equal and fast access to medical care may help to boost confidence in government’s reactions and to sustain community wellbeing. Second, the crisis highlighted the role of catalytic institutions in effective response to the pandemic in Russia, which is characterized by low trust to government and a high level of power dependence. That may serve as a useful example for governments and NGOs, which struggle with low acceptance of catalytic institutions or have a low level of trust in society. Since social, economic, political, and cultural systems are interdependent, policymakers should understand idiosyncratic relations between/among communities and such institutions; they should adjust the message or take actions towards consistency, clarity, and veracity of message, and thus to enhance trust throughout society. Finally, lockdowns forced or accelerated the adoption of digital technologies and transformed traditional forms of communication. The changes in online behaviors and reliance on digital channels are likely to remain, even after the pandemic. New types of communication would pose new challenges; among them are ensuring cybersecurity, understanding of relationships in the digital society, working remotely, and hybrid modes of learning—all of which have long-term impact on well-being of individuals and communities.

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Stopcoronavirus.rf. (2020). Russian vaccines against coronovirus. Retrieved February 25, 2021, from https://вакцина.стопкоронавирус.рф/#about Talmazan, Y. (2021, December 29). Russia’s Covid-19 death toll could be 3 times higher than reported. NBC News. https://www.nbcnews.com/news/world/russia-s-covid-19-death-tollcould-be-3-times-n1252461 TASS. (2020, January 31). In Russia, the first two cases of coronavirus infection were identified. https://tass.ru/obschestvo/7656549 Van Bavel, J. J., Baicker, K., Boggio, P. S., Capraro, V., Cichocka, A., Cikara, M., et al. (2020). Using Social and Behavioural Science to Support COVID-19 Pandemic Response. Nature Human Behaviour, 4(5), 460–471. https://doi.org/10.1038/s41562-020-0884-z Vindegaard, N., & Benros, M. E. (2020). COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain, Behavior, and Immunity, 89, 531–542. WHO. (2020, March 11). WHO Director-General’s opening remarks at the media briefing on COVID-19. https://www.who.int/director-general/speeches/detail/who-director-general-s-open ing-remarks-at-the-media-briefing-on-covid-19%2D%2D-11-march-2020

Alexander V. Krasnikov, Ph.D. is an Assistant Professor in the Marketing Department, Quinlan School of Business, Loyola University Chicago and research scholar at the Center for Research Technology and Innovation, Kellogg School of Management, Northwestern University. His expertise falls in the areas of financial impact of marketing, brand equity, evolution of brands, and customer insights and analytics. He specializes in application of Big Data techniques in understanding branding strategies and consumer responses. Dr. Krasnikov holds PhD degree from University of South Carolina. He received his BS in physics at Rostov State University (Russia). Vera Rebiazina, Ph.D., is an Associate Professor and the Head of Marketing Department, Graduate School of Business, HSE University, Moscow, Russia. She holds her Ph.D. degree in Economics from Graduate School of Management, Saint-Petersburg State University, St-Petersburg, Russia. Her research interests include marketing, consumer behavior, marketing strategies in emerging markets, innovation marketing, e-commerce, and relationship marketing. Vera Rebiazina is a member of American Marketing Association (AMA), European Marketing Academy (EMAC), and GAMMA (Global Alliance of Marketing & Management Associations). Vera Rebiazina serves as a national representative of Russia at the EMAC. Vera Rebiazina is the author of more than 70 publications in the leading Russian and international academic journals. Svetlana Berezka, Ph.D., is a Senior Lecturer of Marketing Department, Graduate School of Business, HSE University, Moscow, Russia. Her previous position was Senior Researcher at the Laboratory for Institutional Analysis, Faculty of Economics, Lomonosov Moscow State University (LMSU), Russia. She obtained her PhD degree from LMSU in 2018. Her research interests include consumer behavior, consumer psychology, behavioral economics, neuromarketing and consumer neuroscience, relationship marketing, innovation marketing. Svetlana Berezka is a member of the European Marketing Academy since 2018. She is the author of more than 20 publications in the leading Russian and international academic journals.

Chapter 19

Battling COVID-19 Pandemic in a Densely Populated Island Nation: The Singapore Experience May O. Lwin, Chitra Panchapakesan, Anita Sheldenkar, Edson Tandoc Jr, Hye Kyung Kim, Shanshan Yang, Zoe Ong, Si Yu Lee, and Melissa Rachel Kwan

Abstract Despite being a densely populated international travel hub in Southeast Asia, Singapore ranks at the top globally as the country with the lowest COVID-19 case fatality ratio as of February 2021. This chapter provides key insights into Singapore’s COVID-19 experience, focusing on the role of Singapore’s government, businesses, and non-governmental organizations as catalytic institutions in bolstering Singapore’s defenses against COVID-19. The chapter begins with an overview of the progression of COVID-19 in Singapore from January 2020 to January 2021. This is followed by a discussion of governmental initiatives to combat the pandemic. Next, emergent issues such as grappling with different types of literacies and the rise of misinformation, as well as changes in public and consumer behaviors are addressed. The impact of COVID-19 on vulnerable groups, and how institutions have helped to mitigate these challenges are also presented. Lastly, the chapter describes key insights that can inform the management of future crises. Keywords COVID-19 · Singapore · Health communication · Pandemic preparedness

This work is supported by Singapore Ministry of Health’s National Medical Research Council under its COVID-19 Research Fund (COVID19RF-005). M. O. Lwin (*) · C. Panchapakesan · A. Sheldenkar · E. Tandoc, Jr · H. K. Kim · S. Yang · Z. Ong · S. Y. Lee · M. R. Kwan Nanyang Technological University, Singapore, Singapore e-mail: [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected]; [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_19

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Background

Singapore is an island nation of approximately 5.7 million (National Population and Talent Division, 2020; Abshire, 2011; Wong & Singh, 2011) in a densely populated setting of only 726 km2 (Singapore Land Authority, 2020). Singapore also serves as an important international travel hub that increases the connectivity of Southeast Asia, with flights to more than 400 cities in over 100 countries. In 2019 alone, Changi Airport, Singapore served 68.3 million passengers and 2.01 million tons of air freight movement (Changi Airport, 2021), earning it the title of Asia’s third busiest airport for international traffic (Park, 2021). Thus, the island nation has faced unique COVID-19 experiences managing the pandemic from early 2020 to date. Singapore is unique in having experience with Severe Acuate Respiratory Syndrome (SARS) in 2003. In 2003, the SARS outbreak spread rapidly within Singapore and the health authorities were unprepared to combat the disease. Poor early communication among various stakeholders also resulted in a further spread of the disease (Goh et al., 2006). Initial delays in the management of SARS brought about the development of new protocols to improve preparedness communication between health authorities, the government, scientists, and the community (Yan et al., 2006). These protocols have been improved with every subsequent disease outbreak such as the 2009 H1N1 outbreak (Zhang et al., 2015) and the 2016 Zika outbreak (Lwin et al., 2018). For instance, outbreak management plans are in place within many organizations for potential pandemics. These plans have been developed from modeling different pandemic scenarios (Lum et al., 2016) to ensure they are prepared for various types of crises. Despite having existing pandemic-management protocol, Singapore grappled with the unprecedented effects of the novel corona virus, SARS-CoV-2, and COVID-19, which threatened to shift community well-being to a distressed state. As Shultz, Rahtz, and Sirgy (2017, p. 407) describe, a community is distressed when “its capacity for continued growth and resiliency” in economic and social domains is “significantly diminished.” This chapter discusses the role of catalytic institutions in drawing on community resilience and guiding Singapore’s response to the COVID19 pandemic from the pre-outbreak period to the current time of writing. Specifically, the Singapore government’s initiatives and policies including government use of technology for the COVID-19 pandemic, ensuring public literacy, and management of misinformation shaped and responded to changes in consumer behavior, to bolster Singapore’s defenses against the threat of COVID-19 and protect community well-being.

19.2

COVID-19 Sequence of Events in Singapore

Figure 19.1 shows the timeline of events of COVID-19 pandemic in Singapore, which can be categorized into three phases of crisis. The developments detailed below, and government policies regarding public health management, illustrate how

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Fig. 19.1 Timeline of COVID-19 pandemic in Singapore

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1-Jan 8-Jan 15-Jan 22-Jan 29-Jan 5-Feb 12-Feb 19-Feb 26-Feb 4-Mar 11-Mar 18-Mar 25-Mar 1-Apr 8-Apr 15-Apr 22-Apr 29-Apr 6-May 13-May 20-May 27-May 3-Jun 10-Jun 17-Jun 24-Jun 1-Jul 8-Jul 15-Jul 22-Jul 29-Jul 5-Aug 12-Aug 19-Aug 26-Aug 2-Sep 9-Sep 16-Sep 23-Sep 30-Sep 7-Oct 14-Oct 21-Oct 28-Oct 4-Nov 11-Nov 18-Nov 25-Nov 2-Dec 9-Dec 16-Dec 23-Dec 30-Dec

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the pandemic posed a threat to well-being through increased disease incidence, and shifting patterns in employment and work productivity. However, Singapore’s resources and channels helped to facilitate its “timely restoration of its capacities to contribute positively to a sustainable and desirable state of flourishing” (Shultz et al., 2017, pp. 410–411).

19.2.1 Pre-outbreak: 2 January to 6 February 2020 On 2 January 2020, as news of the outbreak in Wuhan, China surfaced, Singapore issued a health advisory for the COVID-19 virus and started the precautionary screening of travelers from Wuhan. A multi-ministry taskforce was formed on 22 January 2020 to facilitate the coordination of responses among the various government ministries such as the Ministry of Health and Ministry of National Development. The Ministries, in turn could then liaise with organizations such as academic institutions and scientific bodies to effectively disseminate COVID-19 information among the stakeholders and streamline the optimal actions to prevent further spread of the disease (Ministry of Health Singapore, 2020a, 2020b). The next day, the first incidence of COVID-19 was confirmed in Singapore—making Singapore one of the first countries in the world to report a COVID-19 case outside China (Lee et al., 2020). A week later, on 30 January 2020, the World Health Organization declared COVID-19 as a Public Health Emergency of International Concern (PHEIC).

19.2.2 Developing Outbreak: 7 February to 31 March 2020 After the emergence of new COVID-19 cases unlinked to previously identified clusters, the government announced the elevation of the Disease Outbreak Response System Condition (DORSCON) status of the COVID-19 virus from Yellow to Orange on 7 February 2020. The elevation of the COVID-19 outbreak to the Orange DORSCON status signaled that while the COVID-19 outbreak is still contained in Singapore, the disease was severe and the public could expect moderate disruptions to the community, including measures such as increased quarantine, enhanced disease screening and social distancing (Ministry of Health Singapore, 2014). To enable the community to adapt to social distancing measures, the government enforced 1-m “queue markings” on the floor of public spaces that required queuing, and marked out alternate seats in public spaces, demarcating areas where people were permitted to sit, to keep to safe-distancing regulations. The announcement of DORSCON Orange sparked the first episode of panic buying at the supermarkets and pharmacies across the island on 7 February (detailed in the Public and Consumer Behaviors section).

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19.2.3 Escalating Outbreak: 1 April 2020 to 1 June 2020 On 3 April 2020, Singapore Prime Minister Lee Hsien Loong introduced an increased set of social distancing measures to further restrict the movement of the public, as daily imported cases and local transmission peaked (Singapore Government, 2020a). Termed as the “Circuit Breaker” (CB, or the lockdown of the city), the tightened regulations were set to last from 7 April to 4 May and included measures such as the closure of retail and entertainment establishments, places of worship, schools, as well as non-essential workplace premises. In addition, higher education institutes were shifted to full home-based learning (Singapore Government, 2020a). Singapore residents were not allowed to interact with any people outside their household during the CB. Although physical activity was permitted outdoors, it was limited in scale and scope. The announcement set off another episode of panic buying in Singapore, with long queues and empty shelves seen at supermarkets across the city (Loke, 2020). In May 2020, 2 weeks before the CB was initially slated to end, Prime Minister Lee announced the enhanced restrictions were extended by another month to 1 June 2020 (Singapore Government, 2020b). The CB lasted 54 days, with some evidence of its effectiveness. In mid-April, there was an average of more than 30 new COVID19 cases in the community, daily, but this fell to approximately eight new cases in the early half of May (Lai, 2020a). Some of the tightened restrictions were gradually eased in June, and some schools as well as businesses, including home-based businesses and Traditional Chinese Medicine shops, could reopen (Singapore Government, 2020c). April 2020 saw a specific episode of national concern—a surge in COVID-19 infection among migrant workers living in dormitories. Over 1000 new cases were found each day during the height of the outbreak, marking a shift from previous months when the bulk of the cases were returning citizens and long-term residents (Yong, 2020a). By 6 May 2020, the dormitory cases made up 88% of all confirmed COVID-19 cases in Singapore (Koh, 2020a). Follow-up tests in December 2020 showed that nearly half of all 323,000 migrant workers living in dormitories have had a COVID-19 infection (Lim, 2020). Despite the high infection rates, the mortality rates among dormitory dwelling migrant workers were low, with only two COVID-19 related deaths (Ministry of Manpower, 2020). The outbreaks at the dormitories finally abated in October 2020 (Yong, 2020b). The escalating COVID-19 outbreak also coincided with the peak of the worst dengue fever outbreak in Singapore’s history due to a confluence of factors such as the dominance of a less prevalent strain of dengue and reduction in landscaping efforts due to COVID-19 restrictions (National Environment Agency, 2020e). This untimely dual infectious disease outbreak presented an unprecedented challenge to Singapore’s public health systems as the country fought to control and curb the spread of both diseases.

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19.2.4 Maintaining Outbreak: 2 June 2020 to 31 January 2021 Singapore adopted a three-phased approach for the safe reopening of the country to gradually resume social activities after the enhanced set of restrictions ended on 1 June 2020 (Singapore Government, 2020c). The first phase, named “Safe Reopening,” lasted from 2 to 18 June 2020. During Phase 1 of reopening, each household could receive up to two visitors per day, who must be children and/or grandchildren from the same visiting household. Other non-essential social gatherings continued to be prohibited. Phase 2, named “Safe Transition,” was launched from 18 June 2020 to 27 December 2020, as community infection rates were stable, and no new, large clusters emerged. The new phase allowed social gathering of up to five individuals, the opening of all schools and more businesses, as well as events such as weddings and funerals, up to a certain capacity (Singapore Government, 2020c). Physical retail businesses, sports, park, and other public facilities were reopened, and individuals could dine in food and beverage outlets on a limited scale. Four days after Singapore entered Phase 2, Prime Minister Lee called for the Parliamentary General Election in a televised address to the public (Prime Minister’s Office, 2020). As a result of the COVID-19 restrictions, no physical rallies were allowed, and all political parties were instead allocated airtime on the national television for the first time in Singapore’s election history (Chew, 2020). The parties were also allowed to campaign online through live-streams and were provided with the venues at which they could film. Singaporeans went to the polls on 10 July 2020, and the elections concluded with a victory for the incumbent party (Ho & Sin, 2020). The third and last phase of the safe reopening plan started on 28 December 2020 and is still ongoing as of 23 February 2021. The multi-ministry taskforce had previously announced in October 2020 that progression to Phase 3 will be contingent on several factors including the public adoption of TraceTogether, the national digital contact tracing tool, among the population (Singapore Government, 2020d). In Phase 3, social gathering extended to eight individuals, local attractions increased their capacity limits to 65%, and worship services could hold up to 250 people, but in zones of 50. Individuals were advised to keep a distance in public places at least one meter from one another, unless driving in a motor vehicle or riding public transportation. The lifting of restrictions on dining at food establishments on June 19 brought in rules requiring individuals visiting these outlets to wear a face mask at all times, except when consuming food or drink. As of 22 February 2021, Singapore has reported 59,850 cases of COVID-19 and 29 deaths—the lowest COVID-19 case fatality ratio, globally (Johns Hopkins University, 2021). Citizen-consumers felt their access to basic goods and other services was not guaranteed, with the pandemic-management measures also posing threats to employment, leisure and recreation activities, cultural activities, and even religious practices. CB and subsequent distancing measures forced a society-wide shift to unfamiliar modalities of work and living, wherein it became necessary for all

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stakeholders to adapt quickly in order to sustainably provide the goods and services that are integral to community well-being (Shultz et al., 2017).

19.3

Governmental Directives and Initiatives

Like most countries, to combat the growing number of cases and to ensure the safety of its residents, Singapore introduced several governmental directives and initiatives, many of which incorporated technology. Among the initiatives were efforts such as safe distancing, temperature taking, hand hygiene, and contact tracing. Two of the activities (mask wearing and digital contact tracing) were particularly promoted in Singapore and are detailed below.

19.3.1 Mask Wearing Prior to the COVID-19 pandemic, Singaporeans generally did not have the habit of mask wearing. However, the pandemic brought about new restrictions and rules regarding this practice. The Singapore government initially advised its residents only to wear a face mask when feeling sick. This was to ensure enough local supplies for healthcare workers as panic buying of face masks was observed in the early stages of the pandemic (Goh, 2020b). Yet, as the local cases of COVID-19 dramatically increased in April 2020, the government revised its advisory on mask wearing to make it mandatory in public. This revision mirrors the World Health Organization’s updated recommendation backed up by the emerging scientific evidence that suggests possible asymptomatic transmission of COVID-19 (Boseley, 2020). Although inconsistencies in health advisory can cause public confusion, a recent study showed that Singapore residents updated their mask-wearing practice according to the revised guideline, especially when they had higher trust in the government and were exposed more to the revised advisory on mask wearing from different information sources (Kim & Tandoc, 2021). Temasek Foundation’s three nationwide mask distribution exercises also helped ensure that residents have sufficient masks. On 14 April 2020, mask wearing became compulsory in Singapore when people leave their residence. Those who do not wear a mask in public face a fine of S$300 for the first offense and S$1000 for repeat violations. This regulation was added to the COVID-19 (Temporary Measures) Act. In the initial stage of this mandate, all individuals aged two and above were required to wear a mask covering their nose and mouth, when outside their residence. There are a few exceptions, such as when doing strenuous exercise (jogging, not walking), or traveling in a car alone or with the driver and passengers living in the same place of residence. On 23 September 2020, the Ministry of Health (MOH) revised their mask-wearing policy stating that children below 6 years are no longer mandated to wear a face mask in public. In

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addition, under certain contexts, face shields can be worn instead. A bride and groom were also allowed to wear a face shield in their celebration of marriage.

19.3.2 Technologically Aided Surveillance In addition to challenges surrounding the spread of COVID-19, with access to social media and the Internet, public exposure to a constant live-stream of pandemic information in real-time is historically unparalleled (Cinelli et al., 2020). Citizens from every continent are now digitally connected at an unprecedented scale and public health organizations face many challenges in engaging and informing the public, which was not experienced to such an extent in previous epidemics and pandemics. With the proliferation of the Internet and the ability to rapidly disseminate information, countries around the world have been able to utilize this technology for multifaceted communication strategies. This is particularly true in Singapore, which has been ranked the number one smart city in the world (Institute for Management Development, 2020). In 2014, the country launched a “smart nation initiative” with the aim of creating a digitally and technologically connected society (Chang & Das, 2020; Smart Nation Singapore, 2020). Since then, there has been a sharp increase in digital usage. In 2020, the Internet penetration rate was 88%, the second highest in Southeast Asia, increasing by 5.3% from 2019 to 2020. More residents are also using social media than ever before, with a social media penetration rate in Singapore of 79% (Kemp, 2020). The government has utilized this technology to disseminate and gather information in several ways (GovTech, 2021). The “TraceTogether” contact tracing app was developed by Singapore’s Government Technology Agency with the Ministry of Health and released in March 2020 with the goal of identifying anyone who comes into close contact with positive COVID-19 cases. A physical token has also been provided to residents as an alternative to the application for those do not want to, or cannot use the application (TraceTogether, 2021). Approximately 78% of all residents are currently using the system (Tham, 2021). The TraceTogether Programme has helped to shorten the time taken to identify and isolate close contacts of COVID19 positive cases from about 4 days with manual tracing to less than 2 days (Ministry of Health, 2020c). All businesses and services are required to provide a “SafeEntry” check-in system to record entry and exit into any establishments or public venues with the goal of identifying any clusters and contact trace any potential positive cases (Singapore Government, 2020d). Individuals are asked to provide their national identification number (or passport number for non-residents) and mobile number for quick identification and contact (SafeEntry, 2021). With this information, the government provides daily updates on their website with the number of cases and the profile of the cases such as gender, age, residency status, where they have been hospitalized and their location history (Ministry of Health Singapore, 2021a). Through the application, they can also notify individuals of any potential contact

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they have had with positive cases, where this contact may have happened, and at what time. Residents can also subscribe to COVID-19 updates on WhatsApp from the Ministry of Health. Any updates can be reported within 30 min in four different languages (Basu, 2020). In addition, the government has created a chatbot to keep citizens updated on COVID-19 news. Launched in 2014, the chatbot has been employed within 70 government agency websites and social media platforms to answer an array of questions and, since 2020, has been enhanced and utilized to answer COVID-19 queries using machine learning. A similar chatbot has been developed for businesses to answer any COVID-19 related issues (GovTech, 2021). To minimize crowds, hotspot mapping has also been implemented around Singapore, for example, within national parks and gardens (NParks, 2021), and shopping malls (SpaceOut, 2021). The maps are color-coded to indicate crowd levels based on SafeEntry data. The public can see where there are a high number of people to avoid crowds and maintain social distancing. If residents require information on doctors to visit if they are experiencing respiratory illnesses, FluGoWhere is a government website dedicated to listing public health clinics that can provide special subsidies (FluGoWhere, 2021). Similarly, MaskGoWhere is a website to assist households in finding the nearest collection point for masks provided by the government and the times available for pick-up (MaskGoWhere, 2021). Beyond adopting technology to streamline communication, the government has also promoted several campaigns such as the SG clean campaign (National Environment Agency, 2020a) to promote hygiene and cleanliness, and the SG united campaign (SG United, 2021) to support the community and to encourage citizen participation in overcoming COVID-19. Among the general public, the rise of social media platforms such as Facebook and Twitter has led to a global infodemic within the current COVID-19 pandemic. An infodemic can be described as “an excessive amount of information concerning a problem such that the solution is made more difficult” (Collins Dictionary, 2020). There are multiple channels of information (and misinformation), and many members of the public do not know where to get their COVID-19 information updates (Zarocostas, 2020). To combat this influx of COVID-19 information, the Singapore authorities have been highlighting where to find valid information to ensure the correct information is circulated to the public (Ministry of Health Singapore, 2021b), and providing promotional materials to ensure the public follows regulations. Figure 19.2 shows a COVID-19 poster produced by the Singapore Government urging residents to stay at home and to follow preventative measures. The Singapore government’s synchrony among their ministries and health authorities in both rhetoric and execution as well their utilization of technology to reassure the public in a clear, concise, and transparent way during the pandemic has been hailed a success by other countries (Lee et al., 2020; Yan et al., 2020). The country was also recognized by the World Health Organization (WHO) for its efforts in preventing the spread of the disease (The Straits Times, 2020). This illustrates the role of the government as a catalytic institution in capitalizing on the resilience brought about by technology and other resources, to effectively manage public health concerns.

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Fig. 19.2 Example of promotional poster from Singapore government

19.4

Emergent Issues

Dealing with the COVID-19 pandemic requires health authorities and the various stakeholders to understand the different types of competencies among the public to better inform and communicate the ways of preventing the spread of the disease. The two types of literacies that have emerged in relation to COVID-19 are health and scientific literacy, which focuses on competencies relevant to the understanding the disease and other health-related issues, and digital literacy, which focuses on competencies relevant to the use of technology in this COVID-19 pandemic. Rise of misinformation is another issue the public needs to be aware of and to address.

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19.4.1 Health and Scientific Literacy Health literacy refers to having the “level of knowledge, personal skills and confidence to take action to improve personal and community health by changing personal lifestyles and living conditions” (Nutbeam, 1998). As noted by Spring (2020), having a good level of health literacy “has never been more crucial to survival” than in this COVID-19 pandemic, yet given the novelty of the coronavirus, good health literacy, especially with regard to COVID-19, is difficult to attain. One barrier to increasing the levels of health literacy is the rapidly evolving state of information regarding COVID-19. Since the first report of the COVID-19 outbreak, knowledge about the nature of the disease (e.g., its mode of transmission) and accordingly, recommended countermeasures to minimize the spread of the disease, have seen numerous changes. For example, Singapore’s guidance on mask wearing and safe distancing has undergone various alterations over the year, which may be difficult for citizens, especially the elderly, to keep up with (Ang & Phua, 2020; Wong, 2020). These health literacy-related challenges have highlighted two main issues in Singapore. The first is the importance of scientific literacy. Defined as “the ability to engage with science-related issues, and with the ideas of science, as a reflective citizen,” it has been argued that individuals with scientific literacy will be more likely to recognize scientific discovery as an ongoing process, rather than view scientific knowledge as unchanging objective facts (Wee, 2020). This can in turn lead them to perceive new developments in science (which may at times be contradictory to prior knowledge) less negatively as they emerge. The second issue is the importance of government communication. Having clear government communication can not only help the lay public better understand the rationale behind the government’s decisions (e.g., preventive measures for health), but also prevent citizens from losing trust in the government (Wee, 2020). Indeed, a community study survey headed by the National Centre for Infectious Diseases (NCID) in Singapore (SOCRATES; Strengthening Our Community’s Resilience Against Threats from Emerging infectionS) found that more than 90% of respondents valued communications and information from official government sources and that the level of trust in the government’s COVID-19-related communications was positively associated with the likelihood of adopting recommended COVID-19 preventive measures (NCID, 2020). This supports the idea that government communication has a key role to play in elevating the public’s health literacy. Singapore has also adopted a multi-pronged approach (i.e., media, government websites, social media, and Gov.sg channel on WhatsApp and Telegram) to provide clarifications on fake news and ensure that access to accurate information is readily available (Koh, 2020b). With the emergence of COVID-19 vaccines, sustained efforts to increase residents’ health literacy, particularly knowledge about the COVID-19 vaccine, will be critical. Vaccines can not only protect the individual but also the larger community through the effect of herd immunity when enough people are vaccinated. However, it

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appears that there are concerns about the safety and necessity of the vaccine within the community (Lin & Clapham, 2020). Communicating with the public to allay concerns, and public education to increase COVID-19 vaccine literacy within the community, will likely play a role in increasing the acceptance and uptake of COVID-19 vaccines.

19.4.2 Digital Literacy and the Vulnerable Populations Digital technologies have a key role to play in preserving some semblance of normal life during this COVID-19 pandemic. For the general Singapore public, digital tools were the keys that unlocked not only social connection, but also education and work opportunities as well as physical access to places. The importance of digital technologies was particularly evident during the CB period, when most of the population were spatially separated for extended periods of time, but they continued to play an important role even as regulations eased into Phase 2 and Phase 3. Although the forced adoption of digital technologies during this pandemic was generally taken up quickly by most of the population, it also “spotlighted our deep digital divide and the digital outcasts in our midst” (Ong, 2020a). Issues of digital literacy are often entangled with issues of access to the necessary infrastructure and hardware (e.g., Internet access and computers). In the past year, Singapore residents with lower levels of digital literacy have struggled to keep up with the demands of a new normal entrenched in digital solutions. Especially vulnerable groups that have come into the spotlight include the elderly, low-income households, and the differently abled, many of whom have suffered from lost income and opportunities as well as increased stress due to the lack of equipment, Internet access, and necessary skills to navigate the online space (Ong, 2020a). This is discussed further in the section on vulnerable populations, below. These challenges pertaining to digital literacy prompted responses from the government. Efforts have been made by authorities to minimize its immediate negative impacts through the offering of alternatives. For example, the team responsible for the SafeEntry system supplemented the individual QR code check-in method with alternatives such as group check-ins, where more digitally literate individuals can register on behalf of his/her/their family, the SingPass Mobile app, which detects users’ location to facilitate their check-in without the QR code, and scanning of the barcode on one’s identification card, a low-tech method catered for the less digitally literate (GovTech, 2020). For longer term impact, the Ministry of Education has also brought forward plans for the National Digital Literacy Programme by 7 years to hasten the process of closing the digital divide (Davie, 2020; Ministry of Education, n.d.). Beyond providing all secondary students with a personal learning device, the program also aims to inculcate in students other digital skills, such as the ability to find information, use software and devices, and collaborate online. Targeting students in their education journey would help to elevate the overall level of digital literacy in the Singapore population, in the long run.

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19.4.3 Rise of Misinformation The spread of the COVID-19 virus globally was also accompanied by the spread of fake news and other types of misinformation and disinformation; the same is true in Singapore (Tandoc & Mak, 2020). From unproven home remedies to conspiracy theories about the origin of the virus, a wide range of problematic information spread across social media and messaging apps. Unverified information spreads fast at times of uncertainty, as individuals seek to manage uncertainty by filling information gaps. Unfortunately, clinging to inaccurate information may result in problematic behavior. This can range from unnecessary anxiety that can trigger panic buying, among other things, to ingesting dangerous substances believing they are protections against COVID-19. In the early stages of the pandemic in Singapore, many of the viral social media and messaging app posts focused on how the disease, caused by what was then referred to as the Wuhan virus, was unfolding in other countries, such as in China and South Korea. After the first case was reported in Singapore, viral messages on WhatsApp soon shifted to long lists of places that had been visited by positive cases, such as malls that were closed for sanitation. Most of what were listed were accurate—they contained leaked memos from mall managers about scheduled closures. Some were inaccurate, such as a viral message that claimed that an MRT station was closed-down due to a COVID-19 case. Soon, these lists were accompanied by photos and videos of people supposedly passing-out on streets, purportedly due to being sick with the virus, and being avoided by bystanders; many of these images were misappropriated from other incidents, taken from another country, or misrepresented what had happened. As more and more cases were recorded in Singapore, a shift to fake news was also witnessed, centering on home remedies and unproven cures, many of which seem to have originated from other countries but have also spread in Singapore. One example quoted a Japanese doctor claiming that gargling saltwater can kill the COVID-19 virus. Others claimed that eating garlic, or drinking sesame oil or virgin coconut oil, can protect one from the virus. While many of these were harmless, they might provide individuals adopting these remedies with a false sense of safety from the virus. A three-wave national survey in Singapore conducted between February and April 2020 found that exposure and belief in misinformation about home remedies increased the likelihood of adopting these unproven strategies (Kim & Tandoc, 2021). Analysis of messages forwarded to a WhatsApp group initially founded to serve as a fact-checking platform but has since evolved into a group where the nearly 300 members routinely exchanged information about COVID-19 developments found that of the 153 forwarded messages studied, some 35% were outrightly false (Tandoc & Mak, 2020). Only 28% were accurate, while 20% mixed true and false information. One example of a mixed post that went viral in Singapore was a video of a Malaysian student in London recording a message for his parents; the post claimed the student contracted the virus at a party and had died of COVID-19. The

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video is real, but the student had to clarify in a subsequent Facebook post that he was very much alive. The remaining 17% of the analyzed posts were difficult to verify (Tandoc & Mak, 2020). The elderly were particularly susceptible to believing in problematic information about COVID-19, although even young people had also believed and shared some inaccurate posts. Some of the inaccurate information that went viral includes people wrongly accused of hoarding grocery items during cases of panic buying in Singapore. One post showed two women and a man loading groceries in a cart; the post complained how a group was being allowed to hoard supplies. It turned out that the group were volunteers to an elderly home, and had coordinated with the store manager to stock up supplies for the home. In focus groups involving young adults conducted in the early stages of the pandemic in Singapore, participants expressed concern about their parents and elderly relatives, who they said were sending fake news about COVID-19 in their family group chats (Tandoc & Lee, 2020). Thus, in the beginning, young adults understood the pandemic as a misinformation problem, and that the elderly were more susceptible to both the virus and the fake news around it. In contrast, young adults initially thought the virus was not a serious threat to their generation, citing information they come across online, saying only elderly people were at risk—this could explain problematic behavior from some young people in the early stages of the pandemic (Tandoc & Lee, 2020).

19.5

Changes in Public and Consumer Behaviors

The COVID-19 pandemic greatly affected and changed grocery shopping behavior, daily movements, and dining habits of Singapore residents.

19.5.1 Shopping Behavior Change: Waves of Panic Buys One of the most prevalent behaviors observed at the early stage of a crisis or pandemic is panic buying behavior (e.g. Banerjee, 2020; Yuen et al., 2020). It is defined as the behavior of excessively buying more daily essentials than what is typically needed (Arafat et al., 2020). As a global health crisis, COVID-19 has not only led to a substantial number of deaths (World Health Organisation, 2020), but also the shutting down of business and factories, and disruptions in supply chain globally (e.g., “Supply chain disruption: Repurposed,” 2020). A pause in production does not stop people’s high demands in time of crisis. On the one hand, consumers engage in panic buys hoping to prepare for potential shortage of resources and to restore a sense of control (Yuen et al., 2020). They have been stockpiling essentials, ranging from staple foods to personal hygiene products, such as toilet paper, body soap, shampoo, and hand sanitizer (e.g., Fitzsimmons, 2020; Choudhury, 2020). On

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the other hand, supermarkets were running low in certain daily necessities or staple food (e.g., Quek, 2020a), and those disabled or elderly in the community who are more vulnerable to the virus and might have difficulty in going out are at great disadvantage. Additionally, the large crowds at supermarkets heighten the risk of SARS-CoV-2 transmission. Four major episodes of panic buys were seen in Singapore. One after the announcement of DORSCON Orange on 7th Feb (Ishak, 2020) when photographs of empty shelves and long queues in supermarkets were circulating on social media (Tan, 2020c); one before the lockdown and closure of the Malaysian border on 18th March (Elangovan & Lim, 2020); one before the start of CB on 7th April (Loke, 2020), and a relatively smaller one near 22nd April when restrictions on “essential businesses” were tightened further during CB. Products with a long shelf life such as rice, instant noodles, canned food, and toilet paper were the most popular hoarded products at these peaks of panic buying within Singapore (Tan, 2020b; Ong, 2020c). Supermarkets had to impose buying limits and quantity restrictions on these highdemand products to prevent potential inventory stockouts (Ang, 2020a), and to minimize the possibilities that some people in need would not be able to purchase the goods they require. All retail industries saw declines in sales except for Supermarkets, Mini-marts, and Convenience Stores. Retail sales in Singapore significantly decreased during April and May, seeing a year-on-year 40% and 52.1% drop, respectively, in monitored categories (Tee, 2020; SingStat, 2020). Even in June 2020 when the circuit breaker had officially ended, average sales across the retail industry were “still down nearly 28% (year-on-year)” (Enriquez, 2020). Almost 60% of the retailers polled said that they are “likely” or “very likely” to close at least one store and lay-off staff in the next 6 months (Meah & Chew, 2020). Large department stores as well as retail chains shut down some or all their outlets in Singapore during this period (Tay et al., 2020). People have also shifted their habit of offline shopping to online shopping.

19.5.2 Movement Changes: Staying at Home Instead of Going Outside As the city state implemented strict safe-distancing rules, online platforms have become a popular choice for conducting a wide variety of business and lifestyle activities; from court sessions, home-based learning, and board meetings, to fitness classes and intimate social gatherings such as weddings (Tan, 2020a, 2020e). By early April, restrictions were put in place to reduce the number of people visiting high-traffic places, including popular hyper markets and wet markets, such as implementing a maximum capacity rule (National Environment Agency, 2020c). From 22 April 2020, further entry restrictions were introduced with entry to popular wet markets being controlled based on matching the odd or even last digit of residents’ Identification Cards (ID) to the odd and even date of the month, on the

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day of the visit to these markets (National Environment Agency, 2020d). The government further took to employing Safe Distancing Ambassadors and taking corrective action, including $300 fines, against members of the public who did not comply with the distancing regulations (National Environment Agency, 2020c). The above restrictions and practices were then gradually lifted and eased in CB phase 2 and 3 (Ng, 2020), starting with the lifting of the odd/even entry on weekdays to draw the crowds away from weekend traffic that was still too high. Although people were gradually allowed to go-out in larger numbers, restrictions were still in place. For example, in late August due to high traffic at Lucky Plaza in Orchard, where domestic workers frequent on weekends, the odd/even ID entry restriction was imposed on weekends and is still in effect at the time of writing (Entreprise SG, 2020). This public health measure of controlling the crowds hinged upon the public understanding that they needed to adapt their lifestyles to protect personal and public health.

19.5.3 Meal Habit Changes: More Delivery and Home Dining Instead of Dining Out COVID-19 has brought a boom to the local Food delivery services. The major food delivery companies in Singapore—GrabFood, FoodPanda, and Deliveroo—had seen exponential growth in their business (Toh, 2020a). Additionally, groceries delivery services were also seen in high demand. Redmart, a local online grocery shopping platform, had four times more sales than pre-CB, with 11 times more daily visitors to the page, to the point where delivery slots became extremely limited and delivery times increased (Choudhury, 2020). Another significant change was Singaporeans’ dining habits. Local residents have a culture of dining at open-air food centers called “hawker centres” or “coffee shop,” where people can find a variety of affordable and accessible food. From 7th April, dine in at these hawker centers, coffee shops, and other food and beverage outlets was prohibited, thus people could no longer dine outside or buy food as frequently as before (Kurohi, 2020). On the other hand, residents were restricted to takeaway or delivery options (National Environment Agency, 2020b). Subsequently, Singapore’s hawker culture has been significantly challenged during this period. People are no longer allowed to dine at their usual spots and face restrictions on the sizes of their gatherings outdoors. Although takeaways were allowed throughout CB, hawker center stalls still faced survival risks, as the cost of ingredients, labor, utilities were significantly more than their sales due to the decrease in foot traffic at hawker centers (Toh, 2020b). Merchants’ federations have reported a 70% fall in revenue for some of their members following the DORSCON Orange announcement (Tan, 2020f). Recognizing these struggles, the government offered financial aids to some hawkers in the form of rental waivers—initially for 1 month (Heng, 2020) and subsequently an additional 3 months’ (Ministry of Finance, 2020). Furthermore, to

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increase daily sales and ensure their business sustainability, hawker stalls, with the support of merchant federations, have also collaborated to sell their food online through centralized food delivery platforms, such as WhyQ and Oddle (Chiang, 2020). WhyQ saw a three to four times increase in users and orders during CB (Chiang, 2020). One hawker mobilized his community by starting a Facebook Group titled “Hawkers United—Dabao 2020,” which aimed to support fellow hawkers navigate online platforms to tide through the CB (Quek, 2020b). Hawkers and other F & B vendors have also benefitted from food distribution initiatives supported by philanthropic arms of companies like Citibank (Citi Foundation; Project Makan and the YMCA Wok the Talk Project) and CapitaLand (CapitaLand Hope Foundation; #MealOnMe), which were launched to ensure that vulnerable groups like the elderly, migrant workers, children from low-income households and persons with special needs have access to food and other necessities (Ang, 2020b; “Food for Good: Citi,” 2020). To further support the digitization of hawkers’ business, the government has granted $500 per hawker store to facilitate hawkers’ adoption and utlization of food delivery platforms (“Hawkers who get on,” 2020). A similar initiative was scaled-up from hawkers to wet market sellers during the CB period. In partnership with the Infocomm Media Development Authority (IMDA), some wet market sellers have also tried to bring their services online (Tan, 2020d). Others have sold their goods on Facebook Live and Marketplace, with certain groups helping them to arrange delivery of groceries.

19.6

Special Considerations and Early Lessons

One of the insights from the Singapore experiences so far is the importance of considering the needs of vulnerable groups such as elderly, persons with disabilities, and persons with special needs. Major events like CB, and policies that restrict movement can impose unique and added difficulties on each group, in part due to information gaps, lack of tech-savviness, or social isolation. Some elderly face difficulties adapting to the measures such as limited sizes of social gatherings, restricted entry to wet markets, and 1-m distancing rules (Lai, 2020b; Liu, 2020; Wong, 2020). To assist vulnerable populations, special policies and guidelines need to be considered and introduced in timely fashion.

19.6.1 The Elderly Prime Minister Lee (2020) made an empathic, “special appeal” to older Singaporeans to “stay at home for their own safety” on 10 April 2020. A mixture of strategies has been utilized to support the elderly and encourage them to stay at home. For example, the government increased the programs available on television (Wong, 2020) as well as online videos targeting the elderly (Foo, 2020), and

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collaborated with social service agencies to connect with elderly loitering outside their homes and advise them to stay home or refer them to other agencies to receive any additional support they require (Wong, 2020). Social service agencies and non-profit groups like the Lion Befrienders, Singapore Red Cross, and Touch Community Services also contributed to helping the elderly deal with social isolation by, for instance, continuing to provide befriending calls (Asokan, 2020) and making programs for the elderly available online (Tan, 2020g). Further, in recognition of the importance of digital tools in reducing social isolation during this pandemic, various stakeholders (including both for-profit and non-profit companies) have also implemented efforts to increase the elderly’s access and ability to use such digital tools (CapitaLand, 2020; Singtel, 2020; Tan, 2020g). For those needing to shop for essentials such as groceries, the policy of having reserved shopping and service timeslots at supermarkets and banks was put in place; special checkout lanes have been allocated for the elderly to assist with quick checkout that adheres to social distancing rules (Ong, 2020b).

19.6.2 People with Disability, Special Needs, and Pre-existing Health Conditions To facilitate reach to persons with disabilities, provision of sign language interpretation for live, recorded events and communications and the inclusion of information in different formats (e.g., simple languages, large prints, braille) to ensure access to information, varied positioning of SafeEntry QR codes, as well as monetary relief schemes to reduce the financial stress were established. SingPass Mobile app also allowed users to SafeEntry check-ins based on location-detection systems, thereby avoiding the need to look for and scan the QR codes (GovTech, 2020). The changes implemented during the COVID-19 pandemic can also be frustrating for people with special needs. Forms of support that have emerged for them include announcements by the government’s decisions for flexible enforcements of mask wearing for such persons and recategorization of allied health services as essential services to facilitate access to therapies, the lending of assistive technology and communication devices, and the sharing of intervention strategies by allied professionals with caregivers (Teng, 2020). For people with existing medical conditions, non-urgent consultations were postponed and complemented with phone consultations, while patients requiring refills for chronic medications were allowed to refill their prescriptions without consultations, and may even opt to receive the prescriptions in the comfort of their homes through home-delivery services (Tan et al., 2020).

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19.6.3 Children in Low-Income Households This group was especially affected by the introduction of home-based learning introduced during the CB period. One of the main hurdles faced is access to digital learning platforms, as this segment may not own (enough) computers nor have stable access to the Internet. Organizations such as the Ministry of Education, and volunteer groups like ReadAble, SG Bono, and Engineering Good helped to reduce this barrier by lending devices and Internet dongles or collecting, refurbishing, and installing the necessary software on donated devices (Goh, 2020a).

19.7

Conclusions

In the past 12 months in Singapore, government communication has played a key role in elevating the public’s knowledge of COVID-19 and driving the safedistancing measures. Singapore also successfully adopted a multi-pronged approach using various media channels (e.g., government websites, social media, and Gov.sg channel on WhatsApp and Telegram) to encourage positive public behavior. However, the process of communicating about the pandemic and the desired public behaviors was not without trials. The experiences from Singapore to date provide a number of key insights regarding health communication of a major pandemic. One of the earliest lessons pertained to the importance of determining exactly how much restrictions are to be imposed on the population quickly, and to ensure clear communication guidelines to inform the public in a clear and concise manner. Thus, there is a need to be flexible and amend/add to these guidelines, quickly, as new scientific findings emerge. In the case of some directives in Singapore (e.g., mask wearing) some unclear messaging about the practice in the early phase of the outbreak led to confusion about whether one should or should not wear a mask. Third, the role of misinformation cannot be underestimated as rumors and fake news played a role in the public misperceptions about COVID-19 and societal responses. From food hoarding to vaccine hesitancy, misinformation drove several unexpected public attitudes and behaviors, which the authorities have been quick to debunk, often via mainstream media channels. A final lesson lies in ensuring that credible authorities play a key role in directing public actions. Having clear and transparent government communication not only helps the public to understand better the rationale behind the government’s decisions (e.g., preventive measures for health (Wee, 2020)), but also enables citizens to look to the government for timely communication, to take directives seriously and to behave in accordance with recommended guidelines and directions. This chapter describes the instrumental role of Singapore’s government, businesses, non-governmental organizations (NGOs), and other grassroots movements in meeting the community’s needs during the pandemic. Shultz, Rahtz, and Sirgy (2017, p. 413) theorize that these three catalytic institutions, as well as the citizen-

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consumers, “determine what will be the demand, assortment, amount, quality and choices of goods and services to enhance the QOL in a community.” These key stakeholders had provided relief, sustained social needs by drawing on technological resources, adapted their business models to cater to a consumer base that was grappling with distancing measures, and ultimately catalyzed a shift to new ways of working and living. Some groups of citizen-consumers emerged as more vulnerable due to their difficulties in accessing resources, social capital, and economic standing, but the community has rallied together to look-out for and to care for these under-served. This demonstrates the ability of Singapore to empower its community members in protecting well-being and promoting growth and quality of life for its citizens.

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May O. Lwin is the President’s Chair Professor of Communication Studies, Nanyang Technological University. Her expertise lies in using digital technologies for health communication, particularly focusing on infectious diseases, such as Dengue, Influenza and COVID-19. Her research includes health information-seeking and monitoring of social media discourse to understand population sentiments. She utilizes diverse techniques that have contributed to the understanding of pandemic preparedness, crisis communication, and how misinformation has developed and been debunked. Professor Lwin has played a major role in the development of digital surveillance systems which integrate participatory and predictive surveillance, civic engagement, and health education for disease management. She has made significant contributions in the field of health communication, publishing over 170 journal articles, 11 scholarly books, as well as numerous book chapters and conference papers. She is a recipient of the Fulbright ASEAN Scholar award, and the 2019 International Communication Association (ICA) Outstanding Applied Scholar Award. Chitra Panchapakesan is a Postdoctoral Fellow at Wee Kim Wee School of Communication and Information, in NTU. Her research areas include digital health focusing on understanding public sentiments, information seeking and sharing and new media communication. Her work looks at using public participation for two-way health communication and surveillance. She has also worked on numerous digital health communication projects that conceptualize and develop social media applications for bettering public health. Anita Sheldenkar is a research associate at Wee Kim Wee School of Communication and Information at Nanyang Technological University in Singapore. She is an expert in epidemiology and health communication, with particular interest in infectious diseases such as influenza, dengue and COVID-19. She has worked on several projects exploring discourse surrounding infectious diseases through social media, big data, surveys and content analysis. She has accrued several years of experience in the field, in both Asia and Europe and has published a career total of 29 peer-

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reviewed journal articles. Anita also has an interest in utilizing technology for community engagement, surveillance, and communication; working on various digitally integrated public health projects such as Mo-Buzz for which her team was awarded the International Communication Association 2019 Public Policy Research Award. Edson C. Tandoc is an Associate Professor at the Wee Kim Wee School of Communication and Information at Nanyang Technological University in Singapore and an Associate Editor of Digital Journalism and Human Communication Research. He is also the author of Analyzing Analytics: Disrupting Journalism One Click at a Time (Routledge, 2019) and co-editor of Critical Incidents in Journalism: Pivotal Moments Reshaping Journalism around the World (Routledge, 2020). Professor Tandoc is also the Director of NTU’s Centre for Information Integrity and the Internet (IN-cube). His research focuses on the impact of emerging technologies on news production and consumption. Hye Kyung Kim is an Associate Professor at the Wee Kim Wee School of Communication and Information, NTU, and a Senior Editor of Journal of Health Communication. She designs persuasive messages and innovative tools that could help improve individuals’ health decisions. Much of her research has explored the interplay between the individual factors that are relevant to resistance (e.g., optimistic bias, past unhealthy behaviors) and message (e.g., narratives, framing) and/or technological features (e.g., avatar, self-regulatory tools) in shaping people’s beliefs on public health issues, as well as their health behaviors. Her work has appeared in major peer-reviewed academic journals such as Journal of Health Communication, Health Communication, Human Communication Research, and Risk Analysis. Shanshan Yang (Ph.D.) specializes in human psychology in media communication. Currently, she is mainly focusing on emotion as well as behavioral changes during Covid-19 pandemic and attitudes towards antimicrobial resistance. She has also examined behavioral cues on social media and its impact on romantic relationship and has published works on prestigious journals such as Computers in Human Behavior and presented on international conferences. She’s also experienced with psychometrics and program evaluation prior shifting research focus to communications during pandemic. Zoe Ong is a Ph.D. candidate in the Wee Kim Wee School of Communication and Information, under the Interdisciplinary Graduate Programme (Global Asia), NTU Singapore. After obtaining her B.Sc. and M.Sc. in the biological sciences, her research interests expanded into the social sciences, namely, the intersecting areas between health and science and technology. She has contributed to research examining personalized medicine from a sociological perspective and is now also working on research related to literacy and health communication. Her Ph.D. research aims to develop a theoretically grounded understanding of patients’ experiences of telemedicine in the Asian context. Si Yu Lee is a Master’s Research Student at the Wee Kim Wee School of Communication and Information at Nanyang Technological University in Singapore. Her main research areas are Health Communication and Critical Data Studies. She has worked on several projects pertaining to health issues such as the Covid-19 pandemic, antimicrobial resistance, and stroke prevention as well as projects on misinformation and visual ageism. Melissa Rachel Kwan is a Research Assistant at the Wee Kim Wee School of Communication and Information at NTU Singapore. She has undergone training in sociological inquiry with a focus on using qualitative methods to interrogate social inequalities and community-building processes. Her research interests lie primarily in experiences of urban life, having done a study on young adults’ conceptualization of mobility in Singapore. She hopes to pursue further research in the field of health communication and normative understandings of public health issues.

Chapter 20

“History Repeats Itself”: South Africa, An Epic Sighting—COVID-19 Stefan Kruger

Abstract Sub-Saharan Africa has faced many pandemics in the past and currently COVID-19 is a challenging concern for the South African Government. COVID-19 and its variant has a direct impact on communities at large. On March 23, 2020, the South African President announced measures to prepare South Africa for this pandemic, which included lockdown levels and many interventions. This chapter focus on well-being in relation to communities, need satisfaction, as well as the health and safety and economic impact COVID-19 has on South African communities. Furthermore, a discussion follows, which entails what policies and programs at community level worked and did not work (lessons learned and best practice by the South African Government). Based on the available literature and discussion, the author proposes the bottom-up spillover effect of subjective well-being in dealing with COVID-19 as a pandemic. Keywords COVID-19 · Sub-Saharan Africa · Community well-being · Quality-oflife indicators · Health and safety indicators · Economic indicators · Bottom-up spillover effect

20.1

Introduction

Sub-Saharan Africa, otherwise known as South Africa, is a well-developed country and has a large multicultural population residing in the nine official provinces. South Africa has faced many pandemics in the past, and is currently trying to cope with COVID-19, starting off with the 1918 Spanish Influenza, which caused the death of 13,471 individuals in a very short period of time. Poliomyelitis was another pandemic, between 1918 and 1945 that caused many mortalities. On the other hand, in the northern part as well as in KwaZulu-Natal, Malaria, first discovered in 1837, is now well controlled; however, Tuberculosis and HIV/AIDS are still a challenging S. Kruger (*) Faculty of Economic and Management Sciences, Work Well Research Unit, North-West University, Potchefstroom, South Africa e-mail: [email protected]; http://www.abt-edu.com © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_20

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concern for the South African Government as it affects many vulnerable communities in the country. Then, more recently, the first case of COVID-19 was reported at the beginning of March 2020 in South Africa. COVID-19 brought about many changes in communities. These include behavioral (e.g., hygiene and sanitization, social distancing, self-quarantine, and isolation) as well as to comply with five levels of lockdown regulations imposed by the South African Government. Individuals in communities with comorbidities (tuberculosis, HIV/AIDS, obesity, diabetes, hypertension) and the elderly are thought to be at high risk. The impact of COVID-19 on mental well-being (anxiety, depression, social, emotional) has a direct effect on physical well-being (sleeping patterns, eating habits, lifestyle) (South African Department of Health, 2020). Therefore, distressed communities due to the impact of the COVID-19 pandemic may not flourish for a certain period of time. Quality-oflife (QoL) indicators (Shultz et al., 2017), such as low-order needs satisfaction (health-related well-being) and high-order needs satisfaction (quality of community life at large) are worthwhile for the Government to act on as a priority in supporting citizens and managing this pandemic in uncertain times. On the other hand, COVID19 has a detrimental impact on the South African economy as well as health and safety concerns related to communities in the nine provinces. This chapter will start by introducing the reader to a brief history of pandemics that South Africa has faced in the past up to COVID-19 more recently. Furthermore, the author will then elaborate on well-being in relation to communities, need satisfaction, as well as the health and safety and economic impact COVID-19 has on our country. Furthermore, a discussion will follow, which will entail what policies and programs at community level worked and did not work (lessons learned and best practice). A suggestion will be made in using the bottom-up spillover effect in dealing with COVID-19 as a pandemic.

20.2

Background

20.2.1 History of Pandemics in South Africa 20.2.1.1

Spanish Influenza (1918–1919)

The 1918 Spanish Influenza was caused by an H1N1 virus with apparent genes of airborne origin and was transmitted either by coughing or sneezing (Centers for Disease Control and Prevention, 2018). The incubation period of this dreadful disease was thought to be between 1 and 2 days, affecting the respiratory system of young and healthy individuals (ACSS, 2020; Patterson & Pyle, 1983). According to the Africa Center for Strategic Studies (2020), Spanish Influenza caused 5% of deaths of the total Colonial South African population from 1918 to early1919 at that time. No proper health-related systems were available in 1918–1919 in South Africa, and therefore these had a detrimental effect on all citizens, especially in rural communities.

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20.2.1.2

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Poliomyelitis (1918–1945)

Poliomyelitis is a contagious disease affecting children and is spread by those who are infected by the virus. In many instances, the virus attacks the spinal court and as an end result, paralysis (SAHO, 1989). If no vaccine is available or left untreated then Poliomyelitis could cause death. The South African Government at that time faced many challenges as a little amount (stock) of vaccine was available from 1918 to 1945 and many ethnic communities did not trust alternative medicine, and therefore mortalities remained high (Gear, 1946; Millar, 1949; SAHO, 1989; Wade, 2006). However, all children in South Africa are vaccinated against this outrageous disease. Oral polio vaccine (OPV) is available at clinics and hospitals, accessible to every child in South Africa. The National Institute for Communicable Diseases (2018) is monitoring and managing poliomyelitis with stringent control, and outbreaks of this disease are rare.

20.2.1.3

Malaria (1837–Current)

The distress that Malaria has on tourism and hospitality, agriculture, (rural) communities, and industrial developments in South Africa is noteworthy. The provinces Mpumalanga, Limpopo, and KwaZulu-Natal are mostly affected (Sharp & Le Sueur, 1996). However, our neighboring SADC countries, such as Botswana, Zimbabwe, and Mozambique are also at risk. See Fig. 20.1, map of South African provinces. The Malaria Control Programme had become effective in 1999 and a memorandum of understanding was signed by health ministers of South Africa, Swaziland, and Mozambique (Coetzee et al., 2013). South Africa is well equipped to deal with Malaria. Outbreaks (mortalities) are under control based on a quality healthcare system provided by the South African Government (South African Department of Health, 2019).

20.2.1.4

Tuberculosis and HIV/AIDS (Ongoing)

There seems to be some supportive literature that Tuberculosis (TB) existed in South Africa with the arrival of the Dutch settlers in 1652; however, at a very low level. On the other hand, Europe had significant cases of Tuberculosis during that time (Kanabus, 2019). South Africa was a popular destination for seafarers in the sixteenth century across the globe and the spread of Tuberculosis was evident in this country. With the discovery of diamonds and gold, many individuals had become infected with this disease. According to SAHO (2020), there is an estimation that about 80% of the South African population might have been infected with TB. Many are asymptomatic and are not even aware that they contracted the disease (Kanabus, 2020). TB is an ongoing concern and deaths are high; however, good vaccines are available and prove to be effective. In the same vein, HIV/AIDS is a pandemic that

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Fig. 20.1 Map of South African provinces. Source: d-maps.com. (2020)

faces many challenges within the South African context, as this country has the largest number of individuals who are HIV+ in the world (Simelela & Venter, 2014). The first HIV/AIDS-related deaths due to this virus had been reported toward the end of 1981 (Mayosi et al., 2012). The South African Government is trying its best to administer antiretroviral drugs and educate (developing programs) those who had been positively affected by this virus and not, especially in poverty-related demographics. It is often seen in South Africa that TB and HIV/AIDS go hand in hand (CDC, 2011).

20.2.1.5

COVID-19 (2020–Ongoing)

Coronaviruses seem to be collective around the globe. Many of these Coronaviruses have their origin in animal matter and not many of them could prove to be harmful or cause mortalities in human beings (South African Department of Health, 2020). According to sources, toward the end of December 2019, a SARS-CoV-2 case was identified and confirmed in Mainland China; moreover, in the district of Wuhan

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Table 20.1 Lockdown levels in South Africa to combat the spread of COVID-19 Alert level 5 26 March to 31 April 2020 Goal Radical measures to prevent the spread of COVID-19 and save lives of South African citizens

Alert level 4 1 to 31 May 2020 Goal Extreme safety measures in limiting transmission and/or outbreaks of COVID-19. However, allowing some activity of South Africans to resume

Alert level 3 1 June to 17 August 2020 Goal Restrictions to many activities, including regulations in terms of workplaces and social gatherings. Addressing the high risk of transmission of the virus

Alert level 2 18 August to 20 September 2020 Goal Physical distancing remained in place with a main focus on leisure and socialrelated activities. Prevention of a possible second wave in spreading COVID-19

Alert level 1 21 September to Ongoing Goal Regular activities by South Africans may resume. Health-related guidelines such as wearing a mask and to sanitize still in place. South African citizens are made aware and are prepared that alert level 1 might change to other alert levels if deemed necessary

Source: See South African Government (2020b, 2020c, 2020d, 2020e, 2020f) for detailed regulations

(WHO, 2020). On March 11, 2020, the WHO confirmed that COVID-19 can be regarded as a pandemic. Due to the rapid spread of COVID-19 internationally, South Africa was not excluded. The South African President, Mr. Cyril Ramaphosa, on March 23, 2020, announced a measure to prepare South Africa for this pandemic and to combat the spread of COVID-19 (Mail & Guardian, 2020); some of which included travel restrictions by all citizens imposed by the South African National Defence Force and South African Police Services (Polity, 2020). Lockdown restrictions were imposed by the South African Government at five levels (see Table 20.1). This followed amendments made to the South African Disaster Management Act to deal with this pandemic (South African Government, 2020a). On March 15, 2020, a national state of disaster was declared, and March 27, 2020, a national lockdown proceeded (Primary Health Care Performance Initiative, 2020).

20.2.1.6

Lockdown Levels in South Africa (Disaster Management Act)

The lockdown regulations brought about many challenges, based on well-being in communities (need satisfaction), the economy as well as health and safety within the broader South African context.

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Community Well-Being

I am from a point of view that it is important to first elaborate on what “Subjective Well-Being” (SWB) entails. I have borrowed the working definition based on my understanding from a great scholar, Ed Diener. SWB is subjective in nature, based on affective experiences. This broad term is not only about the absence of negative affect, but also includes positive affect in relation to an individual’s life. SWB includes a global assessment of various life domains that are based on affect and is often synonymously associated with satisfaction with life (SWL), happiness, and QoL (Diener, 2009, 2020). On the other hand, community well-being (CW-B) refers to a variety of factors (e.g., perceptions, needs fulfilment, observed conditions in a community, social, and cultural) (Sung & Phillips, 2016). However, other related concepts such as “economic,” “political,” “environmental,” as well as “health and safety” have a direct impact on the well-being (SWL, QoL, happiness) of residents in a community (Phillips & Wong, 2016). COVID-19 has a direct impact on South African communities. To date (see Fig. 20.1), for geographical representation of the nine provinces in South Africa and in Table 20.2, an update is given on some statistics related to COVID-19, spreading and affecting communities in the nine provinces at large. It is evident from Table 20.2 that COVID-19 has spread more rapidly in some provinces than others. However, population density is much higher in some provinces than others, and therefore the increase of COVID-19 cases.

Table 20.2 COVID-19 statistics in Southern Africa COVID-19 tests conducted 4,607,883 Provinces Limpopo Mpumalanga Gauteng North West Free State KwaZulu-Natal Northern Cape Eastern Cape Western Cape

Positive COVID19 cases 708,359 Confirmed cases 16,956 29,023 226,073 32,202 54,238 121,647 20,690 92,566 114,964

Source: Ministry of Health (2020)

Total recovery cases 641,706 Deaths

Total COVID-19 related deaths 18,741 Recoveries

440 592 4679 403 1402 3160 256 3508 4301

15,890 27,664 205,065 28,727 40,576 112,296 17,099 87,746 106,643

New COVID19 cases 2055

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20.4

423

Quality-of-Life Indicators

The QoL (well-being) indicators of a community could be viewed as “distressed” or “flourishing” (Shultz et al., 2017). Maslow’s needs hierarchy theory (Maslow, 1954, e.g., deficiency needs—physiological, safety, love/belonging, self-esteem, and growth needs—self-actualization) is often used to assess the QoL indicators of residents in a community (Lee et al., 2014; Kruger, 2018; Sirgy, 2011). Low-order needs satisfaction encompasses an indicator (e.g., “diseases”), which could affect health-related QoL (well-being) of residents in a community. To meet the example given based on low-order needs satisfaction, Governments should provide quality healthcare systems to assist communities in terms of diseases. A high-order needs satisfaction indicator may include “population density,” which could affect the quality of community life at large. Population density is often a challenge in South Africa due to overcrowding in informal settlements as well as in bigger cities. See Sirgy (2011) and Shultz et al. (2017) for a comprehensive list of community indicators that have a direct impact on community well-being (QoL). The literature is rich focusing on the concept “flourishing” in relation to residents in a community (Lam & Wong, 2020; Ross et al., 2019; VanderWeele, 2017). However, there is consensus among psychologists as well as positive psychologists that “flourishing” is interconnected with notions such as a wonderful happy and healthy individual (Moore & Lippman, 2006). Keyes (2003) suggests that “flourishing” could be understood as a psychological state of an individual, including the experience of positive emotions in life as well as a positive psychological and social functioning. Sirgy (2020) proposed, based on work done by Seligman (2011), that a new theory exists on “flourishing” and should be objective and subjective in nature. Therefore, “flourishing” as related to well-being comprises “positive emotions,” “engagement” (flow), “positive relationships,” “meaning,” and “accomplishment” (purpose in life), (p. 112). In the same vein, The Conversation (2020) is from a point of view that some approaches made by South African communities to flourish during a pandemic with a focus on lower-order needs satisfaction includes social cohesion. Although social distancing is in the order of the day, it is noticeable how residents are becoming more aware of their neighbors, reaching out via smart phone communications and assisting each other with online purchases may it be goods or food and beveragerelated commodities. Networks had been established on social media platforms in assisting with the prevention of crime-related activities, therefore keeping communities safe. Social workers in these communities are active in handing out masks, delivering pamphlets to post boxes in creating awareness on how to stay safe during the pandemic. NGOs support some residents with food vouchers, especially those that have lost their jobs (National Business Initiative, 2020). On the other hand, there are also some positive initiatives (roles) taken by businesses and Non-Government Organizations (NGOs) in South Africa as catalytic institutions during the COVID-19 pandemic, assisting communities at large to name a few. These are summarized in Table 20.3.

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Table 20.3 South African businesses and NGOs as catalytic institutions Catalytic institutions AngloGold Ashanti Distell a leading company in manufacturing alcoholic beverages Old Mutual

Vodacom (smartphone provider) Nedbank (Financial institution) Transnet Pick n Pay (food retail company) MultiChoice group

Activity Assisting with humanitarian support in slowing the spread of COVID-19 in South Africa Producing sanitizers Sponsorship of ZAR 50 million in partnerships with businesses, civil, and labor societies at large in prevention of the spread of COVID-19 Free online medical consultations. Providing hunger relief to vulnerable communities during the pandemic Providing facilities such as self-quarantine cites to communities “Feed the nation” relief fund Supporting the entertainment industry during the pandemic

Source: Global Compact Network South Africa (2020)

Then, who decides how residents in a community should “flourish” based on an epidemic outbreak? Is that the responsibility of governments, politicians, the WHO, businesses, NGOs or is it the responsibility of residents in a community at large? It is suggested that all stakeholders should work together in finding solutions when faced with a pandemic.

20.5

Health and Safety Indicators

Although the South African Government enacted the Disaster Management Act on March 23, 2020, by inducing lockdown level 5 and other levels that followed (Table 20.1), the healthcare system still remains frail. Some challenges include the inability to provide primary healthcare to communities in all nine provinces (Fig. 20.1) and a definite shortage of highly skilled healthcare professionals as well as governance and management-related issues are evident. Dealing with COVID-19, HIV, TB, and those individuals with comorbidities is an ongoing overwhelming task that the South African Government faces. Lockdown level 5 assisted the South African Government to prepare themselves as well as the national healthcare system for the rapid spread of COVID-19 and to save lives (South African Government, 2020a). Safety measures had been put in place by employing the South African Defence force, South African Police Services, and the South African Department of Transport and Public Works to enforce and assist with the lockdown levels and regulations (Parliament of the Republic of South Africa, 2020).

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In terms of mental well-being, North-West University News (2020), Ina Rothmann conducted research and found that in her study sample among South Africans that many experience pre-traumatic stress disorder (Pre-TSD) during lockdown levels. This is a direct cause based on the impact of COVID-19 has on communities’ mental health. Some of these mental health-related symptoms could be caused by “social distancing,” “disruption of daily routines” normal “day-to-day activities,” “loneliness,” and “depression” (p. 1). According to Mlaba (2020), stress and anxiety levels are constantly increasing (65%) in South Africans residing in all the provinces of South Africa due to the spreading and impact of COVID-19. Many South Africans do not have access to mental healthcare systems (Pharma Dynamics, 2020) and the underinvestment of the South African Government in such a system is evident (El Gharib, 2020; Mlaba, 2020; Oukula, 2020). Furthermore, many South Africans self-reported that they neglected their health, consuming unhealthy food, therefore putting on weight, turned to alcohol, substance abuse, smoking of tobacco illegally purchased, and taking antidepressants (Oukula, 2020). Women who tested positive for HIV are at severe risk of contracting COVID-19 and an increase in domestic-, interpersonal-, sexual trauma as well as gender violence, among some South Africans, is apparent (Joska et al., 2020). Furthermore, it appears that the South African health system focused more on the elderly, HIV+, TB+ individuals, and those suffering from comorbidities, who are high at risk of contracting COVID-19. Although the intention was perceived as good, one can construe that children and young adolescents in communities are also experiencing psychosomatic health-related problems. Children may also experience trauma, anxiety, negative emotions, behavioral, sleep and panic disorders during a pandemic, but are coping much better with it than adults (Norton et al. 2020). The closing of schools as part of “flattening the curve” in communities brought about that many children in rural as well as informal settlements had no access to their “daily feeding scheme” (Norton et al. 2020). On the contrary, the South African Government intervened at lower lockdown levels in allowing feeding schemes to continue (South African Government, 2020a). Another consequence that some children experience in South Africa in the times we find ourselves in with a pandemic is neglect and abuse (Fouche et al., 2020; Nkomo, 2020). This definitely has a detrimental effect on their mental well-being and they could pass trauma-related events (pandemic-related) onto their adult lives (Kim et al., 2020). Based on social media pages visited by the author, not all children or young adolescents in South Africa experience such a huge mental-related impact of COVID-19 in their lives. Only time will tell. On the other side of the coin, how safe are South Africans during all five alert lockdown levels imposed to combat the spread of COVID-19? According to Grobler (2020) and the South African Police Service, the Minister of Police announced that, in the initial stages of lockdown, levels 5 and 4, compared to the previous year, a significant drop in crime-related activities such as “murder,” “assault to cause grievous bodily harm,” and “trio crimes,” is noticeable. Unfortunately, an increase in gender-based violence is at the order of the day. However, Lamb (2020) maintains that, based on a report and his blog, during the other levels of lockdown regulations,

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an escalation in crime-related activities is apparent with a sharp increase in the Kwa-Zulu Natal and Western Cape Provinces of South Africa. The harsh lockdown levels brought about that many South African citizens are faced with an increase in “poverty,” “unemployment,” “food insecurity,” “hunger,” and domestic violence. These can be attributed to the impact that COVID-19 regulations have on the South African setting (Lamb, 2020). Based on the discussion in this section of the chapter, it is clear that health and safety indicators have a huge impact as I call it on the “captured-self” during this pandemic we find ourselves in.

20.6

Economic Indicators

Moody’s, an economic ratings agency, has downgraded South Africa’s credit rating to “sub-investment rate,” that of “junk status” in March 2020, at the same time when lockdown alert level 5 was imposed by the South African Government (Cronje, 2020). According to Cronje (2020) and Moody’s Investors Service (2020), South Africa’s very “weak economic growth” looks negative. The rapid spread of COVID-19 in this country will furthermore complicate the deterioration of the ZAR toward the broader global stance and it is expected that South Africa will enter into a lower global economic growth, which will place this country in a very vulnerable economic position. South Africa finds itself already in a second economic recession during the last quarter of 2019, Cronje said. Going to press, the ZAR trades against major global currencies as follows: USD1 ¼ ZAR 16.10; 1 Euro ¼ ZAR 18.83; 1 GBP ¼ ZAR 20.89. The depreciation of the ZAR is placing communities in a hardhitting situation as goods and services are becoming more expensive, which many cannot afford and as a result poverty is on the increase in some communities. StatsSA (2020a) confirmed that the gross domestic product (GDP) plummeted to 16% between the first and second quarter of 2020 and the growth rate for the year so far is 51%, indicative that the South African economy is not doing well at all due to the impact of COVID-19 as well as the economic recession. Nielsen (2020) furthermore confirms that the South African Consumer Index in the second quarter also dropped to 68, which clearly shows the impact that COVID-19 has on consumer sentiment. Many South Africans lost their jobs and means of financial support during the strict militarized lockdown levels (Neves, 2020), especially those who were employed as domestic employees as well as in the broader tourism industry. South Africa is currently facing a huge unemployment rate in the last quarter of 2020. Mxesibi (2020), in a report, confirms that operators trading in the informal economy of South Africa in communities (e.g., street vendors selling food and beverages, spaza shop owners, grocery related, local entrepreneurs, and building supplies) and informal domestic workers had been largely confronted by the lockdown levels 5–3. It was and still is a matter to survive between small income and coping with safety in protecting themselves against the dreadful COVID-19 virus. According to StatsSA (2020b), 290,000 South African citizens who are earning a living as such in the informal economic sector, which comprises 26% of total

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Table 20.4 Social and support package—South African Government

Key area Health response Hunger and social distress relief Municipalities in communities Job protection and creation Securing of loan scheme Additional tax relief Total

427 ZAR in billions 20 50 20 140 200 70 500

Source: Quantec (2020) and author’s own compilation

employment, operators (17.8%), and domestic employees (8%). This informal economic sector provides employment to many besides domestic employments. Mathe (2020) affirmed based on statistics released by StatsSA (2020a) (lockdown levels) that surprisingly the agricultural sector had an increase of output to 15.1% due to exports and IT-related businesses. The construction sector attained a high 76.7% drop in output, followed by manufacturing (74.9%) and mining (73.1%). Air travel dropped to 67.9%. The retail ban on alcohol and tobacco as well as the closing of accommodation facilities indicated a decline of 67.7%. The finance businesses showed a downward spiral of 28.9%. The demand-side related to the South African economy also showed a negative percentage of 53.2% due to lower exports in general and household overheads/spending. South African economists are of the point of view that it will take years for South Africa’s economy to recover from the current situation. Businesstech (2020a) and Hendrickse (2020) confirm that a possible expected growth of the National Treasury and International Monetary Fund based on the GDP growth in 2020 would range between 7% and 8%, respectively. During April 2020, it was announced by our President that a R500b relief package will be made available to a distressed based on COVID-19-related economic constraints in South Africa trying to stabilize the South African economy. See in Table 20.4 how the South African Government had spent this funding during lockdown levels. Unemployed citizens, small, medium, and micro-enterprises, small increases in social grants, hunger and tax relief are an outflow thereof (The Presidency—Republic of South Africa, 2020). This relief fund had been sourced from major banking facilities, the reprioritization of the South African budget (2019/2020), i.e., The World Bank, International Monetary Fund, and the BRIC’s New Development Bank and the South African Reserve Bank (South African Government News Agency, 2020). This is one of the largest supporting funds sourced in a developing country (Quantec, 2020). However, South Africa had not been spared from economic fraudrelated activities during all lockdown levels as some other countries around the globe also experienced. These include tender fraud, corruption among some officials, South African Government IT systems not functioning well, misspending of relief packages and retail price hiking (Harper, 2020; Tsunga et al., 2020). Therefore, those individuals who should have benefitted from the relief packages imposed by the

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South African Government might not have done so at all. It is also not so clear how the South African Government will repay the funding sourced, placing South Africa furthermore into an economic crisis. However, soon when lockdown levels had been imposed on South Africans in preventing the spread of COVID-19, many started with online purchases and home deliveries had been made. “COVID-19 indeed did catalyse online behaviour.” Access to online products and services included grocery, shopping, education, banking, health, and fitness. However, with such many diverse communities in South Africa, not all had the opportunity to access such services online (Ahlfeldt, 2020). Access to basic commodities is still available and South Africans show sentiment in the new norm of hygiene practices and the wearing of masks when in public spaces (Deloite, 2020).

20.7

Lessons Learned and Practices

Although some important differences exist in how South Africa dealt with previous pandemics (Spanish influenza, poliomyelitis, malaria, TB, and HIV/AIDS), it definitely guided the South African Government in responding to the COVID-19 pandemic. As no vaccine was available during the Spanish influenza outbreak (as currently with COVID-19), social distancing was at the order of the day to prevent this disease from spreading in 1918 (Africa Center for Strategic Studies, 2020). Those communities that practised social distancing, mobilized themselves, and with good hygiene practices did well during that time. Healthcare facilities seemed not to cope well in dealing with those affected, as limited medical professionals were available, and therefore the mortality rate was high as in all cases around the globe. Appropriate communication by the South African Government provided trust in communities. However, rural communities mistrust the Government as they did not understand the dangerous outcome of the Spanish influenza, poliomyelitis, malaria, and TB. Although poliomyelitis and tuberculosis are still a going concern, quality vaccines exist in fighting these diseases. South Africa is also well equipped to deal with malaria and HIV/AIDS (National Institute for Communicable Diseases, 2019; Tizifa et al., 2018; WHO, 2006). Sub-Saharan Africa has and will always be part of a global health security system. Therefore, exposure to COVID-19 was unavoidable. All countries around the globe are connected as a community and should stand together acting on a pandemic threat as with COVID-19. Lessons learned and practices in response to the COVID-19 pandemic are guided by the Africa Center for Strategic Studies (2020) and the author’s own compilation based on available literature. These practices have a direct impact on communities. Best Practices by the South African Government • COVID-19 presents a health security risk that has a direct effect on local and global communities. The South African Government has reached out to

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neighboring countries and around the globe to source and provide information in preparing for this pandemic. The quick response of the South African Government after the first case of COVID-19 was detected, declaring a national state of disaster and imposing lockdown levels soon after had been a good practice. Countries such as Italy, France, Spain, the UK, and the USA Governments did not respond as fast as is the case in South Africa. These countries could learn from South Africa as a global pandemic such as COVID-19 poses a global health security risk. During lockdown levels 5–3, all South African borders had been closed as well as that no movement of citizens between provinces was allowed, including international travel. The closing of borders did not deter individuals from entering or leaving South Africa as many could access South Africa not making use of border posts. This poses a health security risk as it cannot be determined which individuals might spread COVID-19 from and to South Africa (Mbiyoza, 2020). The South African Government has established the National Coronavirus Command Council in March 2020, with its primary functions that of statutory regulations and management of the disaster (COVID-19). This also assisted the Government in managing an anticipated surge in infections caused by COVID-19. Various sources of awareness campaigns had been launched by the Ministry of Health to educate South African communities about the impact of COVID-19 on health-related matters. Some of these include: Road campaigns, South African Broadcasting Corporation, social media, online services, text messaging, leaflets, and banners. The South African president praised two pharmaceutical companies, i.e., Pfizer SA and an associated company BioNTech for the development of a COVID-19 vaccine that seems 90% effective. This could place South Africa at the forefront in providing a vaccine to communities and possibly around the globe. Availability of essential services/goods/medicine during lockdown levels seems appropriate practice. Screening and testing resources are a continuous challenge, but ongoing. Night-time curfew in the initial stages of lockdown (20:00–5:00). Self-isolation/ social distancing guidelines for communities are an effective practice by the South African Government. Closure of schools and tertiary institutions is good practice in protecting South Africa’s future investment in scholars/students. In many rural communities, schools lacked the quality infrastructure and COVID-19 regulations required by Government when scholars returned to school. Training of healthcare professionals in dealing with COVID-19+ individuals and medical equipment is a well-deserved effort made by the Ministry of Health. The South African Government did source the services of Cuban medical experts to assist medical professionals. This is an effective practice to assist medical experts in this country.

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• Identification of additional quarantine sites, hosting asymptomatic individuals and building additional field hospitals are good practices investing in South Africa’s healthcare system. • The provision of economic-related relief packages to businesses and those unemployed during lockdown levels in South Africa is an acceptable approach by the South African Government to assist with economic distress. • During October 2020, the Presidency announced the South African reconstruction and recovery plan with a direct focus on dealing with the economic crisis. It will take time for the South African economy to recover. Lessons Learned • The use of high flow nasal oxygen seems appropriate for individuals being admitted to ICU. • South Africa has a severe shortage of skilled healthcare employees. Some investments need to be done in future to top up the shortage of skilled healthcare professionals. • A good effort was made in testing South African citizens being asymptomatic or COVID-19+ but is not sufficient and the country is faced with not having enough testing kits. • The public sector hospitals and clinics do not have enough ICU beds and need a good upgrade as some of these are below standard. • According to the South African Society of Psychiatrists (2020), a chronic psychiatric bed shortage and lack of psychiatric medication, especially at district level is experienced in the mental health public sector. COVID-19 has placed pressure on this system. The South African Government should engage with the private mental health sector in securing more beds as many patients could relapse due to the impact of pandemic-related stressors. From my point of view, we will definitely see an increase among South Africans in mental health-related (psychosomatic health-related disorders) challenges in the next 2 years. Therefore, it is important for the Government to act fast on this challenge. • Severe shortage of ventilators had been experienced, though the USA assisted in sponsoring some ventilators to South Africa. China also assisted with some personal protection equipment (PPE). • Although the initial stages of lockdown, the Minister of South African Police indicated a downward spiral in crime, moving to lockdown level 2 an increase in trio crimes, domestic violence, gender-based violence, and as well as farm murder crimes is on the increase. This is a huge challenge for the South African Government to act upon and more effective policing is required to deal with the challenge. The ban imposed on alcohol and tobacco sales during lockdown levels 5–3 was not acceptable practice, as illegal trade flourished and Government lost out on tax earnings. • Not sufficient PPE for healthcare employees in the public sector. This has led to some industrial action (unrest) taken by healthcare professionals as they were not provided with proper PPEs. Therefore, community members being admitted to those hospitals could not get the professional healthcare as critically needed.

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• Action must be taken by the South African Government during a pandemic to ensure food security in the midst of a pandemic. All citizens are dependent on sources of continuous food supply; however, some communities are more vulnerable than others. • The unemployment rate increased dramatically in the 3rd quarter of 2020. This has a direct effect on poverty in communities and may be linked to crime-related activities. Many individuals in communities have lost their jobs around the globe. Therefore, governments should focus on a job co-creation strategy to assist those who are unemployed. • Responding to a pandemic could take unexpected turns and strategic effective practices by the South African Government and all other governments around the globe to save lives should be a priority, as a possible 2nd or 3rd wave is possible. This means as lessons learned from the past that a pandemic might last for 2 years (Businesstech, 2020b; Doucleff, 2020; Hogg, 2020; McCoy, 2020; Mbunge, 2020; The Presidency—Republic of South Africa, 2020).

20.8

Conclusion

The main question remains. Is history repeating itself in South Africa facing a pandemic? Yes, indeed. Governments and communities around the globe are shaken by the impact of COVID-19 since December 2019 on their lives. A workable solution for Governments and communities based on the outline of this chapter could be as follows. One might argue that a top-down spillover effect could be appropriate in dealing with a pandemic such as COVID-19. However, I am from a point of view that a bottom-up spillover approach is more suitable. There is a causal relationship between a pandemic, Government’s effective practices in dealing with a pandemic and communities (community life) in general. A linear relationship exists between community life, high- and low-order needs satisfaction, health and safety, and economic indicators, community well-being (distressed, flourishing), and overall well-being or QoL. Therefore, when Government’s effective practices dealing with a pandemic are seen as successful, it could spillover to community life, taking high- and low-order needs satisfaction into consideration for health and safety and economic indicators, community well-being, and then to overall well-being or QoL. This spillover effect would be more measurable at the end of a pandemic or could be implemented when a pandemic outbreak had been discovered. However, when governments do not provide effective practices, then more negative affect would be experienced by communities than positive affect in relation to well-being/QoL. As a final thought. . . Nkosi Sikelel’ iAfrika God Bless Africa

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StatsSA. (2020b). Quarterly labour force survey (QLFS)—Q1: 2020. Retrieved from http://www. statssa.gov.za/publications/P0211/Media%20release%20QLFS%20Q1%202020.pdf Sung, H., & Phillips, R. (2016). Conceptualizing a community well-being and theory construct. In S. J. Lee, Y. Kim, & R. Phillips (Eds.), Social factors and community well-being. Springer. The Conversation. (2020). How COVID-19 changed community engagement in South Africa’s low income areas. Retrieved from https://theconversation.com/how-covid-19-changed-communityengagement-in-south-africas-low-income-areas-146767 The Presidency—Republic of South Africa. (2020). Statement by President Cyril Ramaphosa on further economic and social measures in response to the COVID-19 epidemic. Retrieved from http://www.thepresidency.gov.za/speeches/statement-president-cyril-ramaphosa-further-eco nomic-and-social-measures-response-covid-19 Tizifa, T. A., Kabaghe, A. N., McCann, R. S., van den Berg, H., Van Vugt, M., & Phiri, K. S. (2018). Prevention efforts for malaria. Current Tropical Medicine Reports, 5(1), 41–50. Tsunga, A., Mazarura, T., & Heywood, M. (2020). Covid-19 and the epidemic of corrupt governments: ‘A heart-wrenching, unscrupulous and filthy feeding frenzy’. Retrieved from https:// www.dailymaverick.co.za/article/2020-08-02-covid-19-and-the-epidemic-of-corrupt-govern ments-a-heart-wrenching-unscrupulous-and-filthy-feeding-frenzy/ VanderWeele, T. J. (2017). Religious communities and human flourishing. Current Directions in Psychological Science, 26(5), 476–481. Wade, M. M. (2006). Straws in the wind: Early epidemics of Poliomyelitis in Johannesburg, 19181945. Masters dissertation, UNISA, South Africa. Retrieved from http://uir.unisa.ac.za/ bitstream/handle/10500/1518/dissertation.pdf?sequence¼1&isAllowed¼y World Health Organization. (2006). Southern Africa is moving swiftly to combat the threat of XDR-TB. Retrieved from https://www.who.int/bulletin/volumes/84/12/06-011206/en/ World Health Organization—WHO. (2020). Timeline Covid-19. Retrieved from https://www.who. ont/news-room/detail/27-04-2020-who-timeline%2D%2D-covid-19

Stefan Kruger is currently a professor in Tourism and Hospitality Management at the Work Well Research Unit of the North-West University, South Africa and a researcher in positive psychology applied in the broader context of Tourism and Hospitality. Prof. Kruger’s research interests focus on Quality-of-Life and Subjective Well-being. Prof. Kruger had been the single, first and co-author of many articles. He has attended several conferences nationally and internationally. Prof. Kruger has contributed to book chapters (co-authored) and a book (co-editor) within his scope of research. According to the National Research Foundation of South Africa, Prof. Kruger is an established researcher, with a C-2 rating. Prof. Kruger serves as a Reviewer Board Member for the well acclaimed Journal of Applied Research in Quality of Life. He is currently a member of ISQOLS and serves as outreach coordinator, Tourism and Recreation of the International Society for Qualityof-Life Studies.

Chapter 21

COVID-19 Pandemic and Its Impact on Consumers in South Korea Grace B. Yu and Najung Kim

Abstract Aiming at minimizing the potential negative impact of the pandemic on economic growth, the South Korean government implemented a no-lockdown strategy during the COVID-19 pandemic. The no-lockdown strategy might have helped Korean consumers to maintain their consumption patterns as well as their quality of life to a certain degree, but recent statistics show that South Korean consumers still suffered from lower quality of life and developed new consumption patterns that fit the pandemic lifestyle. Thus, in this chapter, we focus on the following three issues: (1) analyzing the reasons why the pandemic lifestyle could have decreased consumers’ quality of life, (2) introducing new consumption trends that developed in the midst of the pandemic, and (3) identifying the macro factors that might have protected Korean consumers from a steep decrease in their quality of life. Based on the statistics and government and private reports on consumer behaviors and quality of life under the pandemic, we found the following. First, the decrease in consumers’ quality of life under the pandemic was linked with reduced income, psychological stress while facing uncertainty and safety/health risks, and unfulfilled social interactions. Second, in response to these negative conditions under the pandemic, consumers engaged in contactless consumption, anxiety-proof consumption, and egocentric consumption. Third, government policies that ensure regular economic activities, IT and retailing infrastructures that facilitate the seamless online shopping experience, and the population’s digital literacy that empowers consumers to sustain their consumption patterns safeguarded Korean consumers’ quality of life. Based on these findings, we make suggestions to public policymakers and the marketing community at large.

G. B. Yu (*) Department of Business Administration, Duksung Women’s University, Seoul, Korea e-mail: [email protected] N. Kim College of Business Administration, Kookmin University, Seoul, Korea e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_21

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Keywords Quality of life · COVID-19 · Korean consumers · IT infrastructure · Retailing infrastructure · Digital literacy

21.1

Introduction

Since the outbreak of the COVID-19, the South Korean government has been pursuing a no-lockdown strategy, hoping to minimize the impact of the pandemic on the country’s economic growth. As such, South Korean consumers have been able to maintain their lifestyle and their consumption habits. However, recent marketing reports and statistics show that there have been some significant changes in consumption patterns as well as overall lifestyle in South Korea during the pandemic. Nationwide statistics show that Korean consumers are abiding by the social distancing guidelines via a reduction in their use of public transportation, avoiding crowded places, and postponing or canceling face-to-face social events. In the meantime, they are spending more time and money online and adapting to the low-contact way of life. That is, consumers are using various consumption strategies to overcome the given constraints in the consumption environment. These changes in consumption life are likely to influence Korean consumers’ quality of life. To describe how the consumption environment in South Korea has changed since the pandemic and its impact on consumers’ wellbeing, we structured this chapter as follows. First, we briefly summarize the relevant background information before and in the midst of the COVID-19 outbreak in South Korea. Second, we discuss the impact of the pandemic on the overall economy and consumption. We specifically discuss the negative effects of the pandemic on consumers’ quality of life. We also introduce three consumption trends that capture the effects of the pandemic on consumption patterns. Third, based on Shultz et al. (2017)’s theoretical model, we describe the macro factors that have protected consumers from negative externalities of the COVID-19. Finally, based on the preceding discussion, we make some key recommendations to public policymakers and marketers.

21.2

Background

In this section, we describe prior pandemics that have recently afflicted South Korea. We then describe the current state of the COVID-19 pandemic in the country, followed by actions taken by the government to deal with the pandemic.

21.2.1 South Korea Before the COVID-19 South Korea went through two notable infectious diseases in the twenty-first century before the COVID-19 outbreak: SARS (Severe Acute Respiratory Syndrome) in

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Table 21.1 Epidemics that South Korea experienced in the twenty-first century (January 20, 2021)

Confirmed case Deaths Fatality (%)

SARS (2003~) Global S. Korea 8096 3 774 0 9.6 0

MERS (2013~) Global S. Korea 2494 186 858 38 34.4 20.4

COVID-19 (2020~) Global S. Korea 100,203,928 73,518 2,147,443 1300 2.14 1.8

Source: WHO (2021)

2003 and MERS (Middle East Respiratory Syndrome) in 2015. Table 21.1 compares the relative impacts of each crisis globally and domestically. Among various experiences and conditions that could have affected South Korea’s response to the current COVID-19 outbreak, South Koreans’ experiences with MERS seem to be most relevant. The first MERS patient in South Korea was identified in May 2015, and the epidemic continued roughly for 3 months. The MERS outbreak was a crippling shock to South Korea as its fatality rate was the highest with the exception of Middle East countries. A total of 186 patients were infected and roughly one-fifth of them died from the disease, the domestic fatality rate was 20.4%. Most criticisms of how South Korea dealt with the pandemic centered around a non-centralized disease control system and the government’s non-transparent communication style. Since the MERS crisis, the South Korean government invested in building a nationwide centralized crisis management system for future pandemics by developing a cooperative network system among various ministries, local governments, and government agencies.

21.2.2 Current State of the COVID-19 Pandemic in South Korea The first COVID-19 patient was identified on January 20, 2020. Table 21.2 shows the cumulative number of confirmed cases and further statistics related to the COVID-19 in South Korea as of January 20, 2021. According to public health data, there has been a total of 73,518 confirmed cases and 1300 deaths with a fatality rate of 1.8%. South Korea’s incidence per 100,000 was 1434, ranked 124th out of 220 countries. There are slightly more female confirmed cases (female: 37,456 cases, 50.9%; male: 36,062 cases, 49.1%). In terms of age, people in their 50s contracted the disease the most, but the highest fatality rate was among people in the 80s or more (20.1%). Unfortunately, despite a fervent effort made by the government to fight the disease, the number of confirmed cases soared during the third wave (early December 2020 to January 2021, as shown in Fig. 21.1). Figure 21.2 graphically shows how confirmed cases have been spread around the country. The COVID-19 cases seem to have been spread mostly around the Seoul metropolitan area, partly due to the high population density (more than half of the entire population reside in this area).

30s

20s 11,351 (15.4%) 0

10s

4688 (6.4%) 0

9408 (12.8%) 0.1

Deaths 279 1300 82nd

Confirmed cases 22,859 73,518 86th

Notes: Incidence per 100,000 (¼ confirmed/population  100,000) Fatality rate ¼ death by age/confirmed by age Source: COVID-19 Dashboard (https://coronaboard.kr/)

Region Seoul (capital city) Nation total Global ranking (Total 220 countries) By age Under 10 years Confirmed cases 2742 (3.7%) (%) Fatality (%) 0 10,541 (14.3%) 0.1

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Table 21.2 Overall statistics related to COVID-19 in South Korea (January 20, 2021)

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Fatality (%) 1.2 1.8 88th

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Incidence per 100,000 234 1434 124th

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Rep. of Korea COVID-19 Trend Total confirmed: 73,518 | deaths: 1,300 | recovered: 60,180 KCDC Data 2021−01−20 00:00

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Fig. 21.1 Monthly statistics related to COVID-19 in South Korea. Source: COVID-19 Dashboard (https://coronaboard.kr/) Fig. 21.2 Spread of COVID-19 in South Korea by region (January 20, 2021). Note: Darker shades represent more confirmed cases. Source: COVID-19 Dashboard (https://coronaboard.kr/)

21.2.3 The Role of the Korean Government (a Catalytic Institution) Guided by its experience with the MERS pandemic, the Korean government charged the Central Disaster Management Headquarters for Novel Coronavirus Infection (http://ncov.mohw.go.kr/) to take action—to manage the operation and implement a track and trace system to better monitor the spread of the disease. While maintaining

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its nationwide social distancing campaign, the government has revised its social distancing guidelines from a three-tier one to a five-tier one as of November 2020 in response to the prolonged exposure to the virus. The new five-tier guideline is considered stricter, raising social distancing restrictions and instituting regionspecific quarantine programs (see Table 21.3).

21.3

Impacts of COVID-19 on Korean Consumption

In this section, we will describe how the pandemic influenced the economy, consumption, and consumers.

21.3.1 Economic Impact The pandemic has caused a decrease in household income for Koreans. A multicountry comparative survey report of a global consulting firm shows that 46% of Korean respondents experienced a decline in household income since the onset of the pandemic (McKinsey & Company, 2020). Reports on Korean consumers’ attitudes toward the domestic economy indicate that the majority of Korean consumers believe that COVID-19 negatively affected their household finances as well as the national economy (Bank of Korea, 2020a). Figure 21.3 shows that Korean consumers are feeling pessimistic about their household income and the fact that they had to cut their spending since early 2020. The CCSI (Composite Consumer Sentiment Index),1 a composite index measuring consumers’ perceptions of their economic condition, dropped sharply since the virus began to spread around the country. This statistic indicates that pessimism has increased in the midst of the pandemic.2 Also, the CCSI score seems to reflect the severity of the spread in South Korea. For instance, the score dropped drastically around the first wave of the spread (February to March 2020) and the second wave (late August to September 2020) in South Korea.

1

The Composite Consumer Sentiment Index (CCSI) is composed of six major CSIs, including current living standards, prospective living standards, prospective household income, prospective spending, current economic condition, and prospective economic condition, all of which are standardized. The composite index is used to gauge overall consumer sentiment. – Current: current situation compared to that 6 months earlier – Prospective: 6 months ahead in comparison with the current time – CSI ¼ [(very positive  1.0 + somewhat positive  0.5 + similar  0.0  somewhat negative  0.5  very negative  1.0)/total number of households surveyed  100] + 100 2 A score larger than 100 means that consumers’ expectation of their financial condition signifiy optimism (compared to the mean value of the past 10 years).

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Table 21.3 South November 2020 Social distancing guidelines Criteria (daily average new COVID-19 infection cases over the span of a week) Goals

Action taken

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five-tier

social

distancing

guidelines

Level 2

443 implemented

Level 1 Limited transmission Capital region: fewer than 100 ppl and Other regions: fewer than 30 ppl

Level 1.5

Regional epidemic level Capital Capital region: region: more more than than 100 ppl 200 ppl and and Other Other regions: regions: more than 10–30 ppl 60 ppl

Nationwide epidemic level More than More than 400 ppl around 800 ppl the nation around the nation

To maintain everyday life while paying attention to the prevention of COVID-19 – Sport event: 50% of spectators allowed – School population density: 2/3 of students recommended

To minimize unnecessary private gatherings and the use of public facilities

To minimize contact with others and to stay at home

– Sport event: 30% of spectators allowed – School population density: 2/3 of students recommended

– Sport event: switch to non-spectator games – School population density: 1/3 of students – Limit the number of employees at the work by adopting flexible work schedules and working-fromhome (e.g., 1/3 of the total number at the same time)

– School population density: 1/3 to 2/3 of students – Limit the number of employees at the work by adopting flexible work schedules and working-fromhome (e.g., 2/3 of the total number at the same time)

Level 2.5

since

Level 3

– Sport event: suspension – All school activities should be switched to distance learning – Keep the minimum number of employees at work

Note: Population is required to wear mask when using indoor multi-purpose facilities (e.g., libraries, sports facilities, shopping malls, or public transportation) or being outdoors where two-meter distancing cannot be ensured Source: South Korea Central disaster management headquarters (2021)

21.3.2 Consumption-Related Impact Consumers’ consumption experiences have been adversely affected as reflected in the increased number of consumer complaints and consultations requests reported during the pandemic. Specifically, consumer complaints in the first quarter of 2020 have tripled compared to that of 2019 (Ji, 2020). Consumers experienced

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2020/01

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Fig. 21.3 CSI (Jan 2019–Jan 2021). Source: Bank of Korea (2020a), Economic Statistics System (https://ecos.bok.or.kr/)

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Fig. 21.4 COVID-19 related consumer consultation cases (January 20, 2020–January 8, 2021). Source: Korea Consumer Agency (2021), COVID-19 Consultation Map. (https://public.tableau. com/profile/kcabig#!/vizhome/19_15826193726210/19)

inconveniences in obtaining refunds for canceled travel and event bookings as well as for the membership services for health and leisure. They experienced difficulties in purchasing pandemic-related hygiene products such as KF94 masks, hand sanitizers, and alcohol swabs during the early stage of the pandemic. Several scams related to low quality or fake products were reported. Figure 21.4 graphically shows the number of COVID-19-related consumer consultation requests received by the Korea Consumer Agency (2021). The trend mirrors the pattern related to the severity of the infection and the subsequent implementation of stricter social distancing guidelines. Furthermore, consumers reported problems with financial services perhaps due to the fact that these services tend to be complex and risky (Lim, 2020). Specifically, problems with the marketing of financial services were reported most by the elderly. This consumer group tends to be less familiar with digitalized financial services and more likely to be vulnerable to frauds and high-risk financial instruments. As such, we conclude that the pandemic did indeed negatively affect Korean consumers at large.

21.3.3 Korean Consumers’ Response in the Midst of the Pandemic (Trend Overview) In this section, we will describe several trends in consumer response, namely contactless consumption, anxiety-proof consumption, and ego-centric consumption.

21.3.3.1

Trend 1: Contactless Consumption

Even before the pandemic, Korean consumers were relatively familiar with the digitalized services and low contact services across varying industries and sectors (e.g., entertainment, delivery, food and shopping, communication, and wellness). As the pandemic surged, Korean consumers expanded the range of goods and services that was substituted by digitalized and online goods and services. According to a news outlet summarizing weekly survey results of 1000 representative Korean consumer panel members, the gap between online shopping and offline shopping grew by 150% in a year time with online shopping’s lead (from the gap of 16% in

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July 2019 to 24.4% in Nov 2020) (Consumer Insight Shopping Report, 2020a) (see Fig. 21.5). This news outlet has argued that the rapid growth of online shopping expenditure may have been affected greatly by social distancing. The portion of online shopping soared up after the first government announcement of 2.5 level social distancing guideline on August 30, 2020, the second-highest level of South Korea’s social distancing guidelines and the toughest to be implemented. The contactless consumption trend continued under the lower social distancing guidelines announced later. Some consumers might have been forced to adopt online shopping channels because of the pandemic, but now, regardless of their original proclivity toward online shopping, they grew accustomed to it. The fastest-growing sectors in contactless consumption include online streaming services, e-sports broadcasting services, restaurant/grocery delivery services, professional video conferencing services, remote learning for adults and children, and online fitness services (McKinsey & Company, 2020). Initially, Korean consumers were relatively reluctant to make online purchases in relation to certain categories such as fresh food (e.g., meat, vegetable, fruit), high-end consumer electronics, furniture, and educational services (Statistics Korea, 2021). However, they are now spending far more on those categories, irrespective of age (Samjung KPMG, 2020). Results from a longitudinal survey of a South Korea’s leading market research agency shows that the consumers who have been using online shopping before the onset of the pandemic reported a further increase in online shopping (51%), online video streaming services (63%), food delivery services through smartphone applications (58%), and online banking (38%) after the onset (Hankook Research, 2020) (see Fig. 21.6). This trend is expanding to the big-ticket items such as car and homes. So-called “prop tech,” a combination of property and technology, is gradually replacing traditional off-line based real estate transactions. Consumers can easily search for available homes through a real-time three-dimensional viewer system and make purchases accordingly.

21.3.3.2

Trend 2: Anxiety-Proof Consumption

Consistent with the global trend, Korean consumers tend to spend more on hygiene products, high-quality fresh ingredients, dietary supplements, and healthy functional foods to improve their overall health and boost their immune system (Samjung KPMG, 2020). During the pandemic, they seemed to be more concerned about health and safety than ever, and have been willing to pay premiums for health-related home appliances such as air purifiers, steam clothing care systems, dryers, and dishwashers with sanitizing functions and massage chairs. Consumers tend to buy more from companies that use healthy and hygienic packaging methods (Arora et al., 2020). This trend indirectly signifies a tendency to reduce their anxiety and fear via these “virus defensive products.” They also bought these products in bulk, perhaps to reduce the level of anxiety associated with the possibility of future shortages.

The first confirmed case of South korea (1/20)

37.8

Social distancing level 2 (9/14) Social distancing level 1 (10/12) Social distancing Social distancing level 2 (11/24) level 2.5 (8/30)

Online shopping

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Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20

42

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Fig. 21.5 On-off line shopping expenditure trends (Aug 2019–Nov 2020). Note: Survey questionnaire: What are the proportions of your online shipping and offline shopping expenditure (total amount of your shopping expenditure being 100)? Source: Consumer Insight Shopping Report (2020a)

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I’m spending more on home shopping and internet shopping channels

I’m spending more on food delivery services

80 64

32

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51

I’m eating out less than usual

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Fig. 21.6 Longitudinal survey results on consumption trend. Source: Hankook Research (2020), COVID-19 survey dashboard. (https://public.tableau.com/profile/lee.donghan#!/vizhome/HRC_ covid19_survey_dashboard/d__8)

21.3.3.3

Trend 3: Egocentric Consumption

The 2020 labor statistics in South Korea show the sharpest decline in employment rate (0.9%) since 2010 (Ministry of Employment and Labor, 2021), and the majority of households have suffered from reduced discretionary income (McKinsey & Company, 2020). As a result of the decreased income, consumers seemed to trade down on consumer staples to minimize their spending on consumer discretionary goods and services such as apparel, beauty products, and hotel stay. Paradoxically, while overall spending on apparel (e.g., clothes, shoes, bags, accessories, etc.) has been significantly reduced, sales of luxury fashion items have increased. The Ministry of Trade, Industry and Energy reported that sales of luxury products at the nation’s major department stores increased about 9% in the first half of 2020. Consumers seem to be spending the money they saved (money they would have spent on traveling abroad, socializing, and outdoor leisure activities) on luxury items. Generation Z (born from 1995 to 2010) and millennial consumers (born from 1981 to 1996) seem to be key contributors to this new trend. Consumption of luxury goods is closely related to consumers’ desire for expressing and comforting themselves (Lisjak et al., 2015; Shao et al., 2019). Given the lack of opportunities to spend on travel and other egocentric, hedonic goods and services, consumers have resorted to the type of consumption that requires little time and few physical contacts. These goods and services fulfill consumers’ needs for self-expression and stress management. Luxury goods, as an extension of the self, can fulfill selfexpression and self-compensation needs. Furthermore, consumers seem to be spending much more time and money on pleasure-oriented IT services such as OTT (over-the-top media) services, mobile video game applications, and game streaming platforms (Wu & Holsapple, 2014). The pandemic gave much momentum to the OTT service providers such as Netflix, and the number of paid streaming service subscribers of all generations is rapidly growing in Korea. Gamified health training video games are replacing gyms and outdoor activities to help relieve stress and loneliness in the midst of the pandemic.

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Several online concerts (e.g., pop music concerts, classical music concerts, musicals, etc.) have streamed in collaboration with entertainment firms and video content platforms. Overall, these services seem to fulfill the hedonic and experiential needs of Korean consumers.

21.4

Macro Factors Protecting Korean Consumers from Negative Externalities Associated with COVID-19

Shultz et al. (2017)’s a theoretical model of community wellbeing surmises a host of factors required for flourishing communities. The model predicts that well-served citizen-consumers who are effectively linked to a set of appropriately developed macro factors (e.g., social infrastructure, administration, education, and IT) via catalytic institutions (e.g., government and business) are more likely to feel satisfied with their lives in the community. In this section, we discuss important factors that made Korean citizen-consumers’ lives relatively safe and stable under the pandemic. We specifically explore how these factors may have contributed to Korean consumers’ quality of life.

21.4.1 Government Policy: Policies that Ensure Regular Economic Activities One of the notable approaches of the South Korean government during the pandemic is their anti-lockdown policy—the government has been continuously pursuing an anti-lockdown policy to ensure normal economic activity. Despite the ongoing debate on whether to boost the nation’s economy by lowering down the distancing level or to mitigate the transmission of the virus by toughening the mandates, the government has been reluctant to implement a complete lockdown. For example, South Korea faced the toughest situation during the third wave (from early December 2020 to mid-January 2021) when daily confirmed cases reached beyond 1000. However, the Korean government avoided implementing the highest social distancing mandate. While maintaining the second highest distancing mandate (Level 2.5), they modified it with additional rules such as a ban on private social gatherings of more than five people (see Table 21.4). The government was concerned with the negative effects of the highest social distancing mandate on the overall economy. Consequently, Korean consumers were, by and large, able to maintain a semblance of “normalcy.” However, the shift to online shopping (from offline local shopping) resulted in the closure of many brick-and-mortar stores.

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Table 21.4 Economic activities allowed under social distancing guidelines Social distancing guidelines Actions taken

Level 2

Level 2.5

Regional epidemic level National epidemic level Private gatherings of more than five people are prohibited – After 21:00, restaurants – After 21:00, restaurants and cafes are only allowed and cafes are only allowed to make to-go and delivery to make to-go and delivery orders orders – Gatherings in entertain– Gatherings in direct sales ment facilities such as clubs such as door-to-door sales are banned promotion halls, karaokes, – Direct sales such as door- academies are banned after to-door sales promotion 21:00 halls, karaokes, indoor – Operation after 21:00 is sports facilities are shut banned for movie theater, down after 21:00 PC room, beauty/beauty – Food consumption in industry, game room, and movie theaters, PC cafes, reading room beauty/beauty businesses Operation of academies is are banned and should open banned after 21:00 one seat – Operation after 21:00 is – Wearing mask is required banned for mart/store/ for mart/store/department department store (300 m2 or store. Ventilation and disin- more) fection is mandatory. (for over 300 m2)

Level 3

– Only to-go is allowed for Cafes throughout business hours – After 21:00, restaurants are only allowed to make to-go and delivery orders – Facilities except for essential for industry and life are banned

Source: COVID-19 Dashboard (https://coronaboard.kr/)

21.4.2 IT Infrastructure Let us now focus on changes in the infrastructure that enables online transactions (e.g., internet speed, percentage of people that have access to internet). According to the Ministry of Science and ICT, 99.2% of households in South Korea have internet access through PC, mobile, or other devices. South Korea’s internet user population and smartphone user population reached 91.5% and 91.8%, respectively. By launching commercial 5G network services nationwide in 2020, South Korea ranked as one of the top countries in terms of mobile connection speed (International Trade Administration, 2020). South Korea is well-known for its ICT (Information and Communications Technology) infrastructure. The country’s ICT has allowed the country to effectively prevent the spread of COVID-19; it also provided much support for online transactions. Figure 21.7 (NIA, 2020) demonstrates how the Korean government has integrated relevant information from both public and private sectors through its ICT infrastructure to control the disease spread. Citizens can easily access information on the travel routes of the COVID-19 patients and nearby locations of testing stations through mobile applications and web-based services.

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Fig. 21.7 COVID-19 response case by risk alert level and related information. Source: NIA (2020, p. 15)

21.4.3 Retailing Infrastructure: Fast Delivery of Goods and Services South Korean online retail market has been growing in relation to B2C (business to customer), C2C (customer to customer), D2C (direct to customer), Q-commerce (Quick commerce), online grocery, reseller commerce, deal commerce, live commerce, among others. Statistics Korea (2021), a government organization for statistics, reported that the annual online shopping transaction in 2020 has been increased by 26.1% than the previous year (share of online shopping transaction value out of total shopping transaction value in 2019 was 21.4% and that of 2020 was 27.2%). Korean online retail market has grown significantly due to COVID-19 and exponentially increased individual online retailers. The main contributors to this rapid growth of the online market are well-developed delivery services and logistics infrastructure. Domestic online logistics service providers offer a full spectrum of services such as inventory management, packaging, shipping, return and customer services, and almost every consumer in South Korea enjoys high-quality, fast shipping experiences for their online transactions.

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21.4.4 Education: Digital Literacy (e.g., Smartphone Use) Given the rapid increase of online transactions, digital literacy has become more important than ever during the pandemic. Digital literacy refers to the active participation in educational, social, and vocational life through the use of digital learning tools, the management of digital learning platforms, and the secure and ethical use of advanced-level digital (Sozdamar-Keskin et al., 2015). That is, digital literacy involves competencies in engaging in social participation, effective collaboration, and communication, and problem-solving by using digital technologies and information (Cartelli, 2010). Therefore, knowing how to use digital gadgets to participate in online channel-based consumption is critical to maintaining a certain quality of life in the marketplace during the pandemic. Research has shown that the older generation in several countries seems to be most vulnerable in this area (Jun, 2020). Responding to this issue, governmental agencies have conducted nationwide surveys to monitor levels of digital literacy among various groups and offered a series of programs to enhance digital competency. For example, the Korea Consumer Agency (2021) has provided educational services customized by age groups to assist consumers navigate through the digital environment. The agency has distributed reading materials and YouTube videos, especially designed for the silver generation (aged 60 or more) to help them make online purchases (e.g., internet shopping or mobile shopping), use alternative methods of payment (e.g., mobile pay or using self-pay kiosk), conduct QR codebased product information search, and download delivery service apps and place an order on these apps.

21.4.5 Macro Factors, Consumption, and Quality of Life There have been several attempts to gauge citizens’ attitudes toward the pandemic and its potential impact on consumers’ quality of life. For instance, a South Korea’s leading research institution conducted a nationwide survey from 25th to 28th of August 2020 on the impact of COVID-19 on societal wellbeing with 2000 representative consumers. About 30.9% of respondents reported that they were dissatisfied with their lives, and 12.5% of them evaluated their health negatively. About 39.3% of the respondents felt emotional deprivation, and 38.4% of them experienced depression. In the early stages of the pandemic, people experienced much anxiety and sadness, gradually turning into anger and fear as the pandemic continued to wreak havoc. Most of the respondents reported that they felt emotionally drained because of the prolonged COVID-19 situation. These results collectively show that

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the Korean consumers’ quality of life suffered. On a brighter note, respondents also indicated that they trust their government to effectively handle the pandemic.3 A longitudinal analysis of weekly survey results of 1000 representative Korean consumer panel members demonstrated that Korean consumers’ perceived that their prospect quality of life has been worse off after COVID-19 (Consumer Insight Shopping Report, 2020b). The average prospect quality-of-life score for 53 weeks before COVID-19 was 89.1 while that of 41 weeks after COVID-19 was 83.3. Social distancing may have been a strong factor in accounting for the dip in Korean’s quality-of-life expectations. Specifically, when the government raised the social distancing level, respondents anticipated lower quality of life in the near future, while the ease of social distancing level led to a more positive outlook. It is also worthwhile to note that personal economic conditions and consumption expenditure had a much stronger impact on Korean consumers’ quality of life expectations than prior to the pandemic. The correlation matrix among the relevant variables demonstrated that the correlation between personal economic conditions and prospect quality of life increased from 0.222 (53 weeks’ average before COVID-19) to 0.907 (41 weeks’ average after COVID-19), and the correlation between consumption expenditure and prospect quality of life raised from 0.270 (53 weeks’ average before COVID-19) to 0.920 (41 weeks’ average after COVID-19). It is possible that the consumption life gained more weight compared to other life domains during the pandemic. Consumers’ need for stress relief may have intensified given the social distancing restrictions. Thus, we conclude that preserving consumers’ marketplace habits play a key role in the overall quality of life of consumers during the pandemic.

21.5

Lessons Learned

Based on the data on South Korea’s responses to COVID-19 and the effects of pandemic on consumers’ quality of life, we can draw the following two propositions.

21.5.1 The Possible Mechanisms for Why the Pandemic Decreases Consumers’ Quality of Life First, the consumers’ quality of life was negatively affected by the pandemic because of the increased economic burden (e.g., reduced household income), the heightened

3

Respondents said that they trust the COVID-19 quarantine authority (88.1%), the COVID-19 quarantine agencies (88.9%), the COVID-19 treatment facilities (89.7%), expert groups (78.3%), most of people I know (70.6), local governments (63.1%), media (33.6%), most of people I do not know (20.7%).

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psychological stress (e.g., anxiety related to safety and health), and the unsatisfied need for relationships. Citizens anywhere experienced severe restrictions in job opportunities, stress-relieving activities and social interactions, among others. These constraints seem to have negatively affected the quality of life because of unfulfilled lower-order needs and higher-order needs (Shultz et al., 2017). The fact that Korean consumers immersed themselves in contactless consumption, anxietyproof consumption, and egocentric consumption is another proof of how the aforementioned reasons could be the main contributors to the decreased quality of life under the pandemic.

21.5.2 Enabling Macro Factors Under the Pandemic Second, the case of South Korea seems to pinpoint a set of critical macro factors that could protect consumers’ quality of life under the pandemic.

21.5.2.1

Administrative Roles to Keep the Balance Between Economic Stability and Public Health

While many countries implemented complete shutdown policy worldwide, South Korea’s case shows that the anti-lock down policy is a viable option for balancing economic stability and public health given well-administered social distancing principle, thus maintaining a relatively stable quality of life for citizen-consumers. In other words, the government’s administrative competencies made it possible to balance two confronting values. Relatively sound economic indicators and stabilized number of confirmed cases are the reasons to believe.

21.5.2.2

Reliable IT and Retailing Infrastructure as the Backbone of Communities Under the Pandemic

Korean consumers were able to maintain a quasi-normal consumption life based on strong IT and retailing infrastructure despite all the difficulties under the pandemic. As it is hard to estimate when this aspiratory disease comes to an end, it is even more important to invest on IT and retailing infrastructure that supports everyday online/ mobile based social services and economic transactions as well as remote education and telecommuting. Consumers newly accustomed to online-based consumption would find it hard to get back to the traditional consumption lifestyle even after the pandemic.

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Digitally Educated Individuals Well-Suited for Low Contact Way of Life

It is obvious that digitally educated individuals are better off surviving in this new environment and it is important for every citizen to have chances to learn. Welldesigned generation-specific education programs for digital literacy are needed.

21.6

Suggestions for Ways to Enhance Quality of Life Given the Pandemic

Integrating what we have learned from South Korea’s experiences in the pandemic, in this section, we will make specific suggestions on how to improve the quality of life. These suggestions are directed to public policymakers and the marketing community at large.

21.6.1 Suggestions to Public Policy Makers Given the country’s strong social and IT infrastructures, the South Korean government seems to be managing the COVID-19 pandemic well. Based on the Korean experience with the pandemic, we can make a few recommendations that can assist policymakers worldwide.

21.6.1.1

Trust Management Among Citizens

Citizens’ trust toward the government and administrative organizations is the key to fight against the pandemic. The whole nation is working together to block the spread of disease based on citizens’ voluntary cooperation with government policies such as a social distancing guideline. Therefore, it is important to build and manage trust among citizens toward government’s decisions related to the pandemic. Most up-todate information related to the epidemic has to be accessible promptly and transparently so that citizens can understand and cooperate with government’s actions. Also, close communication between the government and population is essential for building trusted relationship, especially when making important decisions with controversies (e.g., the timing of a complete school reopening, adjustments for the prohibition rules, etc.).

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Compensation Plans for Businesses at Risk

Legislated compensation plans could be mandated to implement sustainable social distancing policies. The success of early social distancing practices in Korea was achieved at a great economic cost. Many businesses and other economic enterprises have suffered financially due to social distancing restrictions, and many went bankrupt adversely affecting their local communities and the economy at large. Therefore, it is necessary to protect businesses, especially those who are at high risk of closure (e.g., brick-and-mortar stores such as restaurants, cafes and gyms that are under strict operational regulations). This can be done by developing policies to compensate those firms for the drop in business as a direct function of the pandemic. For example, the Korean government sought help from financial institutions and asked them to lend money to small business owners (the annual sales under US $100,000) at a lower interest rate. Financial institutions also allow grace periods for these small business owners with debts.

21.6.1.3

Systematic Public Mental Healthcare Program

As more people experience depression because of emotional deprivation and isolation from loved ones and salient others, it is important to monitor and implement mental health programs to address this issue. Emotional wellbeing is foundational to overall wellbeing. As such, government should develop and implement programs that can address the adverse mental health repercussions associated with the pandemic. Special attention should be directed to vulnerable groups such as the elderly and those with chronic illnesses. For example, South Korea’s national center for trauma offers a series of guideline tailored to the COVID-19 crisis both for population at risk and medical experts (e.g., Guidance for infectious disease stress relief for patients under quarantine and medical experts), a 24/7 counseling helpline for patients and their family members, and medical treatments based on cooperative network with medical associations.

21.6.1.4

Consumer Education for Online Transaction

Due to the rapid growth of online-based shopping platforms, it is important to educate consumers of all generations to be able to adapt to this change and become more digitally literate. Older generations tend to experience more difficulty in handling online/mobile-based transactions and financial services compared to younger generations. While the average digitalization level of the entire population being 100, average scores of 60s and 70s are 73.6 and 35.7, respectively. In fact, consumers over 60 years old experience lower level of mobile banking usage than the entire population (60s or more: 21.3% vs. total: 57.1%) (Bank of Korea, 2020b). Therefore, we recommend all government institutions (in Korea and elsewhere)

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develop generation-specific education programs for using digital devices. In doing so, consumers of all generations can participate equally in most economic activities within the digitalized environment.

21.6.2 Suggestions to Marketers While South Korea managed to effectively handle the pandemic, current levels of quality of life have been documented as lower than pre-pandemic. We have to acknowledge that there are other consumption needs that a strong IT infrastructure and government support cannot satisfy. For instance, we know that consumers’ wellbeing is affected by the level of quality of consumption experience (Guevarra & Howell, 2015). Public policies mandating social distancing do prevent consumers from satisfying needs related to quality consumption experiences. Below are the suggestions that could improve marketing practices that could lead to a higher level of quality of life under the pandemic.

21.6.2.1

Enhancing Consumer In-store Experiences

Despite rapid transformation toward digital commerce, there are a number of brands, global brands and domestic brands all together, that rather expand or newly open experience-based flagship stores in the major metropolitan areas of South Korea. For example, Dyson Korea opened a “Dyson Demo Store” early this year where consumers could learn from mechanical experts in person and experience the brand in homelike environments. Also, Apple Korea recently opened the second Apple Store in Korea and is scheduled to open two more stores this year. In a similar vein, South Korea’s top 3 department stores are opening new stores of huge scale around the country promising to give brand-new lifestyle experiences. These cases clearly show that the industry recognizes the importance of fulfilling consumers’ need for in-store brand/shopping experiences to differentiate themselves more than ever. Therefore, it is still important for marketers to provide consumers with genuine in-store experiences consistent with the brands’ characteristics.

21.6.2.2

Enhancing Consumer Online Experiences in Support of Technical Tools

Although it is not completely new, leading companies of varying consumer goods and services are now increasingly adopting new technologies using AR (augmented reality) and VR (virtual reality) to support consumer interactions with their brands. For example, a luxury fashion brand Gucci is now partnering with Snapchat, a multimedia messaging application, to offer a virtual try-on service using shoppers’ own smartphone camera pointing at themselves. Another luxury fashion brand Dior

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is now offering virtual store service where consumers could browse products while staying safe at home. Korean cosmetic brands are now commonly offering AR-based make-up testing services online to help consumers make informed decisions. These services tailored to enhance online consumption experience quality are found to generate higher conversion rates to purchase overall. Therefore, it is important for marketers to offer sound online experiences for consumers in support of the most upto-date technical tools.

21.6.2.3

Socially Responsible Actions that Match Societal Needs

Consumers are expecting more socially responsible action from business firms now more than ever. According to a study on Korean consumers’ attitude toward corporate social responsibility (CSR) during the pandemic, 73.6% of respondents opined that companies should be involved in preventing COVID-19 and addressing related issues (Social Gap Report, 2020). An estimated 62.1% of respondents expressed this sentiment by indicating that they are not going to buy goods and services from companies that are not showing responsibility toward society. Respondents also seem to place high value on businesses that are “providing medical supplies such as masks and hand sanitizers,” “providing digital gadgets such as tablet PC to students in need for remote education,” “lending corporate facilities for patient rehabilitation,” etc. As such, business firms should respond to consumers’ requests for socially responsible action.

21.7

Conclusion

This chapter was designed to overview the impact of the COVID-19 pandemic on South Korean citizen-consumers’ quality of life outcomes based on the community wellbeing framework by Shultz et al. (2017). Based on the statistics on Korean consumers under the pandemic and the macro factors that protected Korean consumers’ from experiencing a drastic drop in their quality of life, we drew suggestions for policymakers and marketers that could protect the quality of life for consumers living in the midst of the pandemic. We hope that South Korea’s case may help scholars, public policymakers, and industry managers best cope with similar challenges in the future.

References Arora, N., Charm, T., Grimmelt, A., Ortega, M., Robinson, K., Sexauer, C., & Yamakawa, N. (2020, April). A global view of how consumer behavior is changing amid COVID-19.

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Mckinsey and Company. http://www.amcham-egypt.org/bic/pdf/corona1/a-global-view-ofhow-consumer-behavior-is-changing-mid-COVID-19.pdf Bank of Korea. (2020a). Economic statistics system. https://ecos.bok.or.kr/ Bank of Korea. (2020b). Payment and settlement systems report 2019. https://ecos.bok.or.kr/ Cartelli, A. (2010). Frameworks for digital competence assessment: Proposals, instruments, and evaluation. In Proceedings of informing science and IT education conference (InSITE) (pp. 561–573). Consumer Insight Shopping Report. (2020a). 62% of Shopping expenditure spent online. https:// www.consumerinsight.co.kr/voc_view.aspx?no¼3144&id¼pr16_list&PageNo¼1& schFlag¼0 Consumer Insight Shopping Report. (2020b). Social distancing changed ‘quality of life’. https:// www.consumerinsight.co.kr/voc_view.aspx?no¼3132&id¼pr17_list&PageNo¼1& schFlag¼0 COVID-19 Dashboard. Retrieved January 20th, 2021, from https://coronaboard.kr/ Guevarra, D. A., & Howell, R. T. (2015). To have in order to do: Exploring the effects of consuming experiential products on well-being. Journal of Consumer Psychology, 25(1), 28–41. https://doi.org/10.1016/j.jcps.2014.06.006 Hankook Research. (2020). COVID-19 survey dashboard. Retrieved from https://public.tableau. com/profile/lee.donghan#!/vizhome/HRC_covid19_survey_dashboard/d__8 International Trade Administration. (2020). Retrieved from https://www.trade.gov/knowledgeproduct/korea-ecommerce Ji, G. (2020). Types of consumer problem related to COVID-19 and implications. Consumer Policy Trend, 103, 1–31. Retrieved from https://www.kca.go.kr/home/sub.do?menukey¼4083 Jun, W. (2020). A study on the current status and improvement of the digital divide among older people in Korea. International Journal of Environmental Research and Public Health, 17(11), 3917. https://doi.org/10.3390/ijerph17113917 Korea Consumer Agency. (2021). COVID19 consultation map. Retrieved from https://public. tableau.com/profile/kcabig#!/vizhome/19_15826193726210/19 Lim, B. (2020). Major issues for financial consumers related issues COVID-19 and implications. Consumer Policy Trend, 109, 1-25. Lisjak, M., Bonezzi, A., Kim, S., & Rucker, D. D. (2015). Perils of compensatory consumption: Within-domain compensation undermines subsequent self-regulation. Journal of Consumer Research, 41(5), 1186–1203. https://doi.org/10.1086/678902 McKinsey & Company. (2020). Survey: Asian consumer sentiment during the COVID-19 crisis. Retrieved from https://www.mckinsey.com/featured-insights/asia-pacific/survey-asian-con sumer-sentiment-during-the-covid-19-crisis Ministry of Employment and Labor. (2021). E-employment and labor index. Retrieved from http:// eboard.moel.go.kr/indicator/detail?menu_idx¼2 NIA. (2020). Korean ICT services against COVID-19 pandemic. Retrieved from https://www.nia. or.kr/site/nia_kor/ex/bbs/View.do?cbIdx¼39485&bcIdx¼22151&parentSeq¼22151 Samjung KPMG. (2020). Covid-19 business report. Retrieved from https://assets.kpmg/content/ dam/kpmg/xx/pdf/2020/09/kpmg-2020-ceo-outlook.pdf Shao, W., Grace, D., & Ross, M. (2019). Consumer motivation and luxury consumption: Testing moderating effects. Journal of Retailing and Consumer Services, 46, 33–44. https://doi.org/10. 1016/j.jretconser.2018.10.003 Shultz, C., Rahtz, D., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), The handbook of community well-being (pp. 403–421). Springer. Social Gap Report. (2020). Korea Social Welfare Association. Retrieved from https://crckorea.kr/? menuno¼177&cates¼766&boardno¼610&skin¼crckorea_new_board South Korea Central Disaster Management Headquarters. (2021). Retrieved from http://ncov. mohw.go.kr/

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Sozdamar-Keskin, N., Ozata, F. Z., Banar, K., & Royle, K. (2015). Examining digital literacy competences and learning habits of open and distance learners. Contemporary Educational Technology, 6, 74–90. Statistics Korea. (2021). Online shopping in December 2020. Retrieved from http://kostat.go.kr/ portal/eng/pressReleases/3/5/index.board WHO. (2021). World health data platform. Retrieved from https://www.who.int/data#reports Wu, J., & Holsapple, C. (2014). Imaginal and emotional experiences in pleasure-oriented IT usage: A hedonic consumption perspective. Information and Management, 51(1), 80–92. https://doi. org/10.1016/j.im.2013.09.003

Grace B. Yu (Ph.D) is an Associate Professor of Marketing in the Department of Business Administration at Duksung Women’s University, South Korea. Her research interests include relationship marketing, consumer happiness and quality-of-life studies. Her research has been published in Advances in Consumer Research, Psychology and Marketing, Journal of Business Ethics, Journal of Travel Research, Journal of Happiness Studies, Social Indicators Research, and Applied Research in Quality of Life (ARQOL) among others. She won the 2020 Best Annual ARQOL Paper Award from International Society for Quality of Life Studies. Before joining the academic world, she worked for Saatchi and Saatchi Seoul office, a multinational communications and advertising agency network, as an AE (Account Executive). Najung Kim (Ph.D) is an Associate Professor of Management in the College of Business Administration at Kookmin University, South Korea. Broadly speaking, her research explores the dynamics of individuals’ work experiences in the context of time, focusing on the concepts of identity, emotion, age, and culture. The topics include generational differences on the meaning of career, work-life balance issues across multiple life stages, sustainable work-related learning experiences over the course of life, and age differences in engagement at work. Her work has appeared in various outlets, including Human Resource Management, Human Resource Management Journal, Journal of Organizational Behavior, Journal of Vocational Behavior, and The Oxford Handbook of Retirement. She received her Ph.D in Management and Organization at Boston College in the US and her MSc in Organisational and Social Psychology at London School of Economics in UK.

Chapter 22

The Role of Spain’s Catalytic Institutions to Facilitate Community Well-Being During the COVID-19 Pandemic María José Montero-Simó, Rafael A. Araque-Padilla, Rosa Melero-Bolaños, and Clifford J. Shultz II

We will have to learn to cope with a much more fragile life Slavoj Žižek

Abstract The COVID-19 pandemic has challenged Spanish society to respond quickly and vigorously, to ensure the well-being of its citizens. Extant literature suggests the conceptualization of such a disaster generally determines the responses to it. How a society actually responds however is likely to be conditioned or shaped by its vulnerabilities. Prior to COVID-19, Spain was emerging from an economic crisis that had burdened the country for more than a decade, creating serious structural problems. In this chapter, the authors analyze the extent to which the pre-pandemic Spanish situation has restricted the possibilities for a strategic response to the crisis, both in its nature and in the types of groups served during the time-period marked by social confinement. Based on a content analysis of the main news on the actions undertaken by catalytic institutions, which appeared in the Spanish media, some lessons are drawn that shed light on the relationships among the concept of disaster, the importance of understanding the factors that generate vulnerability and the coordination of catalytic institutions to guarantee a more effective response that allows maintaining social well-being, especially among the most vulnerable populations. Keywords COVID-19 · Spain · Content analysis · Strategies · Catalytic institutions · Vulnerable populations

M. J. Montero-Simó (*) · R. A. Araque-Padilla · R. Melero-Bolaños Universidad Loyola Andalucía, Sevilla, Spain e-mail: [email protected]; [email protected]; [email protected] C. J. Shultz II Loyola University Chicago, Chicago, IL, USA e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_22

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Introduction

Viral pandemics are among the most devastating events in any country, exposing the population to situations of vulnerability and forcing people to deploy resilience strategies. A pandemic, by its very nature, can infect all or almost all citizens. The most disadvantaged members of the population, however, are disproportionately more likely to suffer its effects. A lack of economic resources, job insecurity, previous illnesses and other factors increase the risk of health impacts, suffering, and death. Similarly to other disasters, pandemics are understood to be calamitous, often sudden, and systemically disruptive occurrences that interrupt or destroy the routine functioning of a community, society, or state; causing profound human, material, economic, and/or environmental harm that exceeds the resources and civil capacities to cope and to ensure well-being (e.g., Davies, 2002; International Federation of Red Cross and Red Crescent, 2020). The institutional response tends to focus on returning the community to “normal,” although normal may not be good for all its members, especially where the status quo was poverty or exclusion. Such is the dominant paradigm in disaster research, whereby institutions prioritize perceived vulnerability to determine how and where to invest available resources. When a disaster is perceived as natural, institutions work to control the occurrence of these events, to prepare for them, and to mitigate potential damage. Disasters, however, can also be social phenomena, something socially constructed and rooted in the structure of the community affected by a natural hazard (Perry & Quarantelli, 2005). Thus, disasters are not merely accidents but result from multiple historical, human processes that have produced social vulnerability and risk in the community, which are interpreted in different cultural frameworks and managed through multiple social practices that vary over time and in space (Baez-Ullberg, 2017). Accordingly, the policy response to a natural hazard is not focused on returning a community to normal but instead uses the event as an opportunity to create social change within the community (Baker, 2009; Shultz, 2005). These definitions are not exclusive, but the way in which a disaster is understood affects how institutions should respond, what needs must be met, how to meet them, and to whom we first attend. Given a significant component of disasters is social and that they arise from a combination of threat and vulnerability, considering them as social phenomena permits a more comprehensive and potentially more effective approach. Note that disasters occur and compound at multiple levels, which arise as decisions are made to address them. That is, a pandemic itself is not the only disaster. For example, the closures and confinement or lockdown measures taken against COVID-19 have saved thousands of lives but in turn have had consequences that illuminate other crises: mental health problems, difficulties obtaining food, increased domestic violence, the disappearance of small businesses, etc. (Kelman, 2020). The term “vulnerability” is used in a wide range of contexts and, therefore, is present in a vast body of academic literature. In general, vulnerability refers to an ex ante evaluation of the probability of a negative impact on individual/social

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well-being (Povel, 2010). A key development in the academic approach to the concept of vulnerability has been the reconsideration of a “disadvantaged consumer” as “vulnerable consumer.” The former associates vulnerability with specific groups that are excluded or disadvantaged in the market (according to a judgment based on key indicators such as income, age, education, and race or ethnicity), while the latter considers vulnerability as the result of interaction dynamics between internal and external factors not limited to specific socioeconomic groups (European Commission, 2016). In this sense, vulnerability reflects not only a lack of resources but also defenselessness, insecurity and, perhaps above all, exposure to certain contingencies; it is external (e.g., risks and crisis to which an individual, a family, a community, an organization can be subjected) and internal (i.e., a form of helplessness, often stemming from a lack of resources that enable one to deal with contingencies while still suffering losses) (Delor & Hubert, 2000). Moreover, while vulnerability may be socially produced and frequently is socially compounded, risk in society is unevenly distributed. Threats therefore will affect people unequally (Oliver-Smith, 2017). Adopting a perspective of disaster as a social construction and vulnerability as a dynamic process provides a theoretical lens through which to consider the resilience of individuals and communities and the role of institutions in the process (e.g., Baker, 2009). Certainly, resilience is dependent on institutional responses (companies, civil society organizations, and public administrations). However, community and individual approaches and perspectives have dominated the previous literature on disasters, without fully integrating the role of institutions (Dyer, 1999; Shultz et al., 2017). The failure to consider their role in recovery makes it difficult to capture real experience during the transition from vulnerability to resilience. When disasters occur, survivors often must revisit their means of acquiring food, clothing, housing, electricity, clean water, and other daily needs. To varying degrees, survivors depend on markets, government, and non-governmental organizations to access the means of meeting their consumption needs, which exceed available resources (Manfredo & Shultz, 2007). In other words, institutions are responsible for identifying risks (making subjective and objective assessments of a potential disaster), reducing them (disaster prevention or mitigation), and reducing vulnerability through management (response and recovery policies) (Cardona, 2013). The initial evolution of the COVID-19 pandemic in Spain during the period of government-declared State of Alarm—including confinement or “lockdown”—presents a compelling scenario to study resilience. Of particular interest is the adaptive response of a community seeking to manage its resources and contribute to a desirable and sustainable state of prosperity (Shultz et al., 2017). The analysis of the response to this situation—what needs have been met and what groups have been addressed—enables us to reflect on the concept of disaster and its relationship with the response. Similarly, the main macro factors that characterized pre-pandemic Spain, and how they guided the type of strategies developed, will be presented. Because of the particularities of the Spanish case, the dynamic nature of the concepts of vulnerability and resilience will also be illuminated. Finally, the proposed scenario allows us to observe social and catalytic institutions, which in turn reveals

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useful lessons going forward in our efforts to ensure well-being, especially for the most vulnerable groups.

22.2

Pre-pandemic Spain and the Arrival of SARS-CoV-2

The COVID-19 pandemic has had a heterogeneous impact across countries, reflecting differences in the severity and duration of activity, mobility restrictions, and in the capacity to respond to the crisis, given the variances in idiosyncratic vulnerabilities. Across Europe, the pandemic has been a massive management challenge for people and institutions. Far from a coordinated response, the countries initially began to manage individually the response to the crisis, with mixed results revealing the adequacy/inadequacy of their health systems and EU integration more generally (Molina & Steimberg, 2020). What has become clear: understanding the way in which a country reacts to a disaster such as pandemic requires the consideration of different background factors, coordination, and collaboration among community stakeholders, and the leadership of governments, NGOs, and businesses (Shultz et al., 2017). The development of the Spanish response cannot be understood without considering some of the socioeconomic, political, and cultural factors that had characterized the country shortly before COVID-19 struck. Spain was slowly emerging from a harsh economic crisis that began in 2008. This context is associated with deterioration of social rights, a model of universal care—but with low protective intensity and little capacity to reduce relative poverty—and significant structural deficiencies that made the country vulnerable to global crises, all in the midst of a turbulent political situation domestically and in the EU.

22.2.1 Population Spain has more than 47 million inhabitants. Half these people live in cities with densely populated areas. The Spanish population reflects a dual dynamic: an aging tendency, but a notable foreign population to rejuvenate it (10.71%). This dynamic, though rejuvenating, also raises or reveals concerns. The average household size is 2.5 people (Statistics National Institute (INE), 2019a). One in four households is single-person, which means almost 4.8 million people have spent the pandemic lockdown alone. Of these people, 42% are 65 years or older; during the State of Alarm they were instructed to stay in their homes as much as possible; most (93%) of them receive nonmaterial support, if needed, from friends, family, or acquaintances (INE, 2018, 2019a). Perhaps as many as 470,000 immigrants (about 1% of the total resident population) irregularly reside in Spain, the majority of whom are women. They work in the underground economy or in formal activities (e.g., agriculture, domestic service, and

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other services), without employment contracts. Almost 15,000 people live in extreme conditions, such as shanty towns that lack running water and electricity (Fundación CEPAIM, 2020).

22.2.2 Housing Housing structures vary widely in terms of room size and number, usable area, and building type. However, 13% of homes are smaller than 60 m2, and 20% have four or fewer rooms, including kitchen but not bathroom (INE, 2020); 7.2 million people (4.7% of the population) are estimated to live in an overcrowded home; approximately 35,000 people in Spain are homeless (Ministerio de Sanidad, Servicios Sociales e Igualdad, 2016). These densely crowded and itinerant housing conditions likely contribute to the spread of SARS-CoV-2.

22.2.3 Education and the Digital Divide Spain has a literacy rate of 95.2% (UNESCO, 2020). Education is compulsory from the ages of 6–16 years, although 96% of students are already in school at 3 years of age. The good figures for education contrast with budget cuts. In general, public education continues to be much more common than private education, in both number of schools and students. Nearly 68% of the 8,127,832 students in basic education in Spain are enrolled in a public school (Infoempleo, 2018). Spain, however, has a serious problem with dropouts. Although the dropout rate has been decreasing and is currently 17.3% (Ministerio de Educación y Formación Profesional, 2020), Spain has the second-highest rate in the EU, behind Malta (Schraad-Tischler et al., 2017). Socioeconomic factors and parental education play a prominent role—the dropout rate among the most disadvantaged students is 53%, compared to a 9% rate for students in better situations. The labor market notably influences the dropout rate. Regions with sectors demanding low-skilled workers, such as tourism or construction, tend to have higher dropout rates (Infoempleo, 2018). The pandemic has brought to light another dimension of social inequality: the digital divide; that is, differences in people’s ability to access new technologies, or their knowledge of these technologies (Varela, 2015). An estimated 100,000 families are not connected to the Internet. Another 235,000 homes’ only means of connection is through mobile phones. Approximately half a million children have difficulty accessing new technologies or can access them only under inadequate conditions (INE, 2019b). These data indicate a structural problem, a matter of great concern in the Spanish educational system. Many students are disadvantaged by this problem and are at risk of being left behind; such inequality contributes to school dropout, socioeconomic exclusion, and limits social mobility.

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Spanish education is beset by challenges, characterized by limited resources to redress problems such as the digital divide. The challenges are created or exacerbated by a pattern of budget cuts since 2009 (Nadal, 2020).

22.2.4 Health The health system is fundamental to Spain’s welfare state and it has been key to containing the negative effects of COVID-19. The National Health System aims to guarantee the basic and common elements of comprehensive, continuous care at the appropriate level for all citizens (Ministerio de Sanidad y Política Social, 2009). The state serves as the guarantor of the right to health and is responsible for financing and managing the system. This system includes preventive, diagnostic, therapeutic, rehabilitative and health promotion and maintenance services for citizens via health care services. It is governed by the principles of universal care, accessibility and deconcentration, decentralization, primary care, and community engagement (Ministerio de Sanidad, Servicios Sociales e Igualdad, 2012). The universality that characterizes the Spanish health system represents a strength of Spanish society; indeed, it is widely favored, as indicated by satisfaction scores and the trends of those scores (Ministerio de Sanidad, 2020). The pandemic however nearly caused it to collapse; depending on the ongoing management of the crisis it still may collapse. Universal assistance, coupled with rapid spread of a virulent disease, is taxing the resources—beds, vaccines, medical and health personnel, equipment—of the system, resulting in tremendous harm to the health and wellbeing of people across the country. Tragically, much of this harm could have been prevented, especially the number of dead among health care workers and citizens; delays in medical assistance requisite for other health problems such as emergencies, primary assistance, surgeries; prioritization or “sinister triage” whereby the elderly in nursing homes were relegated or neglected, resulting in deaths.

22.2.5 Politics Spain has experienced great political complexity in the last decade. During this period, important social mobilizations have occurred, such as the “indignant” movement, internal conflicts within traditional parties, the emergence of new groups (the end of bipartisanship and the emergence of an extreme right), the political conflict in Catalonia and its judicialization; these problems are compounded by the loss of social benefits that has led to the impoverishment of a sector of the working class through increased unemployment and job insecurity, and has had a notable impact on younger generations (Martí & Ubasart-González, 2020). At the beginning of 2020, a new progressive coalition government formed, which is an unprecedented event in Spanish democracy. This government faced multiple

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challenges, including its own survival, and fierce political opposition that has challenged the coalition government to make progress. Political tension and rivals have hindered coordinated initiatives.

22.2.6 Economics In 2019, Spain was growing weakly at 2%, with a GDP of 1,244,757 euros (Expansión, 2019), with notable problems in other economic domains. Its public debt was 1,188,859 euros (25,117 euros per inhabitant), causing it to rank among the world’s most indebted countries (95.5% of the GDP). Spain also has one of the highest unemployment rates in the world. In 2019, 13.7% of the active population was unemployed (30.3% among those under 25). Spain also has the highest rate of temporary employment in the EU (22.3% of all workers are temporary workers) (Hernández de Cos, 2020). This situation is partially mitigated by the existence of an underground economy, in addition to social subsidies and family support. Although precise statistics do not exist, Spain’s informal economy could be between 15% and 25% of the GDP—a remarkable figure. The underground economy, family networks and overcrowded households, public aid, and lifestyle raise questions, but the general standard of living is acceptable. GDP per capita in 2019 was 26,430 euros; Spain also has a Human Development Index (HDI) score of 0.904, with only a slight decline from the previous year, which generally points to a reasonably good quality of life (QOL). These data, however, mask serious problems in the form of exclusion.

22.2.7 Business Landscape Although companies are better situated compared to the previous economic crisis— when operating in an environment of certain expansion, with annual real GDP growth of 2.6% from 2013 to 2019—the characteristics of the Spanish business landscape make it potentially vulnerable to future crises. Mainly small companies, 78% of which have fewer than five workers (69% in the EU), form the Spanish business structure. Forty-seven percent of the Spanish labor market works in companies with fewer than 20 employees (37.5% in the EU). This structure makes the Spanish business network vulnerable in cases of recession. In fact, between 2007 and 2013, the number of small businesses faced a decrease four times greater than that of other business types (Martínez et al., 2020). Spain depends more on tourism than any other European economy (14.3% of the Spanish GDP, compared to 9.5% of the EU). This sector was hit hard by restrictions implemented in response to the pandemic.

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Sectoral imbalances also occurred. Even starting from a position of better liquidity and capital than was present at the beginning of the 2008 crisis, some sectors, especially hotels, restaurants, transportation, logistics, automotive, and retail, had lower structural capital and liquidity than did others (0.8 times the average liquidity ratio and 0.6 times the capital ratio than the average of all sectors) (Martínez et al., 2020). However, the Spanish competitive model is based on low wages, little innovation, and low environmental protection. Regarding innovation, the weight of investment in R & D on the Spanish GDP, in both the public and private sectors, is 26%, which is 54% lower than the average for the entire EU (Hernández de Cos, 2020).

22.2.8 Social Exclusion Spain is among EU countries with the highest risk of poverty or social exclusion. European Anti Poverty Network reports 25.3% of the population is at risk; that is, they are affected by at least one of three conditions: risk of poverty after social transfers (monetary poverty) (21.5%), severe material deprivation, and/or living in households with a very low work intensity (10.7%) (EAPN, 2020). More than eight million people (18% of the population) live in a precarious social condition; 8.8% of the population suffer from severe exclusion, with disposable income per unit of consumption less than 60% of median national income (Fundación Foessa, 2019). Such exclusion may have devastating consequences for health, education, and social opportunities. A close relationship between disability and social exclusion also exists. Thirty percent of people with disabilities are in a situation marked by social exclusion, due not only to disability but also to obstacles faced regarding access to quality employment, integration, health resources or social relations. People from outside the EU-15 experience the highest exclusion rates. Two out of 10 people suffering severe exclusion are from non-EU countries (Fundación Foessa, 2019).

22.2.9 Third Sector of Social Action Third sector organizations of social action are undergoing an advanced stage of consolidation, with growth and institutional rejuvenation marked by the emergence of several entities. Specifically, 56.5% of them were created after 2000; many of them are small and must achieve stability or risk possible disappearance. Only 29% of Spanish organizations work at the national or international level; the remaining 71% are small organizations at the local or regional level (Plataforma de ONG de Acción Social, 2020). This sector comprises micro and small organizations, and active with approximately 43 million direct actions.

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Despite this growth, the development of the third sector in Spain has depended on state resources, and thus is difficult to recognize as an independent institutional partner. It represents 1.45% of GDP and has a total revenue of 16.58 million euros, 41% of which comes from public funding, 26% from private funding, and 33% from self-funding. The destination of these funds is distributed among the following beneficiaries: disability, 29%; childhood and adolescence, 25%; general public, 23%; and people at risk of poverty/marginalization, 19%. These factors provide an overview of the context in which the COVID-19 pandemic struck. This specific combination of factors affected the pandemic’s impact in Spain and, as will be discussed, influenced the country’s response to the disaster. In what follows, we offer a perspective on the nature of initiatives orchestrated by Spanish institutions during the confinement phase to slow the spread of the pandemic and to alleviate or mitigate its consequences. This perspective is based on a study conducted by the authors; the methodology is explained below.

22.3

Methods

Management of the first wave of COVID-19 was assessed via content analysis (Elo & Kyngäs, 2008; Krippendorf, 2013) of news during the mandated confinement. A search of Google News app was conducted for the period March 15 to June 20, 2020. After news items that referred to similar events were eliminated, we then analyzed 145 items. Closer scrutiny of these remaining items enabled us to identify 812 different strategies. The process is indicated in Fig. 22.1.

Fig. 22.1 Methodology flowchart

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Four trained coders independently read and classified the strategies, then discussed 20% of the news items. During this phase, the classification criteria were refined, and controversial examples were analyzed. Subsequently, each coder worked independently on another 20% of the news content, and the results were contrasted and discussed among the coders. The agreement for each coding variable was calculated; in general, an acceptable Krippendorff’s alpha was found (alpha > 0.7) (Krippendorff, 2013). Disagreements were discussed in groups. The strategies identified were coded according to four variables: final recipients, needs met, organizations that promoted them, and type of strategy followed. Next, we present the analysis scheme that was followed for each of these variables. The recipients were first cataloged to distinguish between excluded vulnerable groups and vulnerable groups, according to the theoretical approach to vulnerability discussed above. Excluded vulnerable groups included those who were already experiencing adverse and sometimes critical socioeconomic conditions, and social exclusion prior to the pandemic. Specifically, low-income, homeless, and immigrant/refugee groups were included. Vulnerable groups, however, were non-disadvantaged groups who acquired vulnerable status as a direct consequence of the pandemic. The vulnerable group was further divided into three subgroups: individuals in the general public (elderly adults, nursing home residents, people with disabilities, children, students, households, unemployed individuals, and people sick with COVID); companies (companies in general, self-employed workers, employed persons, and small- and medium-sized companies); and professionals whose work involves exposure to the disease (workers at hospitals, health facilities, and at State Security Forces). The needs met were classified according to relationship to the pandemic. Three overarching types of efforts were considered: mitigation of the adverse effects of the pandemic on the vulnerable population (food, education, housing, employment, income, transportation, accompaniment, leisure); mitigation of the adverse effects of the pandemic on vulnerable companies (productivity, liquidity, raw materials, training, or consultation); and stopping the spread of the pandemic (health, medical supplies, medical research, information to prevent and deal with the coronavirus). For the identification of catalytic institutions, distinctions were made among government, business, non-governmental organizations, and civil society. Within the government and given the Spanish context, national, local, and regional initiatives were considered. In companies, both the strategies undertaken by the companies and their foundations were considered. Finally, a distinction was made between NGOs and other civil society organizations. In the latter case, we refer to social initiatives promoted by individuals or groups spontaneously created to meet the needs of the moment and without a preexisting formal structure, such as networks of volunteers or neighbors. Alliances among institutions were also analyzed in terms of the actors involved, intensity of collaboration and objectives. The strategies developed to manage the pandemic were classified as assistance, structural, awareness, lobbying, and coordination. Assistance strategies refer to those that seek to alleviate or mitigate the immediate, direct effects of the pandemic; they seek to return the population to its starting point prior to the pandemic. Structural

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strategies refer to those that pursue social reforms to help generate proactive resilience against future disasters. Awareness strategies are developed to raise awareness about the behaviors and action guidelines necessary during the pandemic. Lobbying strategies focus on pressuring other actors to promote or implement certain initiatives deemed clearly necessary. Coordination strategies aim to organize the management of economic, material or human resources through the participation of various actors. Below, we share findings from our analysis of the strategies developed in response to the first wave of the pandemic, and the role of catalytic institutions to execute the strategic responses. We then consider the post-pandemic context; some lessons learned and share an overarching conclusion.

22.4

Response to First Wave: From Shock to Institutional Dynamism

Recall that Spain had not fully recovered from the great recession when COVID-19 began to spread. A prevailing sentiment among political leaders was that a lengthy lockdown to slow or stop the coronavirus would have placed the state in a precarious position, regarding companies and their employees. Thus, the government gradually adopted and implemented measures intended to balance economic interests and public health; however, as the full effects of COVID-19 became obvious, on March 13, a State of Alarm was decreed, including a social confinement policy. Generally, in situations of vulnerability, risk, and indeed crisis, one tends to think the State should assume responsibility, especially in countries where the government is integral to systems and institutions requisite for societal well-being. In the case of Spain, COVID-19 energized all the involved social institutions in a kind of shared responsibility. During the 3 months of confinement/lockdown, four types of agents—government, companies, third sector, and civil society—developed initiatives aimed at fighting the effects of the pandemic, providing protection, and building resilience in the community. Data in Table 22.1 indicate the business sector Table 22.1 Number of initiatives launched by each type of agent Time framea Until 31/3 Until 15/4 Until 30/4 Until 15/5 Until 31/5 Until 15/6 Total a

Government 77 25 19 8 12 24 165

Business 231 115 87 41 29 25 528

Third sector of social action 20 4 7 7 1 1 40

Civil society 45 3 7 13 7 4 79

Total 373 147 120 69 49 54 812

Note: We opted for a biweekly periodization since the approval of the State of Alarm had to be justified and legally renewed every 15 days

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launched the greatest number of initiatives (64.9% of the total recorded), followed by the government (20.4%), civil society (9.7%), and social organizations (4.9%). The number of initiatives undertaken during the State of Alarm generally decreased. Interestingly, there was an initial boom during the first 2 weeks of confinement, then the number of initiatives decreased at a faster rate. This pattern is also maintained by each of the agents except for the government, which regained a more active role in the last period.

22.4.1 Affected Groups and QOL The initiatives developed by the different social agents aimed to respond to two types of needs: first, to stop the progression of disease among the population (detention) and, second, to mitigate or correct the adverse effects of the disease (mitigation). In the Spanish case, 2/3 of all actions undertaken were limited to the latter goal (Table 22.2). This may be explained by the initial global ignorance of, or skepticism towards, a novel coronavirus, beyond certain preventive measures. Thus, efforts focused mostly on addressing the urgent negative impacts of the disease and the adoption of social distancing. Actions to stop the spread of the virus (29% of all actions) focused mainly on providing medical supplies and conducting tests to detect possible symptomatic and asymptomatic infections, and to mandate isolation and monitoring of these infections. From the beginning, these initiatives faced a shortage of materials and a dependence on international markets for their supply. Spain did not have a consolidated industry for the production of masks or respirators. While the government struggled with this problem, civil society and business communities actively mobilized to make products the market could not supply at that time. Many companies readjusted their processes to produce these items, and many people began to manufacture masks and other medical equipment on their own, which they donated

Table 22.2 Types of needs and groups served

Detention Mitigation in individuals Mitigation in companies Several Total

Several groups 13 17

Excluded vulnerable groups 6 143

Vulnerable individuals groups 71 181

Essential workers groups 132 30

Vulnerable companies groups 13 0

Total 235 371

1

0

0

23

125

149

31 62

10 159

13 265

1 186

2 140

57 812

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to hospitals and health centers. Although it was not enough to meet the demand, this mobilization helped at least to alleviate the problem and to engage the population. Half the initiatives undertaken (52% of the total) however focused on mitigating the impact of the crisis on individuals. This general trend was also observed for each type of agent, which highlights the general concern of Spanish society with maintaining decent levels of well-being for its citizens. The needs addressed basically consisted of guaranteeing access to food and hygiene products, providing accompaniment and emotional support, ensuring access to housing and basic supplies (electricity, gas, water), and favoring employability (Table 22.3). To a lesser extent, the needs of vulnerable companies were also met (17% of all initiatives). The focus was on meeting some of the liquidity requirements, maintaining employment, and providing training and consulting to improve the company’s chances of surviving, especially for small businesses and self-employed individuals. When the specific groups served were considered in detail, we found that vulnerable individuals (elderly, people in nursing homes or disabled, children, students, families, unemployed, and people ill from COVID-19) were the main group of concern, with a third of the actions directed towards them. The next most important group, according to the number of actions taken, comprised professionals with the greatest risk of exposure to the disease (Health and Safety Corps) (22.9% of the actions recorded during the confinement period). The fundamental objective of these initiatives was the provision of medical supplies (e.g., protective gear), food during the long working hours and health care. Finally, the least attended group in terms of the number of actions was vulnerable companies. Assistance for this group predominantly aimed at promoting liquidity or sustaining employment, in the latter case through costly government measures.

22.4.2 Nature of the Actions Administered The analysis of the Spanish case shows a global reaction to the pandemic that had an essentially assistive nature. Three out of four actions implemented aimed to address immediately the negative effects of the crisis. Far behind were actions that sought to take advantage of the opportunities the situation presented for improving the structural conditions of vulnerability and favoring future resilience in similar situations (e.g., strengthening health, improving educational capabilities and strengthening the productive landscape). Such actions represented 14.5% of the total. The use of coordination strategies (organizing resources, aid, and information in very diverse areas to facilitate the action of organizations and civil society) (6.4%) and awareness and lobbying (2%) was limited. Marketing communications campaigns sought to raise awareness of preventive behaviors among the population (e.g., lockdown), while lobbying groups aimed to promote measures that would both help to stop the disease and mitigate its consequences.

Several Total

Mitigation in companies

Mitigation in individuals

Detention

Needs Health care Information Medical supplies Medical research Food and hygiene products Education Housing and basic supplies Employability Income Home delivery/ Transportation Accompaniment and emotional support Leisure Training and consulting Maintaining employment Raw materials Transportation Liquidity requirement Productivity (teleworking, Videoconf.) Several

Table 22.3 Specific needs and groups served

10 159

1 0 0 0 0 0 0

1 0 0 0 0 1 0 31 62

4

Excluded vulnerable groups 3 1 2 0 83 10 27 8 9 1

3

Several groups 4 2 2 5 7 1 4 0 1 0

13 265

22 0 0 0 0 0 0

61

Vulnerable individuals groups 41 8 14 8 32 14 13 18 14 7

1 186

2 3 0 0 17 0 3

2

Essential workers groups 17 1 114 0 23 0 2 0 1 0

2 140

0 28 29 1 0 53 14

0

Vulnerable companies groups 4 5 2 2 0 0 0 0 0 0

57 812

26 31 29 1 17 54 17

70

Total 69 17 134 15 145 25 46 26 25 8

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Table 22.4 Number and type of strategies per group served

Several groups Excluded vulnerable groups Vulnerable individuals groups Essential workers groups Vulnerable companies groups Total

Assistance strategies (%) 66.1

Structural strategies (%) 11.3

Awareness strategies (%) 0.0

Lobbying strategies (%) 3.2

Total 62

4.4

82.4

10.1

1.9

1.3

159

6.8

75.8

10.9

4.2

2.3

265

5.4

87.6

5.9

0.5

0.5

186

3.6

52.1

39.3

1.4

3.6

140

6.4

75.0

14.5

2.1

2.0

812

Coordination strategies (%) 19.4

Assistive initiatives or strategies constituted the predominant type of action for each of the studied groups, with an emphasis on disadvantaged people and professionals at risk (82.4% and 87.6%, respectively) (Table 22.4). On the other hand, structural initiatives focused mostly on vulnerable companies (39.3%). In short, the strategies taken against COVID-19 followed an assistive pattern, with a moderate attempt to work on more long-term (structural) aspects, especially for the group of vulnerable businesses.

22.5

The Role of Catalytic Institutions

Four catalytic institutions emerged as vital to the First Wave response: Government, Business Corporations, Third Sector of Social Action, and Civil Society. Some discussion of their role, strategic initiatives, and actions is shared below.

22.5.1 Government The Spanish government’s reaction to economic policy was, in general terms, rapid and substantial. The COVID-relief package was equivalent to approximately 16% of GDP (versus 15% in France and Portugal, 21% in Germany, and 22% in Italy). However, these measures occurred in a context in which the public sector, given its high level of debt, had less room to maneuver. The types of measures therefore were as important as the amounts granted.

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Table 22.5 Number and category of needs met by each agent

Detention Mitigation in individuals Mitigation in companies Several Total

Government 24 92

Business 174 219

Third sector of social action 8 27

Civil society 29 33

Total 235 371

39

102

0

8

149

10 165

33 528

5 40

9 79

57 812

Table 22.6 Recipients served by each catalytic institution

Government Business corporations Third sector of social action Civil society Total

Several groups (%) 8 6 15

Excluded vulnerable groups (%) 26 17 43

Vulnerable individuals groups (%) 38 28 40

Essential workers groups (%) 4 31 3

Vulnerable companies groups (%) 24 17 0

14 8

10 20

46 33

20 23

10 17

The public administration undertook the second-highest number of initiatives during the confinement period, but only 20% of all initiatives; far from the 65% developed by businesses (Table 22.1). It was most active in the first month and then lost momentum in subsequent periods. Some intensity was again observed in the last month of the State of Alarm. More than a third of the public administration’s initiatives were developed in collaboration with other agents. However, it had the lowest levels of collaboration with other social institutions (15.7%), as it allied mainly with companies. That is, the government was a less-committed actor in the joint response to the pandemic, in both its active search for partners and its selection as a partner by others. Government action strategies mainly aimed to mitigate the impact of the pandemic among individuals (56%). To a lesser extent, it carried out actions aimed at the productive landscape (24%) and on prevention or detention (15%) (Table 22.5). The main recipients of actions taken by catalytic institutions were groups of vulnerable individuals (39%), followed by groups of disadvantaged and vulnerable companies (both with 25% of the actions) (Table 22.6). Although the government initiatives were clearly assistive (64.2%), they were also active in the design of structural strategies, to strengthen long-term social resilience (Table 22.7). Noteworthy is the approval of a law guaranteeing a minimum living wage, which guarantees income of 462–1015 euros to vulnerable families; we estimate a subsequent benefit for 850,000 households and more than 2.3 million people.

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Table 22.7 Types of strategy used by each catalytic institution

Government Business corporations Third sector of social action Civil society Total

Coordination strategies 15 22

Assistance strategies 106 420

Structural strategies 32 78

Awareness strategies 6 6

Lobbying strategies 6 2

Total 165 528

4

28

3

3

2

40

11 52

55 609

5 118

2 17

6 16

79 812

22.5.2 Business Corporations As mentioned above, companies were most active, and they undertook the greatest number of initiatives during the State of Alarm. Forty-six percent of all the analyzed initiatives occurred during the first fortnight after lockdown; efforts decreased in successive periods (Table 22.1). Many of these initiatives were framed as corporate social responsibility (CSR) policies and were communicated as such. Nearly half (46.4%) of the actions taken by companies were joint efforts with other institutions, essentially those from the third sector, and 20.9% of collaborative alliances involved companies. This sector was thus active and committed to the joint work of reconstruction. Although most corporate initiatives focused on mitigating consequences for individuals (41%), companies actively sought to prevent the spread of SARSCoV-2 (33%). They also showed the greatest concern (i.e., number of activities) regarding negative consequences for the most vulnerable companies (Table 22.5). Fifty-nine percent of business initiatives focused on groups of vulnerable individuals and essential workers (Table 22.6). Companies showed the greatest balance vis-à-vis different groups served. Regarding the nature of initiatives, eight out of ten companies were assistive, while 15% were structural strategies (Table 22.7). Companies moreover were responsible for the largest number of structural strategies, which highlights their role as the agent, in collaboration with government, that has contributed the most to longer term resilience of society, mainly through their work (e.g., mentoring, free consultation, and training) with vulnerable businesses.

22.5.3 Third Sector of Social Action This group of agents mainly provided channeling strategies during the State of Alarm. They were in many respects social intermediaries. The institutions of the third sector initiated the fewest initiatives (Table 22.1) (5%), possibly due to lack of resources—a situation worsening in Spain before the pandemic—yet they played a

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pivotal role, as their social connectivity likely was key to securing aid for the various affected groups. Note that 82.5% of the few initiatives of social organizations involved alliances with other institutions—mainly civil society—suggesting this group was a preferred ally for collaboration; indeed, 45.8% of the partnerships emerged from alliances. These institutions developed actions to slow or stop the advancing virus/disease; their work furthermore focused on alleviating or mitigating the consequences of the crisis for individuals (68% of all actions developed) (Table 22.5). Social organizations aimed specifically to help the most disadvantaged individuals (Table 22.6) and primarily used assistance strategies (Table 22.7). This group was the only actor that did not propose strategies aimed at companies.

22.5.4 Civil Society Despite their limitations, citizens also proved to be active agents during confinement, undertaking 10% of the studied initiatives (Table 22.1), including both spontaneously and in an organized manner. They collaborated with other institutions and occasionally sought allies and worked with companies, NGOs, and other social movements; they were essentially the only allies sought by the government and the third sector. The initiatives undertaken by civil society focused equally on slowing COVID-19 (37%), seeking protection for vulnerable individuals, and helping to mitigate the impact of the pandemic (41.8%) (Table 22.5). Vulnerable individuals (46%) and essential workers (20%) were primary foci, followed by disadvantaged people and vulnerable companies (both 10%) (Table 22.6). As with other institutions, civil society implemented strategies that were assistive (70%); however, their work based on coordination strategies should also be noted (14%, representing 21% of all initiatives involving coordination strategies) (Table 22.7). In other words, civil society provided assistance to people who were vulnerable to the pandemic and coordinated initiatives in which other institutions were engaged.

*** In summary, the roles of Spanish catalytic institutions in the face of the pandemic can be characterized as follows: clear activism on the part of the business sector, which was also willing to put itself at the service of other agents; the third sector serving as an ideal ally for reaching people with the greatest need due to its connectivity in society; a civil society with some presence, but without the solid structure necessary to make it a crucial agent; and a government that attempted to lead but showed little commitment to forging alliances for responding to the pandemic. It is also noteworthy that almost half (45%) of all the initiatives undertaken were launched through partnerships.

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The Spanish example illustrates the relevance of dynamic social institutions. In the Spanish landscape, this dynamism has led to multiple initiatives that have complemented the tasks of public administrations with limited resources. The effervescence of the third sector in Spain, and that of other civil society organizations, together with the determined social commitment of the business community, has enabled the assistance of many disadvantaged and neglected people who otherwise would have been outside the radar of government strategy. This collective effervescence was not merely spontaneous but was the result of a society that tries to protect the idea of the common good despite difficulties, advances, and setbacks.

22.6

The Impact of COVID-19: Vulnerability as a Challenge

The asymmetric impact of the pandemic across the EU fueled skepticism, distrust, and even some recrimination among member states. Some countries (e.g., Spain and Italy), expected and were awaiting economic support from the Union; at the same time, other member states were concerned these countries had mismanaged the pandemic and/or had been applying unsustainable fiscal policy that led to the dire situation in which they found themselves. In this delicate dynamic, Spain was facing the challenges of setting up constructive relationships with the EU (cf. Molina & Steimberg, 2020), while controlling a virulent pathogen and fighting to save lives with a fragile economy and overwhelmed health care system. Despite all the new initiatives, the estimated GDP for 2020 is expected to drop between 9.5 and 12.4%, due to the economic shutdown caused by confinement, compared to a range between 5.2 and 11.1% in the eurozone, and between 2.7 and 6.5% worldwide (Martínez et al., 2020). These numbers reflect the horrific human costs and suffering: more than 3.7 million people in Spain have been infected by SARS-Cov-2; more than 80,000 have died from COVID-19, as this chapter goes to press (Worldometer, 2021). Against these figures, the traditional problems of the Spanish economy, which have been accentuated by the pandemic, emerge (Pérez, 2021): loss of business landscape, high unemployment, public deficit, public debt and increased inequality. A loss of approximately 5% of the business landscape is expected. More than 12% of companies of all sizes and in almost all sectors are in danger from the crisis, and the rest likely will face weaker demand for years. The most affected sectors (e.g., hospitality, commerce, small industries, specialized services) will see their businesses decrease by more than 20%. The weakness of demand and the smaller business network will markedly impact employment. The unemployment rate is estimated to be approximately 20–21% based on records of temporary employment regulation (ERTE, for its abbreviation in Spanish), which will surface throughout 2021. This strategy ensures that many workers and small entrepreneurs/self-employed will keep their income. We fear

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however that many companies will not be able to return to prior levels of activity; many workers eventually will be unemployed. Lower economic activity and higher unemployment will lead to more public deficits (approximately 140,000 million euros) due to lower revenue and higher spending on business aid; unemployment benefits, among other issues; increased public debt, which will reach 120% of GDP. Months of confinement did not have equal impact. COVID-19 made some social inequalities visible and magnified others. It had dramatic effects on people at risk of exclusion and on the most vulnerable households, including workers in the informal economy, people with precarious jobs, people with disabilities or health problems, elderly adults, young people, and children in families experiencing and/or at risk of social exclusion, and the homeless, thus highlighting preexisting structural inequalities (economic, social, gender, etc.). COVID-19 poses an extraordinary, ongoing public health challenge. The number of deaths due to COVID-19 is compounded by the stress on the health system that has pushed numerous health units to the brink of collapse, especially during the first wave of the pandemic. COVID-19 infections and deaths among health personnel in Spain have been at levels well above those of other European countries. The higher mortality and infection rates are attributed to a lack of personal protective equipment (PPE). During the first 2 months of the pandemic, PPE availability was considered “chaotic,” with a general shortage of basic elements such as masks and gloves that was aggravated by a lack of foresight in the management of the pandemic (Malgesini-Rey, 2020). ERTE prevented a significant number of layoffs, but those who worked in domestic service and/or care in the informal economy were not eligible to participate in them and remained without income. An increasing number of families joined the ranks of those who needed to obtain food from food banks, which were overwhelmed. The closure of schools and other workplaces led to the rapid development of online education and teleworking, for which many people, households, academic institutions, and businesses were not prepared because they were impacted by the digital divide, lacked adequate devices for connecting to the Internet.

22.7

Lessons Learned

How a disaster is conceived often conditions the types of responses to it (e.g., Baker, 2009; Shultz & Holbrook, 2009). The Spanish scenario reveals a nuanced perspective: regardless of how a disaster is conceived, a country’s previous potential vulnerability to the disaster is what fundamentally conditions its response.

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22.7.1 Disaster Response As has been emphasized, many of the macro factors that characterized the Spanish scenario were decisive in creating vulnerability and, consequently, the response to the disaster. The scourge of the economic crisis, some schisms with and skepticism or mistrust in the EU, dependence of the elderly, the particular features of the business sector, a strong dependence on the tourism sector, the digital divide, exclusion rates and macroeconomic imbalances, among other factors, meant that the onset of the pandemic caused a need for help among important and numerous vulnerable groups and not just among the most economically disadvantaged. This vulnerability caused by the pandemic accentuated the urgency and prioritization of attending to all these groups. To this dynamic was added the obligatory decision to lock down the country. Although social agents tried to use the disaster as an opportunity to make structural changes that would protect society against future, similar crises—and, in fact, initiatives to this effect were proposed, as previously mentioned—the imperative obligation to serve vulnerable groups directed the destination of very limited resources. Most of the aid provided for Spanish society arose more from urgency and necessity than the result of a narrow conceptualization of disaster. Spain tried to contain the damage to a society already weakened by the previous economic crisis rather than lay the foundations for a structurally more resilient society. In short, the containment of the damage focused on returning society to its starting point without paying special attention to the oppressive circumstances of the most vulnerable and disadvantaged, thus maintaining previously existing imbalances. We conclude therefore that the greater a country’s vulnerability, the more difficult it will be to undertake structural reforms in times of disaster. In a society, which is again showing cracks, the focus is usually on how to plug holes rather than to build a stronger container. Consequently, the design of strategies that protect a society from a future disaster must start with a careful analysis of the macro factors that characterize the society and their potential contribution/resolution to social vulnerability (Shultz et al., 2017). As has been emphasized, vulnerability is more than insufficient resources; other variables come into play that make any citizen potentially vulnerable to a crisis (Shultz & Holbrook, 2009). Understanding the particular features of each community is essential to guide political and strategic decisions beyond shortterm political calculations.

22.7.2 Response Effectiveness A robust civil society with institutions that have greater independence from state resources is essential to strengthen social dialogue and the coordinated search for better action strategies, and ultimately response effectiveness.

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In Spain, the lack of recognition of the third sector as a social partner leads the state to use institutions of the social economy to initiate intervention as a means of reducing costs. This problem is derived in large part from the considerable atomization of third sector organizations, their weakness in attracting resources from individuals and, sometimes, the lack of professionalization or management knowhow. This generates dependency and an inability to mobilize more stable and larger actions. Crises such as pandemics require a third sector with a more structural approach that can play a relevant role in social debates. It is also necessary to become more creative over time in combining structural strategies with more assistive strategies that are immediately derived from the emergency. Certainly, the role of channeling government aid is very important in the face of disasters such as the one analyzed, but remaining in that role prevents the third sector from taking advantage of its full potential to improve the living conditions of a community. On the other hand, the response by other movements and civil society organizations was good, but also markedly assistive. Attempts to create platforms for collaboration resulted in a handful of initiatives that disappeared, leaving nothing stable to foster coordination required during future crises, and to create long-term social changes. This more assistive role of the Spanish third sector contrasts with the more structural approach of many initiatives launched by the business sector. Most of the identified structural actions came from this sector in the form of collaboration and aid initiatives among companies. These actions may be related to the nature of these agents, which are accustomed to longer term planning and vision. Therefore, the role of companies is essential, not only to guarantee access to basic products/services in crisis but also to provide a more long-term vision to the strategic debate that guides other social agents in their work. The Spanish situation also shows how ignorance or uncertainty regarding disaster control generates attrition or fatigue. The data collected during the confinement indicate a decrease in the intensity of the initiatives of the various social institutions over time. Spain is an empathetic, compassionate society. In all global humanitarian crises, the Spanish response can be described as effervescent: it is an enormous initial force that dissolves in the medium and long term. This characteristic was also observed in the response to the pandemic. Once again, it is essential to work on response approaches that creatively combine welfare and work to produce necessary reforms with long-term effects. The evolution of the impact of COVID-19 has illustrated the limited effectiveness of excessive assistance for solving problems. The enormous social and economic efforts of the country, which must be paid-for in the coming years, could be diluted in a short time due to the lack of more stable structural reforms. This is especially significant in the case of excluded vulnerable groups. In Spain, these groups have been the great losers of the pandemic. The fight against the pandemic so far has meant another missed opportunity to improve the conditions of vulnerability that generate exclusion. In the Spanish case, excluded vulnerable groups have barely

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been acknowledged by media, political, or social concerns beyond purely rhetorical mentions.

22.7.3 Constructive Engagement Among Catalytic Institutions and Their Stakeholders It is impossible to fully understand the resilience of a country or community without analyzing the roles of its social institutions. Cooperation among them is essential to guarantee well-being to a large part of the population most affected by the disaster. The case of Spain provides an example of how different catalytic institutions have woven a network of solidarity to provide aid for the most disadvantaged and vulnerable groups. The relationships and interactions among them pique interest for the study of possible dysfunctions or missed opportunities to improve the effectiveness of the response to the pandemic. The way in which these institutions behave during a crisis is also an indicator of potential vulnerabilities in a given community. Some lessons regarding constructive engagement in the response to the COVID-19 pandemic are shared below.

22.7.3.1

Establish a Solid Institutional Landscape

A system of solid—effective, reliable, and resilient—institutions for collaborative work, without clear weaknesses, is vital. Recall that the government of Spain was in a complicated position due to the need to maintain pacts with other political forces that would allow it to stabilize and carry out its policies, including some as relevant as the general budgets of the state.

22.7.3.2

Recognize Other Catalytic Institutions as Valid Partners

As mentioned, in Spain, the third sector is not recognized as a valid partner in the definition of social policies; it is viewed more as a collaborator in the field. This oversight is a missed opportunity that compromises decision-making.

22.7.3.3

Recognize Other Key Social Institutions in the Community

A good understanding of the dynamics of well-being involves considering and supporting other relevant social institutions. In Spain, the family is a deeply rooted social institution that has been decisive in helping to sustain the well-being of its members, although at the cost of overburden.

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Understand Common Self-interests

The internal and external pressures that each actor experiences must be known and understood; common points of concern must be found. We submit this is the best way to connect shared interests and to reach agreements. A prevailing sentiment in Latin societies, including Spanish society—the position of “you are with me or against me”—makes difficult the process of negotiation, agreement, and ultimately some serviceable policy to address crises.

22.7.3.5

Establish Coordination Mechanisms

An organized structure of dialogue is needed. It should not be left to chance, as has occurred in Spain in the case of improvised alliances that may arise from prior mutual knowledge.

22.7.3.6

Know When: And When Not: To Take Credit

During this pandemic in Spain, each initiative has been viewed as an opportunity to gain social returns. It is necessary to know when and to whom successful initiatives should be attributed and to put the common good first. Share the credit for successes.

22.7.3.7

Evaluate the Impact of Actions

Information is needed to guide decision-making. This information must be collected truthfully and quickly. It must be adequately managed to improve decisions in response to a disaster, produce a clear objective, focus beyond the restoration of the previous conditions, and generate social changes in the medium and long term.

22.8

Conclusion

A pandemic is not generally predictable, either in the timing of arrival or activism once present. When it arrives, it affects a community, especially its most vulnerable people, generating new imbalances and inequalities. However, this unpredictability is not an excuse for inaction. The depth and breadth of impact/devastation will greatly depend on the social conditions of vulnerability. Consequently, working to overcome those conditions by attacking the causes of inequality is imperative to mitigate the damage of possible disasters. Such efforts will be difficult to undertake without solid social institutions that work together with a vision of common good that transcends agendas, interests, particularities, and distrust.

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The COVID-19 pandemic has forced the world community to face its fragility. Spain is no exception to this reckoning. Accepting this condition—learning from it—facilitates future preparedness, resilience, and appropriate, well-coordinated systemic responses. We have observed that state leadership cannot adequately address the situation without the help of a consolidated and committed civil society led by key catalytic institutions and a market that functions efficiently, inclusively, and fairly to guarantee at least decent levels of individual QOL, and in turn resilient, flourishing communities and a larger society and state before, during and after the crisis. We have shared insights into the Spanish condition, both strengths and weaknesses, that have been revealed or made less opaque during the crisis and offer some actionable lessons. Our hope is that these insights will result in better preparedness, a socioeconomic structure that is resilient and responsive, which will help to reduce and mitigate the effects of the next pandemic or other crisis, thus enhancing the probability of sustainable QOL and well-being for people, communities, and Spain as a whole.

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María José Montero-Simó is Professor of Marketing at the Universidad Loyola Andalucía (Spain). She is the head of Management Department and coordinates the Research group in Business Capabilities, Economic Growth and Development of the Doctoral Program in Inclusive and Sustainable Development. She handles research on macromarketing, social marketing, critical marketing, and food marketing systems. She teaches at, undergraduate, graduate, and doctoral degrees, courses such as Marketing Fundamentals, Marketing and Development, Social Marketing, or Research Fundamentals. Rafael A. Araque-Padilla is an Associate Professor of Marketing at the Universidad Loyola Andalucía (Spain). He is the current director of the Ph.D. Program in Inclusive and Sustainable Development. Dr. Araque-Padilla handles research on Macromarketing, Marketing and Development, Food Marketing Systems, Social Marketing, CSR and Marketing, and Ethical Marketing. He teaches at undergraduate, graduate, and doctoral degrees, in courses such as Marketing Fundamentals, Marketing and Development, Social Marketing, or Commercial Distribution. Rosa Melero-Bolaños is a Professor of Marketing at the Universidad Loyola Andalucia (Spain). She is a member of the Board of the Loyola University Foundation. She handles research on marketing and social marketing. She teaches at, undergraduate and graduate degrees, courses such

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as Marketing Fundamentals, Market Orientation, Business Economics and Organizational Communication. Clifford J. Shultz II (Ph.D., Columbia University) is Professor and Charles H. Kellstadt Chair of Marketing at Loyola University Chicago. His scholarly focus is responsible marketing, policy, development and community well-being in distressed and transforming economies, particularly countries and communities recovering from war and other systemic traumas in Southeast Asia, the Balkans, Latin America and the Middle East. Research projects include peace-marketing initiatives in Afghanistan, Bosnia, Cambodia, Vietnam, Lebanon, Syria, Colombia, Myanmar, Nicaragua, and Iraq; social traps; the global refugee crisis; pandemics and other public health crises; sustainable agribusiness and tourism; food, water and energy in the Mekong River Basin; plastics pollution; externalities of the FIFA World Cup; intellectual property rights; and constructive engagement for win-win socioeconomic development, social justice and sustainable peace. Dr. Shultz has over 250 scholarly publications, including books, articles, chapters and conference proceedings. He served two terms as Editor-in-Chief for the Journal of Macromarketing, as President of the International Society of Marketing and Development, and President of the Macromarketing Society; he currently serves as Associate Editor for the Journal of Public Policy & Marketing and the Journal of Macromarketing, and he serves on several editorial and policy boards. His professional distinctions include two endowed professorships, numerous research grants and fellowships, Fulbright appointments in Vietnam and Croatia, distinguished visiting professorships, best article awards, several commendations for outstanding research, teaching and service, and recognition for extraordinary and sustained contributions to the field of Macromarketing. Dr. Shultz has been invited to lecture, to make research presentations at universities and research institutes, and to counsel governments, NGOs, and businesses on six continents.

Chapter 23

Case Study: Swedish COVID-19 First Wave Response in European Context Ira Haavisto, Tommi Uimonen, Suvi Karvinen, Hlekiwe Kachali, and Riikka-Leena Leskelä

Abstract In this case study, we have described and analyzed the case of Sweden during the COVID-19 pandemic in spring 2020. Our aim was to deepen the understanding of how the Swedish welfare state with its healthcare system responded to the external event of COVID-19. In their response to the COVID-19 pandemic in Spring 2020, Sweden relied on the responsibility of the individual citizens with an intervention strategy of asking the citizens to respond to the pandemic, instead of instructing or forcing the population to react. The sociocultural concept of “folkvett” (translated as the common sense of the people as a collective) was the guiding philosophy (Orlowski and Goldsmith. Journal of the Royal Society of Medicine 113(8):292–298, 2020) of the Swedish strategy. The impact of COVID-19 and the response in Sweden shows a larger number of affected people (as a share of the total population) than in most other European countries. When analyzing the death toll per capita, it seems that Sweden was hit the second hardest out of all European countries. Although it is early to say, and more research needs to be done before definite answers can be given, it seemed that countries that bought time with strict lockdowns managed to “flatten the curve,” which reduced the impact on the healthcare systems. However, to further understand the impact on the wellbeing of the population in Sweden, a long-term study including psychosocial factors could be conducted. Keywords COVID-19 · Sweden · Healthcare · Impact

This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No. 101003606. I. Haavisto (*) Nordic Healthcare Group, Helsinki, Finland Hanken School of Economics, Helsinki, Finland e-mail: ira.haavisto@nhg.fi T. Uimonen · S. Karvinen · H. Kachali · R.-L. Leskelä Nordic Healthcare Group, Helsinki, Finland e-mail: tommi.uimonen@nhg.fi; suvi.karvinen@nhg.fi; hlekiwe.kachali@hanken.fi; riikka-leena.leskela@nhg.fi © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_23

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Sweden in COVID-19

In modern history, Sweden has not needed to respond to external events and crises very often. In this chapter, we describe and analyze Sweden’s response to the first wave of the COVID-19 pandemic in spring 2020. We focus on the response in the Swedish health care sector and reflect over the COVID-19 impact on the Swedish society at large using the framework adapted from Shultz and Peterson (2019) and Shultz et al. (2017). Sweden is often viewed as a stable country well prepared for crises of any kind. The crisis management and preparedness “philosophy” in Sweden has, since the cold war times, moved from a centralized responsibility of the society to a more individualistic or household view, where the societal responsibility has been decreased and the individual citizens responsibility to “civil preparedness” increased (Larsson, 2020). Individuals have, for example, been encouraged to improve their own mental and material preparedness for crisis situations as the public authorities have decreased the centralized resources available for this purpose. To encourage households and individuals to take on the responsibility of preparing for external events and crises the Swedish Civil Contingency agency (MSB, 2018) has distributed a pamphlet to all Swedish households in 2017 named “If Crisis or War Comes.” In their response to the COVID-19 pandemic, Sweden opted to rely on the crisis awareness of individuals with a strategy of cooperation between the state’s response and people’s individual responsibility to slow the spread of the COVID-19 epidemic. The strategy was deemed as a very “Swedish” strategy (Orlowski & Goldsmith, 2020) with the sociocultural concept of “folkvett” (translated as the common sense of the people as a collective) as a guiding philosophy. Given the nature of the consensus-driven Swedish society, the decision-makers wanted the response strategy and policy to be read as a cooperation between the citizens and the state instead of a hierarchical relationship with dictated instructions. Although the Swedish head epidemiologist Anders Tegnell never stated it out loud, with the “softer” COVID-19 interventions, it seemed as Sweden was opting for herd immunity, at least for the younger population, while trying to secure the health of the individuals at risk. The goal of the approach was to bridge the pre- and post-vaccine (or no vaccine) periods while still having a functional and functioning society (Orlowski & Goldsmith, 2020), retaining the wellbeing of the citizens. The public discussion in Sweden has therefore focused on the overall goal or the objectives which are seen to lead to wellbeing, such as providing an opportunity for physical activity and maintaining important social functions (Kavaliunas et al., 2020). Wellbeing is a key concept of the Swedish welfare state. Although there is an ongoing debate whether the Swedish welfare state has actually declined or even failed, Sweden can be seen at least in comparison to most states, to have an extensive welfare system that has been developed to care for and protect the population (Petridou, 2020). This welfare system includes a healthcare system with the primary purpose to promote, restore and maintain the health of the Swedish population. In Sweden, the

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Fig. 23.1 Response and features of COVID-19 impact [modified from Shultz and Peterson (2019)]

healthcare system is set up so that universal health coverage provides financial protection against overwhelming personal healthcare costs and promotes equal access to care and improved life expectancy. The Swedish healthcare services are mainly financed through government grants, various forms of stimulus funds and by the regions and municipalities through the tax income they have at their disposal. The governance of this system is organized in three layers: national government, regional councils, and municipal governments. Twenty-one regional councils are responsible for organizing healthcare for their residents and 290 municipalities are in charge of providing elderly care, care for those with physical or psychological disabilities and supportive care, such as home health services. In this [case] study we build an understanding of how the Swedish welfare state with its healthcare system responded to the external event, the COVID-19 pandemic, and reflect over the impact of the event on the Swedish community. We consider both the intrinsic resilience and vulnerability of the system and the community as well as decisions and actions by the Swedish government and individual citizens in responding to the crisis (Fig. 23.1). As a result of an external event, such as COVID19, communities can be seen to transition either to a more distressed or a flourishing state. Although COVID-19 is still ongoing at the time of writing we make a very preliminary analysis of the impact of the first wave of the event on Swedish society. We first introduce the COVID-19 crisis in Sweden by going through the event and the impact of the event in numbers. We review the Swedish COVID-19 response, and as a synthesis, we describe how the different phenomena within the COVID-19 response might have or could shift the Swedish community toward a flourishing state or toward distress. This case study is based on combining publicly available data from various sources and news items. COVID-19 response data was extracted from The Blavatnik School of Government (OXFORD COVID-19 Government Response Tracker, 2020).

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Fig. 23.2 COVID-19 daily diagnosed and daily deaths in Sweden (Ourworldindata, 2020)

23.1.1 COVID-19 Outbreak in Sweden The COVID-19 outbreak in Sweden began during Spring 2020 with the first officially diagnosed case in March 2020. The number of diagnosed cases per day increased from practically zero at the beginning of March to roughly 400 at the end of March and to 600 per day at the end of April as portrayed in Fig. 23.2 [data extracted from Ourworldindata (2020)]. However, the number of daily diagnosed cases can be assumed to have increased both because of the increase in the actual number of infections and the increased coverage of testing. Due to the bias caused by the increase in the testing coverage, the daily number of COVID-19 deaths has often been assumed a better proxy for the spread of the virus and the serological surveys have supported this assumption (Mieskolainen et al., 2020). When assessing the spread of the virus with the number of deaths, the lag of a couple of weeks from infection to deaths should be taken into account. Deaths actually peaked during mid-April which indicates that the peak of infections was around the turn of MarchApril. Compared to Europe as a whole, the spread of COVID-19 began later in Sweden measured both with diagnosed infections and deaths (Fig. 23.3).

23.2

The COVID-19 Response in General

The response of governments to the COVID-19 crisis has been divided into three different components for the purposes of this article: (1) prevent, (2) test, trace, isolate, and (3) treat (Fig. 23.4). Prevention refers to government interventions to slow down the spread of the virus. The aim of the test, trace, isolate strategy is to quickly identify the infected and potentially infected people and prevent them from infecting others. Finally, those who have been infected and suffer from severe symptoms need to be treated by the healthcare system in hospitals. The preventive interventions to slow down the spread proved to be the most important factor in moderating the health outcomes (the number of infections and deaths) (HERoS, 2020). During the first wave of COVID-19 in Europe in spring

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Fig. 23.3 COVID-19 daily diagnose and daily deaths/1M inhabitants in Sweden and Europe (Ourworldindata, 2020)

Fig. 23.4 COVID-19 interventions

2020, the interventions were often implemented on a national level, which makes an evaluation on a national level feasible. The interventions to stop the rapid increase in the rate of infections were often referred to as lockdown, as freedom of movement was often greatly reduced. The patients infected with COVID-19 utilize in general two separate lines of healthcare services: Firstly, the diagnostics to identify the infection and secondly the hospital care to support the healing process. The diagnostics to identify the infected, often referred to as testing, did not have self-evident value when the first wave of COVID-19 started to spread in spring 2020. It is true that testing does not cure or help infected patients. However, during the pandemic, testing has proved as a valuable response for several reasons. Firstly, identifying the individuals and communities with infections makes it possible to slow down the spread by targeted quarantines instead of full-scale lockdowns. Secondly, comprehensive testing is required to create and maintain national and global situational awareness required for strategic decision-making. Thirdly, early diagnostics may help with patient-level treatment decisions. The intensive care unit (ICU) capacity provided in the hospitals was the most critical capacity required in the treatment of the COVID-19 patients in hospitals. In addition to ICUs, COVID-19 patients also utilize general ward care capacity. Most often, the intensive care capacity has proven to be the bottleneck in the hospital care required by the COVID-19 patients. Thus, at the core of the “treat” part of the COVID response strategy was to manage the ICU capacity. This can be done in three ways: (1) cutting down other activities that require ICU capacity (e.g.,

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complicated surgical operation), (2) increasing ICU capacity (ICU equipment and personnel), and (3) sharing capacity across regions or even countries, if the pandemic is unevenly spread geographically.

23.3

The Swedish Response

While the Swedish response followed the example of other countries in which the epidemic had started earlier, there are some significant differences in the measures taken.

23.3.1 The “Swedish Lockdown” In the spring of 2020, the Swedish government, like all governments in European countries affected by the COVID-19 pandemic, responded with social distancing measures. It issued an ordinance on a prohibition against holding public events of over 500 participants (13.3.2020) and advised against non-essential travel to all countries on 14.3.2020. Furthermore, public events or gatherings of over 50 people and visitations in nursing homes were banned in late March. Upper secondary schools and universities transferred to online teaching, and people who could work remotely were advised to do so. Cafés and restaurants had to reduce their capacity. The main difference between Sweden and other similar countries was that daycare, elementary schools and middle schools remained open, restaurants and cafés were allowed to remain open, although with reduced capacity, and gyms and swimming pools remained open. Unlike in many other countries, there was no recommendation issued to wear a mask in public places in Sweden. The public authorities in fact discouraged people from wearing masks, both due to lack of evidence at the time for the benefit of the mask, and since there was fear of not having enough masks for healthcare workers. Also, Sweden differed from most countries in that most measures were expressed as recommendations, not mandatory requirements, following the preparedness strategy of individual responsibility and the Swedish law. Figure 23.5 demonstrates how the development of the Oxford stringency index (OxCGRT, 2020), describing the stringency of the COVID-19 interventions, in Sweden remained below the average index in other European countries in the spring and early summer of 2020. Indicating less stringent lockdown measures in Sweden. For example, on March 30th the stringency index in Sweden was 35, whereas France and Italy that implemented large-scale lockdowns had significantly higher stringency indices: 88 and 92, respectively. Also, the trend in the stringency index in Sweden differed from most of the European countries: the stringency index did not decrease in Sweden during the spring toward the summer, when virtually in all other countries some of the

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Fig. 23.5 Stringency of COVID-19 interventions in Sweden and Europe

lockdown measures were lifted. As a result, the stringency indices in Sweden and Europe as a whole approached each other at the end of June 2020. It would be over-simplifying to suggest that Sweden did not react to the emerging COVID-pandemic when, in fact, it did, but it was done with rhetoric distinguishably different from other EU countries. The official Swedish response was to appeal to the residents by asking and advising them to avoid risky situations while simultaneously carrying ahead with everyday life.

23.3.2 To Test or Not to Test? Alongside lockdown measures, the countries affected by the COVID-19 crisis started to ramp up their test, trace, isolate -strategy in order to reduce the stringency of lockdown measures while still keeping the spread of the virus at bay. The critical first step in implementing the strategy was ramping up an adequate testing capacity, both in sampling and the analysis of samples. There is no single figure available for evaluating the COVID-19 testing strategies holistically. For our purposes, we used three different figures to assess the testing. Number of tests per capita tells us practically how wide the scope of testing was, as there are always people experiencing similar symptoms from seasonal cold or flu. Tests per positive COVID-19 case tells us more about the relation between the number of infected versus the number of tests since a significant portion of infections might remain undiagnosed. The third figure we used was the number of deaths to give perspective in the overall COVID-19 situation of the country. As our aim is to evaluate the first responses, we have timed our observations not based on calendar days but based on the first reported COVID-19 death in order to set an equal starting point in comparison between countries. Sweden was quick to start testing: the first tests were taken 12 days before the first COVID-19 death was reported (see Fig. 23.6). In the beginning, Sweden had a policy to test individuals with symptoms coming from known risk areas abroad and

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Fig. 23.6 COVID-19 testing policy in Sweden, UK, Finland, and the Czech Republic

trace their contacts until March 12th, when the focus already shifted to individuals in need of in-patient hospital care1 with less effort on tracing. The absolute testing volumes increased steadily during the observed period in Sweden and reached 4.3 tests per 10,000 people per day after 60 days since the first death caused by COVID-19. Tests per positive case remained under 10 at the end of the 60-day period since the first death. The situations differ significantly within the European countries (Fig. 23.6). The UK first adopted a strategy somewhat like Sweden where the scope of testing was not extended to the whole population until around 50 days after the first death. The number of tests per capita was on a similar level in countries with significantly less deaths as it was in Sweden, but the ramping up was faster, e.g., in Finland and the Czech Republic. It would seem that Sweden did not rush ramping up the testing capacity and broadening the scope of the test, trace, isolate -strategy even though the infection was quite widespread.

23.4

Impact of COVID-19 First Wave in Sweden

23.4.1 Impact on the Healthcare System In order to evaluate the relative strain of the COVID-19 on intensive care, capacity utilization by the COVID-19 patients was compared to the normal-state ICU total capacity on a national level year on year. As a result of the high number of infected people, Sweden was one of the countries with the highest ICU capacity utilization rates during spring 2020. Figure 23.7 shows the ICU utilization rate in 20 European countries.2 Of the 20 countries, 8 were able to keep the maximum utilization rate under 20% of the total capacity, five countries under 50%, and seven countries required more than 50% of their normal-state capacity for the COVID-19 patients (the bold curve is showing the average). Sweden is positioned within the countries with the highest peak utilization rates. 1

Folkhälsomyndigheten: Estimates of the peak-day and the number of infected individuals during the COVID-19 outbreak in the Stockholm region, Sweden February—April 2020. 2 Spain excluded from the analyses as there were discontinuities and uncertainties about the comparability with other countries.

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Fig. 23.7 ICU utilization rate in 20 European countries during COVID-19 Fig. 23.8 COVID-19 ICU utilization and normal state in Sweden from March 1, 2020

Within the countries with peak utilization rate over 50%, Sweden peaks secondhighest behind the Netherlands. Sweden differs from the other countries in two distinctive ways: The peak utilization occurs later and the utilization close to the peak seems longer than with the other countries in this category (Fig. 23.8). Four out of the seven countries (The Netherlands, France, Belgium, and Portugal) all reach their peak utilization levels on April 7th or 8th. Italy reaches its peak level roughly a few days earlier on April 3rd whereas the UK reaches its peak roughly 1 week later on April 15th. Sweden reaches its peak utilization still 10 days later on April 25th. After the moment of peak utilization, the strain on ICU by COVID-19 patients decreases significantly in most countries. By the end of April, countries other than the UK and Sweden had reached a decrease between 37 and 58% since the peak utilization. The UK shows a steady but slow (12% by the end of April since the peak) decrease and the decrease in Sweden barely begins by the end of April with a 6% decrease since the peak. The ICU utilization in Sweden finally started to decrease after April but remained on a significantly higher level still at the end of June compared to other countries.

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It seems that the strategy adopted by Sweden including the decisions regarding the interventions and testing did not result in distinctively higher ICU utilization rates compared with other countries; several countries had high utilization rates, and the Netherlands had an even higher rate. What distinguishes Sweden the most from its peers is the late timing and especially the length of the peak. The above analyses do not take into account that many countries, including Sweden, ramped up temporary extra ICU capacity. Sweden managed to increase both its regular ward and ICU capacity, as did many other countries. As a result, there seems to have been an ICU bed for every patient requiring and benefiting from one. To conclude, the ICU capacity demand rose and stayed at significantly high levels but Sweden’s response of increasing the capacity seems to have worked from the perspective of adequacy of the ICU supply in contrast to some of the other European countries.

23.4.2 COVID-19 Immediate Economic Impact Sweden has relied on voluntary social distancing guidelines since the start of the pandemic, including working from home where possible and avoiding public transport. Although businesses have largely continued to operate in Sweden, the country’s economy is highly dependent on exports, which have been hit by a lack of demand from abroad (BBC News, 8/2020). Sweden and the other Nordic countries are among those judged to have the lowest economic risk from COVID-19. In general, economies where a smaller percentage of activity is within sectors that require physical interaction are affected less by COVID-19 and the requirement for social distancing. Some of the most affected sectors in Sweden, such as hotels and restaurants, in which physical interaction is key to service delivery, account for a relatively small percentage of the jobs (Dingel & Neiman, 2020). It is for example estimated that 44% of the jobs in Sweden were possible to do from home (Noy et al., 2020). Doerr and Gambacorta (2020), who have looked at the effects of the pandemic on employment in different regions in Europe, also find a reason to believe that Sweden is among those who are not hit hardest. However, the Swedish economy may be considered more dependent on international trade than many other countries’ economies, both with regards to exports in relation to GDP and participation in global value chains. As international trade has been affected by the COVID-19 crisis, disruptions to global value chains and protectionism can make the Swedish economy vulnerable (Baldwin & Tomiura, 2020; Georgiadis & Gräb, 2016). “It is, as expected, a dramatic downturn. But compared to other countries, it is considerably better, for instance if you compare to southern Europe,” said Nordea bank chief analyst Torbjorn Isaksson for BBC News (8/2020). Swedish GDP growth tends to follow that of other countries, but with slightly larger fluctuations. Particularly in times of deep crisis, GDP can fall more in Sweden than in its most important trading partners (Korhonen & Granberg, 2020).

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Fig. 23.9 Development of GDP volume and impact of demand items on the change in GDP (Statistics Sweden, 2021)

Investments have, however, recovered from the COVID-19 crisis fairly rapidly in Sweden (Fig. 23.9). The impact of net exports on GDP was negative on Sweden. The drop in the volume and sub-items of GDP caused by the COVID-19 crisis was somewhat more pronounced in Sweden than in for example Finland at the early stages of the crisis. It remains to be assessed how significant an impact the different strategies to combat the virus have had on the real economy.

23.5

Discussion

In this case study, we have described and analyzed the case of Sweden during the COVID-19 pandemic in spring 2020. Our aim was to deepen the understanding of how the Swedish welfare state with its healthcare system responded to the external event of COVID-19. The population has to some extent question the strategy Sweden chose, as can be identified in the Swedish media in autumn 2020, since the strategy lead to lost lives. Can this, now subtle questioning lead to larger distress in the society, caused by an “identity crises” for how resilient the Swedish community actually is? Or will the Swedish strategy of not forcing stringent social distancing measures help with the eventual exit from the COVID-19 pandemic and return to normal? In their response to the COVID-19 pandemic in Spring 2020, Sweden relied on the responsibility of the individual citizens with an intervention strategy of asking

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the citizens to respond to the pandemic, instead of instructing or forcing the population to react. The sociocultural concept of “folkvett” (translated as the common sense of the people as a collective) was the guiding philosophy (Orlowski & Goldsmith, 2020) of the Swedish strategy. The impact of COVID-19 and the response in Sweden shows a larger number of affected people (as a share of the total population) than in the rest of Europe. When analyzing the death toll per capita, it seems that Sweden was hit the second hardest out of all European countries (after the Netherlands), which could be understood as leading toward a more distressed than flourishing society. However, Anders Tegnell, the Swedish state epidemiologist claimed that although Sweden’s response strategy might have seemed different than the other European counties who adopted a more stringent response, but that the impact in the long run in these countries would be similar to Sweden. He also argued that particularly when analyzing also the wellbeing of the population and the economy, Sweden will not have performed badly (Tegnell Interviewed in New Statesman, 2020). At the time of writing, the pandemic is still ongoing. Thus, it is difficult to yet portray the long-term impact of COVID-19 both on the Swedish healthcare system and on society as a whole. When considering the case of Sweden’s response in terms of intrinsic resilience and vulnerability of the system, we can identify that the Swedish society has previously been resilient and that the society has been fairly well prepared for the impact of external events. However, during Spring 2020, the Swedish community experienced an external event that was unprecedented in the country’s history—and globally for that matter. It seems that the objectives for the Swedish response were not met at least when looking at the health impact. Still, at the end of 2020, Swedish society seems to have been hit hard compared to many European countries, when studying the actual health impact of COVID-19. The Swedish society does not seem to have done any better than the other European countries in terms of economic impact either. Some of the decisions made in the spring were based on assumptions that turned out not to hold, for example, it seems most experts were in the understanding that the COVID-19 impact would not be very long term. Firstly, the second wave hit Sweden as hard— or even harder—than many other European countries indicating that herd immunity had not formed despite the high numbers of infected people during the first wave. Secondly, keeping the society more “open” did not help in softening the economy. Also, the number of nurses who have resigned their jobs from hospitals in the Stockholm region is four times higher than normal (SVT, 2020) indicating that at least for the healthcare system the transition has been toward distressed rather than flourishing. Whether this distress will remain in the society with a long-term impact, and whether the distress experiences by healthcare workers, reflects the community as a whole, cannot, as of yet, be determined. Although it is early to say, and more research needs to be done before definite answers can be given, it seemed that countries that bought time with strict lockdowns have been content with the decision. At least they (e.g., the other Nordic countries) managed to “flatten the curve,” which reduced the burden on the healthcare systems. Also, as professionals globally learned more about the COVID-19, they learned to

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treat the patients’ symptoms better improving the prognosis of hospitalized patients. Strict visitation restrictions and resourcing practices aimed at avoiding spreading the disease in elderly care services were also an important measure in reducing mortality, since the mortality of COVID-19 is high among the old and frail. With a total lockdown of the society, and social distancing measures being implemented among all population groups, it is much easier to protect the risk groups as well. Even Tegnell has admitted that Sweden failed in protecting the elderly population. However, understanding the impact of COVID-19 on Swedish society, one would need to not only understand the impact on the healthcare system, individual citizens health, public health and economic impact as in this chapter but also analyze the impact on wellbeing. Researchers have, as of yet not, analyzed COVID-19 impact on wellbeing, but a previous study did detect that the possible psychological impacts of COVID-19 in Sweden are no worse, and no better, than impacts shown in other countries, such as, in Italy or China (McCracken et al., 2020). To further understand the COVID-19 impact on the wellbeing of the population in Sweden, a long-term study including psychosocial factors could be conducted.

References Baldwin, R., & Tomiura, E. (2020). Thinking ahead about the trade impact of COVID-19. In Economics in the time of COVID-19 (p. 59). CEPR Press. BBC News. (2020). Analysis by maddy savage, coronavirus: Sweden’s economy hit less hard by pandemic. BBC News. Retrieved October 2020. Dingel, J. I., & Neiman, B. (2020). How many jobs can be done at home? Journal of Public Economics, 189, 104235. Doerr, S., & Gambacorta, L. (2020). Covid-19 and regional employment in Europe (No. 16). Bank for International Settlements. Folkhälsomyndigheten. (2020, February–April). Estimates of the peak-day and the number of infected individuals during the covid-19 outbreak in the Stockholm region, Sweden. Georgiadis, G., & Gräb, J. (2016). Growth, real exchange rates and trade protectionism since the financial crisis. Review of International Economics, 24(5), 1050–1080. Hale, T., Webster, S., Petherick, A., Phillips, T., & Kira, B. (2020). Oxford COVID-19 government response tracker, blavatnik school of government. Retrieved 12, 2020, from https://data. humdata.org/dataset/oxford-covid-19-government-response-tracker HERoS Deliverable. (2020). D2.2—“Healthcare system analysis”. https://www.heros-project.eu/ wp-content/uploads/HERoS-D2.2-Healthcare-system-analysis.pdf Kavaliunas, A., Ocaya, P., Mumper, J., Lindfeldt, I., & Kyhlstedt, M. (2020). Swedish policy analysis for Covid-19. Health Policy and Technology. Korhonen, J., & Granberg, B. (2020). Sweden backcasting, now? Strategic planning for covid-19 mitigation in a liberal democracy. Sustainability, 12(10), 4138. Larsson, O. L. (2020). The connections between crisis and war preparedness in Sweden. Security Dialogue, 52(4), 306–324. https://doi.org/10.1177/0967010620936849 McCracken, L. M., Badinlou, F., Buhrman, M., & Brocki, K. C. (2020). Psychological impact of COVID-19 in the Swedish population: Depression, anxiety, and insomnia and their associations to risk and vulnerability factors. European Psychiatry, 63(1), e81.

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Mieskolainen, M., Bainbridge, R., Buchmueller, O., Lyons, L., & Wardle, N. (2020). Statistical techniques to estimate the SARS-CoV-2 infection fatality rate. medRxiv. https://doi.org/10. 1101/2020.11.19.20235036 Noy, I., Doan, N., Ferrarini, B., & Park, D. (2020). Measuring the economic risk of COVID-19. Global Policy, 11(4), 413–423. Orlowski, E. J., & Goldsmith, D. J. (2020). Four months into the COVID-19 pandemic, Sweden’s prized herd immunity is nowhere in sight. Journal of the Royal Society of Medicine, 113(8), 292–298. Petridou, E. (2020). Politics and administration in times of crisis: Explaining the Swedish response to the COVID-19 crisis. European Policy Analysis, 6(2), 147–158. Shultz, C. J., & Peterson, M. (2019). A Macromarketing view of sustainable development in Vietnam. Environmental management, 63(4), 507–519. Shultz, C. J., Rahtz, D. R., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In Handbook of community well-being research (pp. 403–421). Springer. Statistical Database Sweden. (2021). Retrieved January 2021, from https://www.statistikdatabasen. scb.se/pxweb/en/ssd/ SVT-Sveriges Television. (2020). https://www.svt.se/nyheter/inrikes/har-har-34-av-50-skoterskorsagt-upp-sig. Tegnell Interviewed in New Statesman. (2020, October 19). (newstatesman.com). The MSB. (2018). If crisis or war comes. Retrieved 11, 2020, from https://www.dinsakerhet.se/ siteassets/dinsakerhet.se/broschyren-om-krisen-eller-kriget-kommer/om-krisen-eller-krigetkommer%2D%2D-engelska-2.pdf The Oxford COVID-19 Government Response Tracker (OxCGRT). (2020). Retrieved from https:// ourworldindata.org/coronavirus

Ira Haavisto (Ph.D) has worked in international research projects within humanitarian supply chain management and healthcare for the last 10 years, the last 4 years at Nordic Healthcare Group as a Senior research manager. She has previously led The Humanitarian Logistics and Supply Chain Research Institute (HUMLOG Institute) at Hanken School of Economics. She has several peerreviewed publications on performance management and innovations in non-profit organizations. Tommi Uimonen works as a Senior Manager in a health and social care consulting company Nordic Healthcare Group in Helsinki, Finland. With an educational background originally in economics, Tommi has worked on projects for both public and private health care organizations including multiple research projects focusing on Nordic health care systems. Suvi Karvinen is a consultant with a focus on healthcare and outcomes research. She works a consultant in the management consulting industry with a focus on research, scientific writing and value-based health care with subject matter experience in oncology and cancer research. She has experience ranging from clinical nursing to startups, research and business development within the healthcare industry. She holds a MSc in Biomedicine from the Karolinska Institute. Hlekiwe Kachali is a practitioner and researcher in the system dynamics of disaster resilience and recovery and humanitarian logistics. Hlekiwe’s interests in system dynamics, disaster recovery and resilience led to her undertaking Ph.D. work on the key elements of disaster recovery and resilience after the Christchurch earthquakes. Hlekiwe now works in the areas of emergency management, disaster risk reduction, humanitarian logistics, emergency telecommunications, global flows, conflict dynamics and information management in emergencies. Hlekiwe also has a Bachelor of Engineering (BEng) in Computer Engineering from Finland and a Master of Engineering (MEng) in Systems Engineering from Australia, and has extensive experience in the telecommunications industry.

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Riikka-Leena Leskelä is Research Director at Nordic Healthcare Group, an advisory company specializing in social and healthcare research and development in Finland. Her research is mainly in the fields of health economics and healthcare operations management. She is particularly interested in studying healthcare systems and how to implement value-based healthcare on a system level.

Chapter 24

Thailand and COVID-19 Pandemic: Lessons Learned, Challenges, and the Silver Linings Busaya Virakul, Chartchai Na Chiangmai, and Kalayanee Senasu

Abstract China declared the first case of COVID-19 in Wuhan on December 31, 2019. On January 8, 2020, Thailand was the first country outside China to detect a case of novel coronavirus infection. The country declared a state of emergency and implemented lockdown policies on March 26, 2020, after a spike of COVID-19 cases was reported. From March 26 to the end of June, Thailand implemented several measures to prevent the spread of COVID-19 and the first wave of the outbreak ended in early July 2020. Since then, the Thai government has declared plans to soften the strict lockdown in order to expedite economic recovery, especially in tourism and related industries. In September 2020, Thailand was ranked as the number one country in Asia and second among 184 countries worldwide for its success in responding to the COVID-19 pandemic. It is also one of seven countries listed by World Health Organization (WHO) as a model for other countries in fighting future pandemics. This chapter therefore shares Thailand’s experience with the pandemic from December 2019 to September 2020 in terms of COVID19 management, lessons learned from the experience, and the silver linings that can be expected. The chapter also discusses future challenges that will need to be overcome. Keywords SARS-CoV-2 · COVID-19 · Pandemic · Thailand · Public health management · Lessons learned · Challenges · Silver linings

Abbreviations APEC ASEAN CAAT

Asia Pacific Economic Cooperation Association of Southeast Asian Nations Civil Aviation Authority of Thailand

B. Virakul (*) · C. N. Chiangmai · K. Senasu School of Human Resource Development (HRD), National Institute of Development Administration (NIDA), Bangkok, Thailand e-mail: [email protected]; [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_24

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CCSA CDC CG COVID-19 CSR FETP GCI GHS MOPH MOPH-DDC MOPH-DH MOPH-DHSS MOPH-DMH MOTS NESDC NGO NNT OECD SD SDGs UNDP UNGC USA VHV WHO

24.1

Center for COVID-19 Situation Administration, Thailand Centers for Disease Control, USA Corporate Governance Coronavirus Disease 2019 Corporate Social Responsibility Field Epidemiological Training Program Global COVID-19 Recovery Index Global Health Security Ministry of Public Health, Thailand Ministry of Public Health, Department of Disease Control, Thailand Ministry of Public Health, Department of Health, Thailand Ministry of Public Health, Department of Health Service Support, Thailand Ministry of Public Health, Department of Mental Health, Thailand Ministry of Tourism and Sports, Thailand Office of the National Economic and Social Development Council, Thailand Non-Governmental Organization National News Bureau of Thailand Organization for Economic Co-operation and Development Sustainable Development Sustainable Development Goals United Nations Development Program United Nations Global Compact United States of America Village Health Volunteer (“Bangkok Health Volunteer” if in Bangkok) World Health Organization

Introduction

This chapter describes Thailand’s experience with COVID-19 pandemic between 31 December 2019, when the first case of COVID-19 was reported in China, through to September 1, 2020, after the first wave of the pandemic in Thailand had ended. The handling of the pandemic in Thailand during the first wave of outbreak (January–July, 2020) is a success story. Thailand was able to control the outbreak and was listed by World Health Organization (WHO) as one of seven countries whose management of the pandemic should be a lesson for international communities. The chapter is organized into five sections: (1) A timeline of COVID-19 pandemic in Thailand; (2) Key measures implemented for controlling COVID-19

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outbreak in Thailand; (3) Factors contributing to Thailand’s success in controlling the pandemic; (4) Lessons learned, challenges, and silver linings of the pandemic; and (5) Conclusion. Data and information were obtained by using two research methods: A literature review and interviews with five key informants. Selection of key informants was based on their expertise and involvement in Thailand’s COVID19 management at the national level. Four of the interviews were conducted face-toface and one was conducted online. The period of each interview varied from one to three hours. Details of key informants and highlights of their interviews are presented in Appendices 1–6.

24.2

Timeline of COVID-19 Pandemic in Thailand

Thailand is one of the ten member countries in the Association of Southeast Asian Nations (ASEAN, 2020). Approximately 11 million tourists from China visited Thailand in 2019 (MOTS, 2020). At the time, a cluster of pneumonia cases appeared in Wuhan in December 2019, China accounted for the highest number of international tourists visiting Thailand. Aware that Thailand was at high risk for an outbreak of the disease, Thailand’s public health authority and personnel implemented several measures to detect and monitor the spread of virus. The first case of COVID-19 outside China was confirmed in Thailand on January 13, 2020; starting in March 2020, Thailand implemented several measures to curb the spread of the virus including declaring a state of emergency and enforcing lockdowns and curfews (see Fig. 24.1). These measures resulted in the first surge of COVID-19 outbreak ending in July 2020. Following is a more detailed timeline of the outbreak of COVID-19 in Thailand (see also WHO, 2020a, 2020b, 2020c, 2020d, 2020e; MOPH, 2020; MOPH-DDC, 2020a; Hinjoy et al., 2020; Patcharanaruamol et al., 2020; Wacharapluesadee et al., 2020). • December 31, 2019—China reported a cluster of pneumonia cases in Wuhan, and a novel coronavirus was publicly identified as the source (WHO, 2020a). Thailand’s public health scientists and infectious-disease specialists were alerted to the outbreak by China. • January 3, 2020—Measures for screening international tourists from Wuhan arriving at Thailand’s four international airports were implemented and surveillance at public and private hospitals was increased. • January 4–8, 2020—Specimens were collected from five quarantined individuals from Wuhan who exhibited fever or signs of respiratory symptoms and the specimens were sent to laboratories for diagnostic testing. • January 8, 2019—Scientists in Thailand were able to identify that the tested specimens contained the SARS-like coronavirus. The virus was identified by family-wide PCR (polymerase chain reaction) method and subsequently confirmed by whole-genome sequencing.

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Fig. 24.1 Timeline of first COVID-19 case in Thailand and outside China. Note: Sources of Fig. 24.1 are: Hinjoy et al. (2020), MOPH (Ministry of Public Health, Thailand) (2020), Wacharapluesadee et al. (2020), and World Health Organization (WHO) (2020a, 2020b)

• January 12, 2020—China publicly shared the genetic sequence of COVID-19. • January 13, 2020—Thailand’s Ministry of Public Health (MOPH) confirmed that the genetic sequence of SARS-like coronavirus detected from the tested specimens was identical to those of China’s COVID-19. This was the first case of COVID-19 detected in Thailand and also the first COVID-19 case outside China. • March 1, 2020—COVID-19 was officially declared a dangerous communicable disease due to the increasing number of local transmissions. Capacity for quarantining was increased in response to the expected influx of Thais returning from countries abroad. • March 12, 2020—“Center for COVID-19 Situation Administration” (CCSA) was established 1 day after WHO declared COVID-19 as a pandemic in order to serve as the nation’s special task force to manage the situation. • March 26, 2020—Thailand declared a state of emergency to control further spread of the virus after the number of COVID-19 cases grew rapidly. People were requested not to travel to other provinces. All international and domestic flights were banned. All department stores (except for stores selling food and essential items), movies and theaters, and business places having mass gathering of people (e.g., fitness centers, barbershops, markets, bars, restaurants, boxing stadiums, hotels, educational institutes, public parks, etc.) were required to close. • April 3, 2020—A curfew between 10.00 pm and 4.00 am was imposed nationwide because some groups of people violated social distancing measures. Exemptions were given to medical and banking personnel, logistics workers handling consumer products and necessary supplies, and those who normally work night shifts. • May 4, 2020—The first time that there were no reports of new local infections.

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• June 16, 2020—The Cabinet endorsed three economic measures to revive ailing tourism industry. • June 29, 2020—The Emergency Decree was extended to July 31. • July 1, 2020—Schools were allowed to re-open and restrictions were removed from domestic air travel. High-risk entertainment venues such as pubs, bars, and massage parlors were allowed to re-open with some restrictions being maintained. Visits by foreign individuals were allowed on a controlled basis. • July 8, 2020—First wave of COVID-19 outbreak ended. • August 3, 2020—The restrictions to international travel, imposed since April 4, 2020, were lessened and all inbound travelers, both international individuals and Thai-citizen returnees from abroad, were required to be quarantined for 14 days with enforcement of laboratory protocols (CAAT, 2020). From December 31, 2019, to August 31, 2020, a total number of 845,781 laboratory tests were carried out in Thailand. At the end of August, there were 3412 confirmed COVID-19 cases; 3274 recovered and discharged from hospitals; 80 undergoing treatment; and 58 deaths. Globally, as of 31 August 2020, there were a total of 25,406,582 confirmed cases with 850,877 COVID-19 deaths across more than 213 countries (MOPH-DDC, 2020b).

24.3

Key Measures Implemented for Controlling COVID-19 Outbreak in Thailand

Many measures were immediately implemented in Thailand when China reported pneumonia cases in Wuhan, in December 2019. In handling COVID-19, Thailand implemented measures that can be classified into five categories: (a) Managing emergency crises in public health; (b) Preventing and controlling the spread of disease; (c) Diagnosing, treating, and developing vaccines; (d) Promoting health policies for disease control; and (e) Restoring wellbeing of pandemic-affected people and citizen participation (see COVID-19 control in CDC-Division of Global Health Protection, Global Health, 2020; Limsawart et al., 2020; MOPH, 2020; Patcharanaruamol et al., 2020).

24.3.1 Managing Emergency Crises in Public Health Emergency Operations Center—EOC, Situation Awareness Team (SAT), and Incidence Command System were created by MOPH to monitor the global pandemic and respond to the COVID-19 situation in a timely manner. The teams worked in a “24/7” approach. When the number of COVID-19 confirmed cases reached 70 on March 12, 2020, the “Center for COVID-19 Situation Administration (CCSA)” was established by the Thai Prime Minister to unite all involved government units in

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controlling COVID-19 at the national level. The center was headed by the Prime Minister and the committee included: Ministers of all ministries; Minister of Office of the Prime Minister; Secretary-General of the National Security Council; and Director-General of the National Police Bureau (Limsawart et al., 2020, p. 62; MOPH, 2020, p. 56). Medical and nonmedical experts were invited to join CCSA as consultants to provide sound advice in managing and controlling the outbreak. At the ministerial level, the Ministry of Public Health created “Team Thailand” to create measures to be implemented nationwide. The Team consists of medical doctors who are heads of medical schools, institutes, and associations whose work and responsibility were significantly related to public health. The Team provided several measures for preventing or minimizing the spread of COVID-19. Some of the measures are: (a) “Stay Home—Stop Virus—Help Nation” Campaign which focused on encouraging Thais to stay home and avoid travel activities; (b) “Social Distancing, Wearing face Masks, and Handwashing” Campaign to prevent personto-person viral transmission; (c) Restricting social gatherings; (d) Stopping interprovincial travel by giving authority to make decisions and enforce this measure to provincial governors and public health officials; (e) Monitoring “fake news” or misleading information on social media, which caused the public to become confused; and (f) Having all MOPH’s hospitals in the country step up their preparations (e.g., personnel, facilities; medicines) for treating patients, especially those at high risk of infection or serious illness. All measures, suggestions, decrees, and COVID19 statistics (both nationally and internationally) were communicated to the public on a daily basis through nationwide television, online surveys, and websites, as seen for example in Fig. 24.2.

24.3.2 Preventing and Controlling Local Spread of the Disease “On arrival screening” commenced at international airports on January 3, 2020, to detect COVID-19 infection in people entering the country. The screening enabled Thai authorities to detect the first case of COVID-19 outside China. In addition, screening was carried out at all entry ports with neighboring countries. Screening and testing were also carried out among people with high risk of COVID-19 infection, such as people who worked in the tourism industry. In addition, “Work from Home” was encouraged and places of mass gatherings—such as schools, military units, cinemas, sports stadia, and massage parlors—were closed to decrease the spread of the disease. From March 26 to July 1, 2020, a state of emergency was declared throughout the country, a curfew from 10.00 p.m. to 4.00 a.m. was enforced, all air and land borders were closed and movement of people between provinces was restricted. Thailand’s Prime Minister went on television to declare the state of emergency and informed the public that the lockdown and curfew were necessary. He said that he had accepted

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Fig. 24.2 English infographics on MOPH-DDC’s website in March 2020. Note: Source of Fig. 24.2 is MOPH-DDC (Ministry of Public Health, Department of Disease Control, Thailand) (2020c)

the advice of medical specialists and agreed that during the pandemic situation, social benefits and safety should come before personal freedom of individuals (Limsawart et al., 2020, p. 94). “Isolation and Quarantine” is another important health measure for controlling local spread. Three types of quarantine were applied regardless of nationality: (a) 14 day home quarantine for low-risk contact cases with daily reporting to healthcare workers; (b) local quarantine managed by the MOPH for all international travelers arriving through land and sea border crossings irrespective of clinical symptoms; and (c) state quarantine, sponsored and managed by the Ministry of Defense, for international flight arrivals irrespective of clinical symptoms. State quarantine also lasts 14 days and is vital in preventing the spread of the virus from hundreds of thousands of Thais who needed to come back home because of the pandemic. Individuals who test negative for COVID-19 after 14-days of quarantine are given a medical certificate and released from quarantine (see Fig. 24.3). In addition to the measures mentioned above, there were other measures implemented for preventing the spread of COVID-19 in Thailand. Those mentioned are deemed most critical.

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Fig. 24.3 Pathway of 14-day state quarantine for international flight arrivals irrespective of clinical symptoms. Note: Sources of Fig. 24.3 are Limsawart et al. (2020, p. 84), Patcharanaruamol et al. (2020, pp. 13–14), and interview with Key Informant 5 (see Appendix 6)

24.3.3 Diagnosing, Treating, and Developing Vaccines MOPH is responsible for providing drugs and medical equipment for treating COVID-19 patients and for protecting medical personnel who take care of patients. Thailand’s MOPH medical teams collaborated with Japan and China in producing and stockpiling Favipiravir, an antiviral medication, for treating COVID-19 patients. At the beginning of COVID-19 pandemic, medical equipment for protecting medical workers and doctors was in short supply due to the rapid increase of COVID-19 cases. With the help of private citizens and the business sector, the most needed supplies were later provided for hospital use all around the country. Many services— e.g., food, close-to-hospital housing, and support staff visits—were provided free of charge by volunteers throughout the lockdown period (Limsawart et al., 2020, p. 116). Most public hospitals in Thailand adapted and improved their work systems to continue their work for both regular health treatment and for COVID-19 treatment. Led by MOPH, this “New Normal Medical Service” involved medical institutes and professionals. In addition, MOPH supported many hospitals to create new COVID19 treatment units to treat COVID-19 patients in their areas. On March 4, 2020, MOPH through the Department of Health Service Support (MOPH-DHSS) announced that COVID-19 patients would be eligible for free treatment in all private and public hospitals (MOPH-DHSS, 2020a; National News Bureau of Thailand, 2020a, 2020b). This public health policy allows Thailand’s CCSA to keep track of COVID-19 cases and control the spread of the disease, because hospital cost was an important factor influencing peoples’ decisions to report their COVID-19 status. On April 7, 2020, MOPH created COVID-19 strategy “1 Province 1 Laboratory—Whole Country 100” which meant that Thailand would establish one laboratory in each of the 77 provinces and at least 100 laboratories nationwide to detect SARs-COV-2. As of July 8, 2020, 205 COVID-19 laboratories had been established—79 laboratories in Bangkok and 126 laboratories across the country. In total, 749,213 specimens were tested as of August 3, 2020, (MOPH, 2020, pp. 24–26). Commencing in April 2020, Thailand focused on making stocks of

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Favipiravir (antiviral medication) and producing COVID-19 vaccines for its own use so that Thailand would be self-reliant in providing medical treatment to Thai citizens. Throughout the COVID-19 outbreak, medical, financial, and human resources were increased to support the work of front-line doctors, nurses, and workers all over the country (Limsawart et al., 2020, pp. 126–127).

24.3.4 Promoting Health Policies for Disease Prevention “Wearing Face Masks” is a major campaign by CCSA and MOPH aimed at encouraging Thai people to halt the spread of COVID-19 by wearing face masks when leaving their homes and coming into contact with others during regular activities. To address the shortage of face masks, which occurred during the initial stages of the pandemic, the MOPH-DH advised Thai residents how to make their own face masks from cloth (MOPH-DHSS, 2020b; see Fig. 24.4). On March 8, 2020, MOPH-DHSS initiated a “VHV Visit Your Door-Resist COVID-19” campaign employing nearly 1,040,000 village health volunteers (VHV) and 15,000 Bangkok health volunteers to work with local government officials in keeping records and maintaining contact with all 12 million villages in the country regarding the health and COVID-19 status of Thai citizens. The village health volunteer initiative was established in Thailand in 1977 and has always been a

Fig. 24.4 MOPH-DHSS Campaign: “Making your own face masks from cloth”. Note: Source of Fig. 24.4 is MOPH-DHSS (Ministry of Public Health, Department of Health Service Support) (2020b)

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vital factor in controlling Thailand’s major health pandemic threats including COVID-19 (WHO, 2020f). For people to accept and follow “Work-from-Home” and “Stay Home—Stop Virus—Help Nation” campaigns, they needed good food and effective delivery systems. Therefore, MOPH-Department of Health provided guidelines and measures for proper handling of food services during the COVID-19 outbreak (Limsawart et al., 2020, pp. 148–149; National News Bureau of Thailand (NNT), 2020a, 2020b). MOPH-DH (2020) developed the “Thai Stop COVID-19” website (https:// stopcovid.anamai.moph.go.th/) as a source of COVID-19 knowledge and practices in environmental health for common people, small-and-medium businesses, and government officials. The platform contains posters, infographics, video clips, online training, and health evaluation guidelines in the following subjects: (a) Guidelines for attending food court service; (b) Suggestions for environmental health of fresh markets; (c) Suggestions for areas providing street foods services; (d) Suggestions for environmental health of Sunday markets; and (e) Public-health suggestions for construction sites and housing for workers. MOPH-DH, Bangkok Mass Transit Authority (BMTA), and Mass Rapid Transit Authority of Thailand (MRTA) also provided guidelines for proper conduct when using BMTA transportation services. Since March 31, 2020, BMTA and MRTA have maintained strict social distancing and wearing face masks policies while using their services (Limsawart et al., 2020, pp. 152–153). From May 3, 2020, when the number of COVID-19 cases was under control to a certain extent, CCSA prepared a national exit strategy and eased the enforcement of certain measures so that people could enter a “new normal” era. The strategy took into account public health, public administration, and economic factors to guide communities and business owners in continuing their activities without posing a high risk of a second surge of the outbreak. CCSA uses the “Thai Stop COVID-19” platform to provide knowledge, suggestions, and public health guidelines for the following public areas: (a) parks for exercise and sports; (b) fresh markets, Sunday markets, and floating markets; (c) convenience stores, supermarkets, minimarts, grocery stores, retail stores, small wholesale shops; (d) restaurants, pubs, drink shops, shopping carts, stalls; (e) schools, universities. Thailand maintains some key strategic actions to prevent a second COVID-19 outbreak such as state quarantine, community surveillance, constant risk assessment, and active case finding. These strategies enabled Thailand to relax some restrictions and resume many activities while maintaining an effective approach to the COVID-19 outbreak (Limsawart et al., 2020, pp. 154–155).

24.3.5 Restoring Wellbeing of Pandemic-Affected People and Citizen Participation CCSA had policies on controlling fake news which could affect the psychological well-being of people. Fake news on internet reported false numbers of deaths from

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COVID-19 as well as misleading health suggestions. When fake news was found, the CCSA would warn the public about believing or sharing it. The CCSA also provided suggestions/guidelines for public attitude towards COVID-19 patients who had recovered from the disease. It was advised that COVID-19 infection should be viewed as a normal health problem and not be stigmatized. Thailand followed WHO guidelines (WHO, 2020g; Limsawart et al., 2020, pp. 166–167) on reducing social stigma for COVIID-19 recovered patients. There were three approaches adopted: (a) “Words matter”—not using name-calling words (e.g., using “COVID-19” instead of “Wuhan pneumonia” and not using religious or location names connected to the outbreak); (b) “Do your part”—including as many groups/sectors of people as possible in sharing right knowledge/information about COVID-19 and focusing on sharing success stories or positive figures in treating COVID-19 cases; and (c) “Communications tips and messages”—employing effective communication techniques and messages with clear, correct, and positive information. CCSA and MOPH included at least 1.2 million health volunteers to participate in controlling the spread of COVID-19 by delivering medicines to homes so that they did not have to travel to hospitals or mix with crowds. Health volunteers, both in Bangkok and in villages, have repeatedly been one of the key factors influencing the success of Thailand in controlling infectious diseases. Due to their outstanding contribution, they will continue to remain significant players in Thailand’s public health management (Reuters, 2020a; WHO, 2020f; Limsawart et al., 2020, pp. 168–169). In managing COVID-19 outbreak, MOPH-DMH (2020) is providing guidelines to help individuals experiencing stress, burnout, depression, or suicidal tendencies, especially during the 14-day quarantine. The services of the MOPHDMH will continue to play a key role in restoring the wellbeing of people who are vulnerable to the effects of the pandemic. On July 8, 2020, the first wave of COVID-19 outbreak was declared ended. Thailand implemented an exit strategy involving a loosening of strict lockdown regulations. In September 2020, Thailand was praised by WHO as one of seven countries whose preparation and response offers lessons for the rest of the world (World Economic Forum-COVID Action Platform, The, 2020; WHO, 2020c, 2020h). In July 2020, the Global COVID-19 Recovery Index ranked Thailand as first in the world as an example of best practices in stopping the ongoing COVID-19 pandemic (GCI, 2020; Global Pathfinder Initiative (GPF), The, 2020). In August 2020, Thailand was ranked second.

24.4

Factors Contributing to Thailand’s Success in Controlling COVID-19 Pandemic

Thailand is an excellent example of how a whole-of-government, whole-of-society, comprehensive approach can contain this virus—even without a vaccine. Dr. Tedros Adhanom Ghebreyesus Director-General of World Health Organization (WHO, 2020j)

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From July to September 2020, Thailand was reported by WHO and other COVID-19 monitoring agencies as one of the top countries in the world in terms of its performance in curbing the COVID-19 pandemic. WHO and MOPH reviewed the COVID-19 situation in October 2020 and shared Thailand’s management activities with the global community (WHO, 2020d). The report listed the following as factors contributing to the successful management of the pandemic in Thailand: • Strong leadership that accepted the advice of medical experts. • Administrative systems adapted to changing demands. • A strong, well-resourced, and inclusive medical and public health system; this includes early and effective management of patients in hospitals and a strong capacity to trace and quarantine contacts using “Rapid Response Teams” and “Village Health Volunteers.” • Previous experience with major infectious disease outbreaks including SARS, Avian Influenza, and Influenza H1N1. • Starting entry screening early led to detection of the first case outside China; this allowed authorities to educate hospital and public health workers as well as members of the public to the threat. • Cultural norms including non-contact greeting and mask wearing, supported by consistent and transparent communication improved public compliance with protective measures. • Early adoption of a “whole of society” approach included active engagement with academia and the private sector (see details in WHO, 2020d). MOPH (2020) also listed the proper implementation of law enforcement/mandatory regulations as one of the key success factors. Proper enforcement of regulations allows medical and government officials to safeguard society at large in times of a pandemic crisis. Many effective disease-control activities such as social distancing, wearing face-masks, limiting travel, curfew, and 14-day quarantine could be applied nationwide due to the Emergency Decree. Such law enforcement was required to handle some groups of people who violated what were initially voluntary measures and caused damage to the majority. Multi-sectoral cooperation between health and non-health sectors, military and non-military sectors, government and non-government sectors was also listed as contributing to Thailand’s success. For instance: The Ministry of Defense (military) and the Ministry of Foreign Affairs, Ministry of Interior, Ministry of Justice, Ministry of Transport, and Ministry of Commerce (non-military) were involved in 14-day quarantine measures; disease assessment/monitoring was conducted by both public health agencies and non-health related agencies; and both the government and the private sector were involved in providing quality food and necessary goods to the people (MOPH, 2020, pp. 47–50, 56; Patcharanaruamol et al., 2020, p. 14). Another factor was Thailand’s epidemiological expertise and adequate/effective human resources (Thai PBS World’s General Desk, 2020). Competent field epidemiologists from Thailand’s Field Epidemiology Training Program (FETP) and more than 1.2 million VHVs worked on tracking, containing, and eliminating COVID-19 infections before the rate of infection became an epidemic. FETP was established in Thailand in 1980 replicating CDC’s Epidemic Intelligence Service or EIS

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(CDC-Division of Global Health Protection, Global Health, 2020). The top leaders of MOPH and WHO in COVID-19 management also listed the effective leadership of Prime Minister General Prayut Chan-o-cha and his cabinet for properly balancing medical recommendations with social and economic measures so that outcomes would benefit the country’s majority (Thai PBS World’s General Desk, 2020; WHO, 2020d, 2020i). The authors of this chapter were living in Thailand throughout the period from December 2019 to September 2020. From a literature review, interviews with individuals who were involved in Thailand’s COVID-19 management (see Appendices 1–6) and our own experience of COVID-19 in Thailand, we list the following as key factors in Thailand’s success in containing COVID-19: (a) Effective leadership of decision-makers in Thailand’s COVID-19 management team which consists of Prime Minister—Prayut Chan-o-cha, government officials (both military and non-military), and medical and nonmedical experts; (b) The strength and effectiveness of MOPH, medical experts, and Thailand’s public healthcare personnel. Medicine and public health have been strongly supported by most governments and leaders in Thailand for many decades, especially by the Thai Royal Family (Harvard T. H. Chan, School of Public Health, 2020; Medical Council of Thailand, The, 2019); (c) Universal healthcare coverage (UHC), launched 17 years ago by Former Prime Minister Thaksin Shinawatra’s government; (d) Cultural norms valuing collectiveness and complying with public-rules behavior which benefit society at large, and non-touching greeting gestures; (e) Equal participation and contribution of government, business, and citizens; and (f) Having an environment and climate that are conducive to agriculture and food production, which are critical basic needs in crises. These factors have always been crucial in helping Thailand survive crises in the past, such as the 1997 economic crisis, the tsunami in 2004, and severe flooding in 2011.

24.5

Lessons Learned, Challenges, and Silver Linings of COVID-19 Pandemic

COVID-19 pandemic has affected Thailand in many ways. Despite the damage done to the country’s economy and social wellbeing by COVID-19, Thailand has learned lessons from this experience. The following themes indicate lessons learned and challenges, which might contribute to future improvements and betterment, as well as some silver linings.

24.5.1 Global Challenges and SDGs Infectious disease and pandemics have been listed among the top 10–15 global challenges, which the global community needs to be prepared to handle properly

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(Millennium Project, The, 2017). It is still a global risk (World Economic Forum, The, 2020). COVID-19 has taught us how important it is for each country to be prepared to prevent and handle future pandemics. At the same time, it stresses the importance of SDG 3 “Ensure healthy lives and promote well-being for all at all ages” (UNDP, 2020). Thailand overcame the COVID-19 outbreak because of its robust public healthcare system. As of September 2020, Thailand’s health security ranks 6th out of 195 countries with a score of 73.2 on the Global Health Security (GHS) Index (Global Health Index, 2019, pp. 21, 290). Thailand might not have been able to manage COVID-19 so effectively had it lacked a good and strong public healthcare system for the whole population. Therefore, one lesson learned from the COVID-19 pandemic is that there are long-term benefits to be gained for a nation from investing in and developing an appropriate public healthcare system to shield a nation from future pandemics and related damages.

24.5.2 “New Normal” Thailand may be doing well in terms of public healthcare system and is better prepared to face future pandemics than many other countries, but Thailand has problems in other areas such as politics, education, economy, technology, and the environment. Thailand needs to solve these problems quickly otherwise there may not be sufficient resources to maintain the current public healthcare system (see Appendix 2). International agencies forecast that Thailand’s economy in 2021 will be seriously affected and may show negative growth due to reduced external demand for Thai products and the economic disruption resulting from domestic lockdowns (Dalpino, 2020; Fitch Solutions Group, 2020). OECD reported that Thailand has done well in COVID-19 management, but the economy’s heavy reliance on the flagging tourism industry will take a toll on Thailand’s economic outlook in 2021 (OECD, 2020, pp. 36, 39, 50–51, 151). The COVID-19 pandemic forced Thailand to review its national development plan and to initiate “Thailand New Normal” in September 2020 (NESDC, 2020). Some key strategies of “Thailand New Normal” include: (a) develop a digital government; (b) support and increase the strength of local economies; (c) restore environmental and natural resource management; (d) develop human resources for handling any future crises; (e) strengthen provincial and village economies; (f) improve the quality and safety of tourism services; (g) support start-up businesses; and (h) support the development of “sharing economy” and business participation in the public sector’s activities to restore the wellbeing of people and communities affected by COVID-19. Thailand is in the same situation as many countries around the world in that the country must find right approaches to “new normal.” Finding the right way is challenging and difficult. It will require strength, an ability to reach the target, and a sharing of knowledge and cooperation among members of the international community to ensure both human and environmental survival.

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24.5.3 Supplies of Basic Needs From March to August, 2020, people’s basic needs (e.g., food, clean water, and medicines) were adequately met. Most Thai residents did not suffer from a lack of good food and clean water, or from being deprived of necessary medical care. However, Thais were not free to travel or gather in crowded places such as restaurants, pubs, bars, or theaters. For more than 30 years, national development has focused on non-agricultural industries (e.g., automobile assembly, electronics, machine/engineering, financial services, steel production, and textiles) as these industries generate more national income, produce faster returns, and are more predictable than agriculture (NESDC, 1977, pp. 36–38). After COVID-19, the Thai government recognized the importance of agriculture and food security, and emphasized both issues in the latest national development plan (NESDC, 2020, p. 160). This is an important lesson learned from the COVID-19 pandemic—each country should be prepared for future pandemics by maintaining the ability to meet the basic needs of its citizens during crises.

24.5.4 Global Leaders and Multilateral Collaboration Thailand was able to manage the fight against COVID-19 because of the assistance and supply of necessary items from other countries. Thailand’s experience of COVID-19 alerted us to many global challenges/risks and taught us that countries can avoid severe hardship through international collaboration—or can be severely damaged if they are divided and do not cooperate. Below is the excerpt from an interview given by a public health doctor who had experience working both for Thailand and for an international organization: Thailand could not work alone in coping with communicable disease outbreaks or pandemics. Multilateral collaboration is crucial so that best practices, knowledge, and information as well as innovative tools, drugs, vaccines, and technology in saving people’s life and health from COVID-19 could be shared and developed. (Key informant 3; see Appendix 4).

Had President Trump been more positively responsive to the scientific community regarding management of COVID-19, the USA might not have had—and indeed likely would not have had—the highest cumulative number of COVID-19 cases in the world (12,763,997 cases; WHO, 2020j). In November 2020, the USA also had the highest number of newly reported cases in last 24 h (322,072), the highest cumulative number of deaths (261,460), and the highest number of newly reported deaths in the last 24 h (3635 deaths; WHO, 2020j). Trump was the first American President in history to be condemned by four prestigious scientific communities for his poor performance as a national leader regarding citizens’ health safety (Editorial—The Lancet, 2020; Nature—Editorial, 2020; The Editors (Editorial-NEJM), 2020; Thorp, 2020).

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Moreover, the COVID-19 pandemic might have been contained more effectively if global leaders of countries such as the USA and China had maintained better relationships and collaboration (e.g., USA–China tensions in Cossa & Glosserman, 2020; Sutter & Huang, 2020). The silver lining of the COVID-19 pandemic is that it gives an opportunity for many national leaders to form multinational collaborations in solving a pandemic and to learn from their experiences in handling such crises. The COVID-19 pandemic should encourage global/international leaders to value a culture of international collaboration in discovering a “New Normal” global leadership and strengthening cooperation to tackle global challenges, effectively.

24.5.5 Community’s Three Pillars Community is “all the people who live in a particular area or country and who we talk about as a group” (Hornby, 2007). Community in this chapter refers to villages, provinces, sectors, countries, or global areas. It is commonly in the context of a community that issues are analyzed and reported (e.g., COVID-19’s outbreak, management, problems, situation, etc.). Shultz et al. (2017) listed government, business, and NGO citizens, as three catalytic institutions vital to the creation and maintenance of a community’s marketing system and quality of life. Similarly, Virakul and Senasu (2017) proposed a model, which depicted government, business, and citizen sectors as key players for responding to global challenges and sustainable development in ASEAN countries. The interviews of two key informants who worked as top officers of government units in COVID-19 management (see Appendices 5 and 6) supported the important roles of businesses and citizens in helping the government sector contain COVID-19 outbreak in Thailand. In the Sustainable Development Goals Report 2020, United Nations explained the participation of the three sectors as follows: Containing COVID-19 requires the participation of all governments, the private sector, civil society organizations and ordinary citizens around the world. Strengthening multilateralism and global partnership are more important than ever (United Nations, 2020, ‘Goal 17: Partnerships for the goals’, p. 58).

The lesson learned from COVID-19 pandemic is to recognize the impact of global challenges and to understand the contribution of key players so that their strengths can be fully utilized for an effective response. Figure 24.5 presents the key players as three pillars of community response: government, business, and citizens. Their role, framework of duty, and performance outcomes were based on a literature review on public sector governance (APEC, 2011; Council of Europe, 2020a; Transparency International, 2018), business and SDGs (Elkington, 1999; UNDP, 2019; UNGC, 2019), and citizen participation (Council of Europe, 2020b; United Nations, 2020; UNDP, 2019). The government’s mission is to be an effective policy maker, the mission of business is to be responsible providers, and the mission of citizens is to be quality citizens. Figure 24.5 presents a conceptual framework of how

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Fig. 24.5 The three pillars of community response. Note. 1Organizational sustainability is balancing ‘TRIPLE P’—profits (economic), people (social), and planet (environment)—all together

business can significantly participate in SDGs and minimize global challenges. It is recommended that business can do so by embedding CSR, CG, and sustainability concepts all together at the strategic level. Organizational performance is measured according to four categories: (a) profits; (b) CSR; (c) CG; and (d) sustainability (Virakul, 2015; Virakul & Russ-Eft, 2019).

24.5.6 Environmental Gains The silver lining of COVID-19 pandemic is that it allows humans to see that natural environments can be restored quickly if damaging human behavior is reduced or contained. Thailand implemented a lockdown policy in March 2020. One month later, wild animals not commonly seen in many tourist sites were spotted by local residents and wildlife researchers/observers. Wildlife rarely seen in Thailand appeared after their habitats were free from large numbers of tourists. Those rare or nearly extinct animals include leatherback sea turtles, a large group of dugongs, the endangered green turtles, black-tipped reef sharks, bottlenose dolphins, and hairy leg mountain crabs (Israngkura & Yasen, 2020; Associated Press, 2020; Reuters, 2020a, 2020b; Thai PBS News, 2020). This same phenomenon was observed in many places around the world. In the UK, rare wildflowers and declining bee populations started to recover during the coronavirus lockdown because many councils were leaving roadside verges uncut (Watts, 2020). The grounding of planes and shutdown of factories, due to the travel

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bans and lockdowns, caused global economic loss but they had a beneficial effect on air quality (Lenzen et al., 2020). Thailand’s particulate matter 2.5 (PM2.5) levels, from May to October 2020, were lower than those in 2017–2019 (Air Quality Historical Data Platform, 2020). However, reports from United Nations (2020) and European Environment Agency (2020) included the notion that it is a challenge for the global community not to let environmental degradations climb back to pre-pandemic levels once the lockdowns are loosened.

24.6

Conclusions

The overall experience from COVID-19 pandemic shared in this chapter is essentially about how humans manage their “relationships”—with nature and with other human beings. If such relationships are balanced, peaceful, and with mutual respect, then we could reasonably expect the world would be a better, safer, healthier, more sustainable, and flourishing global community. If our relationship with nature is not as it should be, then negative consequences are very likely to occur. This knowledge is nothing new. It is, in fact, an ancient wisdom that has been passed down for thousands of years humans should live in harmony with nature. As for humans and human relationships, the COVID-19 experience taught us that cooperation among groups in a nation and among nations in a global community can help us solve many challenges we will be facing in the future. If we do not succeed in living harmoniously with nature and with others in a global community, the human race might perish because of its own actions. Acknowledgment The authors would like to thank all key informants for their time and effort in providing information about the COIVD-19 pandemic in Thailand. Their contribution is sincerely appreciated.

Appendices Appendix 1 Details of key informants Key informant Gender Age 1 Male 67 2 Male 67 3 4 5

Male Male Male

63 54 59

Professional position Political scientist; National Reform Committee on Politics Medical doctor; Infectious disease specialist, National Reform Committee on Public Health Medical epidemiologist; Public health practitioner Medical doctor; Hospital Director Government official; Supervisor of national quarantine units

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Appendix 2 Highlights of Interview with Key Informant 1—September 14, 2020 Even though Thailand has handled COVID-19 pandemic effectively, public health is the only area in which we have performed well. We are facing many challenges which we need to solve urgently in a ‘new-normal’ way. If we don’t solve these problems, our country will experience severe problems. The new-normal way for us is to find new ways to address problems and also partners, both locally and internationally, to collaborate with in addressing the country’s weaknesses. We have weaknesses in many areas including the economy, finance, education, technology, and agriculture. We must solve social problems, unemployment, the lag in technological development, political conflicts, and corruption quickly. These problems have persistently damaged our country. My point is; after COVID-19, the challenges which the country faced before the pandemic will become even more serious. The term “new-normal” is not just words; it is something that is necessary for us. We must all learn to collaborate together and respond to the challenges we face in a timely manner.

Appendix 3 Highlights of Interview with Key Informant 2—September 25, 2020 COVID-19 has proven Thailand’s ability to handle a pandemic effectively. Thailand has partnered with many international agencies in providing information on outbreaks and how to strengthen public health infrastructure. In the past, Thailand was able to set up laboratory facilities in time for diagnosing hazardous pathogens in suspected persons, such as for the influenza pandemic in 2009 and the Ebola epidemic. There have been isolation wards and negative pressure rooms in all provincial hospitals ever since. Success stories in handling pandemics include those for SARs, Ebola, MERS, and the influenza pandemic in 2009. Collective experience and a strong primary health care structure with more than one million village volunteers have made us better prepared and have resulted in the detection of the first case of MERS and the first case of Covid-19 outside China. Thailand has also succeeded in containing the spread of these viruses. In December 2019, we were alerted by news from China of a peculiar syndrome which first appeared in a fresh market in Wuhan. The initial mode of transmission was determined to be animal-to-human but was considered likely to become human-to-human. An emergency operational center was set up and entry screening at the airport was activated on January 3rd with quarantine of the first case on January 8th. Our scientists were able to identify the virus to be SARs like coronavirus by family wide PCR method and subsequently confirmed by whole genome sequencing. The result was identical to that reported by Chinese authorities on the following day. This, then, became the first documented case of COVID-19 outside China and was identified just 1 day after China publicly shared the genetic sequence of COVID-19 on January 12, 2020. The silver lining for Thailand of COVID-19 pandemic is that it has made us more confident in our ability to protect our country from future global pandemics and in our ability to assist other countries as well.

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Note: (1) SARs is Severe Acute Respiratory Syndrome (Outbreak 2002–2004); (2) Ebola is Zaïre Ebola Virus (EBOV, Outbreak 2014–2020); (3) MERS is Middle East Respiratory syndrome also known as camel flu (Outbreak 2012–2018); (4) PCR is Polymerase Chain Reaction.

Appendix 4 Highlights of Interview with Key Informant 3–October 2, 2020 Firstly, trust is one of the key factors which make Thailand’s management of the unprecedented COVID-19 pandemic a success case. The Thai public and the government trust that health personnel are capable enough to lead the whole society to safety, given the situation. Both the public and the government took health personnel’s viewpoints seriously. They agreed to follow most suggestions given by a national team of experts together with health authorities on strategic directions and day-to-day management with a shared view that people’s life and health must be the topmost priority. They agreed that cases of COVID19 and resulting deaths need to be kept to a minimum while simultaneously optimizing other non-health impacts of the pandemic. This high level of trust from both the government and the public does not come easily or happen overnight. It is the result of long-term, continual, laborious, and collective contributions to Thai society by traditional and modern medical and health personnel over several decades. Secondly, Thailand has also built up a reasonably strong health system. We are grateful that over the last 40–50 years, the strength of Thailand’s health system has been gradually developed with strong support from many international development partners. Major contributors over the years have been the World Health Organization (WHO) and the US-CDC (Centers for Disease Control and Prevention, USA). These organizations have been our main sources of support and technical know-how on the arts and sciences of disease prevention and control since 1980 when the Thai Field Epidemiology Training Program (FETP) was established. The Alma Ata Declaration on Primary Health Care of September 1978 as advocated by WHO also helped Thai authorities plant Village Health Volunteers (VHVs) firmly within the health system. Thousands of disease surveillance and rapid response teams (SRRTs) led by competent field epidemiologists and 1.4 million VHVs living in almost all communities in Thailand have made a significant difference in slowing down and/or stopping community spread of COVID-19 pandemic. Lastly, Thailand could not work alone in coping with communicable disease outbreaks or pandemics. Multilateral collaboration is crucial so that best practices, knowledge, and information as well as innovative tools, drugs, vaccines and technology in saving people’s life and health from COVID-19 could be shared and developed. Evidence has shown that nowadays a disease can be transported from an isolated rural village to any major city in as little as 36 h. Therefore, the age-old observation of ‘An outbreak anywhere is a threat everywhere’ holds true for COVID-19. To be safe from communicable disease outbreaks and pandemics, humans need to unite, be alert, use sciences, share information and thoughts, and help each other through multilateral collaboration. We should always keep in mind that ‘Nobody is safe until the world is safe’. History has demonstrated how a little help from good friends can make Thailand more capable in keeping their people safe. Therefore, countries of the world, big or small, should learn from history and contribute to making the world safer through multilateral collaboration.

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Appendix 5 Highlights of Interview with Key Informant 4—October 8, 2020 The silver lining of the COVID-19 pandemic is that it has helped us improve Thailand’s public health system. Two months after the first case of COVID-19 was reported, facilities and capability to detect the virus had increased from 3 hospitals nationwide to more than 200 hospitals. Therefore, we can now detect the virus better and faster than before. We are quite confident that Thailand’s public health functional units have adequate experience, knowledge, personnel, and facilities to safeguard the country from any future pandemics. The lesson I learned from supervising COVID-19 management was to understand more clearly the need for teamwork among the three key sectors of society—public, private, and citizens. One of my responsibilities is to advise big department stores on how they could prevent the disease from spreading. I found that they implemented all of our suggestions to a degree even more than we expected. I was very impressed by their willingness to comply with all the government’s requests. The behavior of Thai citizens has also been crucial in preventing COVID-19 from spreading. Unlike in other countries, incidents of people protesting or behaving violently against the government’s public health suggestions were very rare in Thailand. The collective participation of private citizens and business sector in following the government’s lead has been one of the key factors contributing to Thailand’s success in controlling the COVID-19 pandemic.

Appendix 6 Highlights of Interview with Key Informant 5—October 13, 2020 The 14-day quarantine is one of the crucial factors in curbing the spread of COVID-19. It is one way of making sure that the hundreds of thousands of Thais who came back to Thailand from overseas would not carry the COVID-19 virus into the country from abroad. Decisions on how to control the pandemic needed to take into account many factors—legal, financial, social, physical, and psychological. So far, our quarantine procedures have yielded good results. Most people that have had to quarantine have followed and accepted our guidelines without any serious conflict. In order to secure premises to use for quarantining people entering the country, the Thai government joined with the business sector and selected hotels whose facilities passed the quarantine guidelines set by medical experts. This was a win-win situation because many hotels did not have any guests due to the emergency lockdown. I think that Thailand’s success in controlling the COVID-19 pandemic is mostly due to the effective teamwork and leadership of top government officials from every agency involved, both medical and nonmedical. The fact that the Thai government decided to carry the burden of quarantine costs contributed greatly to people’s willingness to participate in quarantine procedures rather than try to avoid them. Moreover, we review our work daily and respond promptly to complaints and suggestions for improvements.

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Busaya Virakul holds a B.Sc. and a D.V.M. from the School of Veterinary Medicine, Chulalongkorn University, Bangkok, Thailand. She continued study in the U.S. and earned a M. Ed. and Ph.D. in Agricultural Education from the University of Minnesota. Before taking up teaching, she spent 6 years working with agribusiness companies. Her last position in the private sector was a human resource manager for a multinational company. She now teaches business ethics, leadership development, and human resources classes at the School of Human Resource Development, The National Institute of Development Administration (NIDA), Bangkok. Chartchai Na Chiangmai is a professor in Political Science at the Graduate School of Human Resource Development, National Institute of Development Administration, Thailand. Prof. Chartchai has published many research reports, books and articles in areas of Thai politics and governance, development management, decentralization policy and administration, human resource development and organizational design. He received the most Distinguished University Professor in Social Sciences in 2009. He was a member of the National Reform Council in 2014–2016 and a member of the Constitutional Drafting Commission in 2015–2017. He received B.A. in Political Science with honors from Chiang Mai University in 1974, M.A. in Government from Chulalongkorn University in 1976 and Ph.D. in Political Science from University of WisconsinMadison in 1983. Kalayanee Senasu , Ph.D., is a Professor of Economics (Human Resource Management) at the Graduate School of Human Resource Development, National Institute of Development Administration (NIDA), Thailand. Currently, she serves as a chairperson of the Ethics Committee in Human Research, National Institute of Development Administration, and the editor of Human Resource and Organization Development Journal. Her research is focused on happiness, quality of life, and sufficiency economy philosophy. She has a Bachelor’s Degree in Science (Public Health) from Mahidol University, Thailand, and holds a Ph.D. in Public Policy Analysis—Economics from the University of Illinois at Chicago, U.S.A.

Chapter 25

Local-Level “Best Practices” During COVID-19 and Their Impact on Community Well-Being: Cases from the Municipality of Kadıköy, Istanbul Ahmet Ekici

Abstract In times of increased uncertainties that make community vulnerability even more complex, citizens’ well-being can be a direct function of whether the society chooses to engage in activities that result in flourishment or distress. By utilizing the above argument and the theoretical framework offered by Shultz et al. (The handbook of community well-being. Springer, 2017, pp. 403–422), this chapter aims to demonstrate how one of the largest districts in Istanbul–Turkey (i.e., the municipality of Kadıköy-MK) has chosen to respond to the challenges introduced by the COVID-19 pandemic to make progress toward a flourishing community. More specifically, by examining the pandemic-specific programs of MK, this chapter aims to demonstrate how the well-being of both served and underserved citizen-consumers can be maintained by best practices that are offered to the market through the marketing systems created by the catalytic institutions of government, NGOs, and business. Keywords COVID-19 · Vulnerability · Flourishing communities · Community well-being · Catalytic institutions · Quality of life

25.1

Introduction

The theory predicts that whether a community is characterized as flourishing or distressed as it goes through difficult times, to a large extent, is a function of the resilience developed through the cooperation among community stakeholders (a.k.a. the “catalytic institutions”), namely, the governments, NGOs, and businesses (Shultz et al., 2017). Moreover, it can be argued based on Shultz et al. (2017) that the tensions between the “catalytic institutions” have the potential to contribute to the

A. Ekici (*) Bilkent University, Ankara, Turkey e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_25

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vulnerabilities of the country, which may result in distressed (rather than flourishing) communities in the aftermath of a pandemic (also see Füssel, 2007). Turkey, as a country, has suffered from the recent COVID-19 pandemic, a situation that was compounded by significant problems in the economy and international politics (Moody’s, 2020). In addition, the publicized conflict between the central government and crucial business organizations and the NGOs of the country regarding the management of the COVID-19 pandemic has created concerns about personal well-being. For example, TUSIAD, the biggest business organization in Turkey, penned a letter to the government, asking for larger governmental support for business to no avail (Bloomberg, 2020). Government officials were criticized by the country’s largest trade union for doctors (Turkish Medical Association, its membership covers more than 80% of the doctors in Turkey) because the government mispresented COVID-19 cases and failed to share important health information from the public (Bianet, 2020). Consequently, the preexisting macro-level vulnerabilities, coupled with conflict and lack of cooperation among the government, businesses, and NGOs, have the potential to result in decreased personal wellbeing through the COVID-19 pandemic. On a more positive note, the “catalytic institutions” at the local (i.e., municipality) level across Turkey were able to better manage the challenges related to the pandemic (compared to efforts at the national level). Cooperative ecosystems (marketing systems) at the local level were much more successful. These systems demonstrated that they have the potential to create flourishing communities, resulting in increases in personal well-being. By utilizing the “Framework” offered by Shultz et al. (2017, p. 49), this chapter aims to demonstrate how the “best practices1” initiated by the Municipality of Kadıköy-MK (one of the largest municipalities in Istanbul–Turkey) can contribute to the community well-being of the vulnerable consumer-citizens residing in the Kadıköy district. The recent COVID-19 pandemic has exacerbated the challenges of vulnerable groups (such as the poor, homeless) while introducing new vulnerabilities (e.g., due to strict curfew measures). As a result, by describing the pandemic-specific programs of MK, this chapter aims to demonstrate how the well-being of both served and underserved citizen-consumers can be maintained by best practices of marketing systems facilitated by catalytic institutions (Shultz et al., 2012, 2017). The chapter also aims to identify system-level barriers that prevent program and policy implementations and, thus, impede the flourishment of communities. We hope that the lessons learned at the local level can motivate public policy at the national level. The chapter will begin with a brief history and impact of the COVID-19 pandemic on the Turkish economy and society at large. Then, the changing nature of vulnerabilities will be described. Next, I will describe the social programs implemented by the Municipality of Kadıköy (i.e., the “best practices”), and how

1

UNESCO has announced/promoted the COVID-related programs of Kadıköy Municipality as among the best practices (https://en.unesco.org/news/there-nothing-neighbourhood-kadikoymunicipalitys-support-elderly-face-pandemic).

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these programs facilitated by “catalytic institutions” managed to overcome the many challenges associated with the pandemic.

25.2

Brief History and the Impact of COVID-19 in Turkey

The first officially reported positive case of COVID-19 in Turkey was recorded on March 11, 2020. Like many other countries, the number of positive cases in Turkey has increased as more people were tested nationwide. By the end of 2020, the number of officially recognized cases reached approximately two million and approximately 20,000 deaths. The Ministry of Health first reacted to the pandemic by establishing a Scientific Committee composed of scientists and medical doctors. The committee has played an “advisory” role to the Ministry of Health and other governmental bodies (such as the Ministry of Education, Ministry of Interior Affairs, Ministry of Labor, and the Office of the President). Since the first officially recognized cases dated back in December 2019 in Wuhan, China, the COVID-19 has increasingly been recognized as a global problem. The government’s initial response to the pandemic has been an immediate partial lockdown with gradual increases in restrictions. Turkey has never implemented a full lockdown contrary to the advice of many economists, who recommended a full lockdown. They argued that it takes approximately 40 days to contain the virus in the case of a full lockdown, while it might take up to a year in a partial one (Demiralp, 2020). The restrictions, including travel bans in most parts of the country, were relaxed in late May and were gradually lifted during the summer of 2020. However, with the increasing reported cases in late August, the restrictions have been gradually reinstated. Currently, approximately 40% of the population is under full lockdown (with a few hours of restriction easing a day), including the elderly and the youth. Additionally, a full lockdown seems to be in place during the weekends and holidays.

25.2.1 Economic Impact Besides saving human lives, recovering from the economic fallout has been an important goal as both businesses and consumers have suffered much. A recent survey conducted in Turkey shows that 62% of local enterprises were substantially impacted, and the business volume of more than half of all local business firms has decreased by more than 50%. In time, it became clear that small and medium enterprises (SMEs) were the hardest hit, especially those employing the poor and other vulnerable groups compounding the adverse socioeconomic impact of the pandemic (UNPD-Turkey, 2020).

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Like other nations, the Turkish economy has been negatively affected both from the supply and demand aspects. With respect to the supply side of the economy, production levels have dropped as people who became infected dropped out of the labor force. In addition, as part of the pandemic controlling measures, many “nonessential” businesses (including most of the services) have been required to close down, further reducing the total supply of goods and services. The pandemic has also created important changes in consumer behavior and consumption patterns. People either voluntarily avoided (or forced to avoid due to nationwide closedowns) shopping centers and many other public places for shopping, travel, and entertainment. Parallel to the decline in production and reduced business operation, workers have lost significant income, further reducing their consumption. The third factor affecting the demand side is attributed to the uncertainty related to the pandemic. Specifically, consumers ended up spending less and saving more (Demiralp, 2020). The abovementioned supply and demand challenges are being experienced in other countries too. However, as noted by Çakmaklı et al. (2020), the COVID-19 pandemic is unique in the sense that it is considered to be the most significant emerging market crisis ever recorded. In addition to problems being faced by the developed economies, emerging countries such as Turkey also suffer from capital outflows. During the pandemic, investments in emerging economies have declined significantly—investors seem to prefer safer investment alternatives (e.g., gold, cash, US government bonds) that have led to increased outflow of capital and investment from emerging markets (Park, 2020). For a fragile economy like Turkey, where the external debt is approximately two-thirds of the GDP, this is particularly worrying because the amount of foreign investment (and currency) has declined at a time when foreign currency revenue (e.g., from tourism) has also declined. The above-described macro environment has increased the need for foreign currency funding, causing a depreciation in the Turkish lira by about 25% since the start of the pandemic (Hessler, 2020).

25.2.2 Social Impact The current pandemic has resulted in two major changes in Turkish society. First, vulnerabilities felt by women have intensified; and second, new vulnerable groups have emerged. Before describing the MK relief efforts, the reader may benefit by better understanding the background related to these two main societal trends.

25.2.2.1

Changing Lives and Intensified Vulnerabilities of Women

The idiosyncratic characteristics of the pandemic have affected the lives of women substantially. Globally, women do three times as much unpaid house and care work as men. This situation is even worse in the case of Turkey where women do as much as five times unpaid house and care work as men (United Nations-Turkey, 2020).

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Self-isolation measures have increased the burden on women with the increasing unpaid house and care work as more family members had to spend time at home. Childcare responsibilities have increased significantly when most schools have switched to distance learning—the heaviest responsibility often fell on women. This problem was exacerbated as daycare facilities were shut down. Customarily, when parents need to work and no childcare centers are shut down, childcare responsibility usually is assumed by grandmothers, but they, too, have been declared as a “risk group.” As a result, for women who also were forced to work remotely from home, this meant increased working hours and increased care responsibility, which adversely influenced their physical and mental well-being. To offset this burden on women, a support mechanism has to be in place. The COVID-19 pandemic has also increased social and economic insecurities for women. According to the UN-Women’s “Progress of the World’s Women 2019–2020: Families in a Changing World” report, in 2017, more than half (58%) of all female victims of intentional homicide were killed by a family member (UN-Women, 2019). The current pandemic caused families to spend more time at home, which in turn caused a significant increase in marital conflict. As a result, reported domestic violence and sexual abuse cases have increased (Ünker & Bellut, 2020). Meanwhile, according to a report by the UN, young women are subject to increased cyber-violence as they spend more time at home and online while quarantined (United Nation-Turkey, 2020). The economic consequences of the COVID-19 pandemic have also increased the financial vulnerabilities of women. Nearly 60% of women globally work in informal sectors of society; they earn less, save less, and have a greater risk of falling into poverty in times of crises (ILO, 2020). Women are responsible for close to 80% of the farming and agricultural work in the world. Disruption in the food supply chain because of the pandemic has had a significant impact on women’s financial autonomy and well-being. Approximately half (42.2%) of the women employed in Turkey work in the informal economy as house cleaners, caretakers, and seasonal workers without social security (UN-Women, 2020). Women working in the informal sector were hit by the pandemic first and lost income. Many governments, including the government of Turkey, have introduced economic relief packages (including unemployment assistance) to minimize the negative economic impact of the pandemic on the public at large; however, given the fact that women who are employed in the informal sector do not have any social security, they also had to forfeit unemployment assistance. To sustain their financial independence and improve their financial well-being, more flexible and creative relief programs and policies are needed to provide financial assistance to women employed in the informal sectors of the economy.

25.2.2.2

Changing Nature of Vulnerable Groups for Social Services

The current pandemic’s effects are being most felt by those not only economically but also socially vulnerable. The description of vulnerability in the face of

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COVID-19 is usually based on personal health history. People are categorized as vulnerable based on their underlying health conditions. Age is one of the important criteria for categorizing people vulnerable: compared to other age categories, elderly people are more likely to be more severely affected by the virus and therefore require a longer treatment time to recover. The youth are more likely to recover sooner, even at times, without showing any symptoms, but at the same time they become agents carrying the virus and infecting the more vulnerable such as the elderly. As such, both age-related groups (elderly and the youth) are subject to more strict regulations to ensure that they are sufficiently isolated from the rest of the society. In times of social distancing, older citizens experience isolation and social deprivation, which in turn increase their vulnerability and reduce their overall well-being (Macdonald & Hülür, 2020). Before the pandemic, however, those with financial resources tend to experience less vulnerability. The financially secure elderly citizens tend to find creative ways to socialize, do their shopping, and hire help for self, house cleaning, cooking, etc. As reported so far in this chapter, like most other countries, Turkey has been greatly impacted economically and socially by the challenges brought on by COVID-19. Those considered vulnerable before the pandemic (e.g., poor, homeless, refugees) have experienced greater vulnerability during the pandemic. In addition, the pandemic resulted in significant loss of production and business closings, which in turn have led to unemployment and financial distress for a large segment of the labor force. Moreover, the pandemic has introduced new vulnerabilities that went beyond economic distress. As a result of restrictions, many who have been financially self-sufficient have been driven into poverty. Food insecurity has become a major problem even for those who have the financial means. Similarly, those who had the financial means to hire help for childcare, self-care, and house cleaning could not obtain these services during the pandemic. As a result, many parents experienced much stress and ill-being. The elderly citizens have suffered too. Their health and well-being were adversely affected due to lack of health-care and home-care services, access to food/daily meals, and loneliness that came along with social isolation (Wu, 2020). As described in the preceding sections, the pandemic has created conditions that adversely affect the well-being of many communities throughout Turkey. In times of increased turbulence and uncertainty, communities can choose to engage in activities that result in protecting the well-being of their residents (Shultz et al., 2017). The rest of this chapter describes how a particular community in Turkey has chosen to respond to the challenges. The community I will focus on is the Municipality of Kadıköy (MK), a large district in Istanbul. To respond to the challenges brought on by COVID-19, MK officials have quickly developed close to two dozen new services and aid programs ranging from hot meal services to technology/computer support, delivery of food parcels, and online arts and cultural activities. Some of these programs received international recognition and are selected as “best practices” of pandemic response efforts by UNESCO (2020). The following sections will provide sufficient details describing the challenges the municipality faced during the pandemic and how certain catalytic institutions

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rose to these challenges by developing and delivering programs that served to protect (and possibly enhance) community well-being. Due to space limitations, I will focus on two major projects: Hot Meal Delivery (HMD) and Food Parcel Assistance (FPA). I will also describe other programs (such as Shelters for Women and Computer Supply for School Age Children), however briefly. The data presented in this chapter comes from the online face-to-face interviews with three key informants who are involved in the development and delivery of the social programs at MK.

25.3

Social Aid Programs to Maintain the Well-Being of Kadıköy Community

The COVID-19 pandemic has created several challenges for the MK community, and community leaders rose to meet these challenges by designing and delivering services to the community residents. As discussed in the previous sections, an unprecedented number of community residents lost income, and the vulnerable became more vulnerable. Moreover, the MK situation was exacerbated by macrolevel systemic problems at the national level. The following sections describe these challenges as well as the catalytic institutions that MK community leaders have used to overcome the challenges.

25.3.1 Challenges Faced During the Design and Implementation of Social Services The COVID-19 pandemic has created harsh community conditions and disrupted many public services. One major hurdle community leaders faced was the dire fact that they had to deal with this crisis without any clear road map. They have been forced to deal with the rapidly and ever-changing conditions, and they had to cope with the challenges along the way. As our informant stated: We are in the middle of an ocean without a compass or a route, but we have to sail this ship. If everyone stays calm, we can do it. We have a talented crew but no route or road map. So, we had to think short term and sail the boat to nearby shores. Normally, public services in the municipality are guided by a five-year strategic plan. As the crisis evolved, we had to make daily, even hourly decisions. Normally, we revise our public service plans every quarter, but now we had to make needed changes almost every day. And this has become a major challenge.

The main problem described above (i.e., the lack of a clear road map) has become an important threat to the continuity of delivering public services. Nevertheless, like in many countries, the public servants at MK have been quick to adapt and adjust the way in which services are delivered to minimize the negative impact of the

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pandemic. More specifically, when the provisioning of public services was severely disrupted, MK officials were able to place on hold many traditional services and manage the delivery of critical services through online platforms. That is, many traditional services that require face-to-face (in-person) interaction could not be made available. For example, public education and training services, including arts and crafts classes, are normally held indoors. These services had to be delivered remotely through online platforms. Some had to be delivered outdoors as much as possible. Education had to adapt to new conditions by using a new set of pedagogical approaches, technological resources, and infrastructure. Implementation of these new approaches to service provisioning heightened the demand for technological access and equipment for community residents. After all, the services could be made available only to the extent that the residents have the necessary digital/online skills and resources—computers, tablets, and Internet access. As such, MK has established a coalition with NGOs and local businesses to supply computer equipment and Internet access to residents who lack these resources. People found themselves in vulnerable positions in a noticeably short period. For relief efforts to be effective, the services had to be provided to the community residents sooner than in normal times. That is, the potential recipients of the services had to be identified quickly. Moreover, the procedures that had been used to identify the needy individuals and households had to be revised to allow some degree of flexibility to deliver those services. For example, during most of the COVID-19 period, unlike other times, “self-declaration” was considered sufficient to apply/ redeem social welfare services. This type of flexibility was required given the fact that many government offices were either closed or were open for limited hours with limited staffing. Relatedly, the collaboration between MK and NGOs (such as the occupational/professional chambers) helped identify and rank the needy small business owners (and their employees) quickly without requiring additional official documentation from the governmental agencies (the normal procedure during nonpandemic times). As noted earlier, one of the negative externalities of the COVID-19 has been the increased cases of domestic violence. Normally, certain legal and law enforcement procedures are in place for the battered person to start receiving shelter services. However, during the pandemic, the normal procedure had to be rescinded—no documentation was required for shelter services. Moreover, the normal procedure was to separate mothers from their over 12-year-old sons if the battered women were to stay in the shelter. To address this situation, new shelters became available to accept battered women with their over 12-year-old sons with the assistance of NGOs and local businesses. Furthermore, systemic vulnerabilities often create an environment that heighten consumer-citizens’ felt-deprivation (Blocker et al., 2013). Although the current pandemic has disrupted the functioning of markets and communities worldwide, our informants believe that many countries with a “social state mentality” have protected their citizens from the abject adversities of the pandemic. For example, as our informant indicated below, unlike countries such as Germany and the United Kingdom, consumer-citizens in Turkey (and in Istanbul–Kadıköy more specifically)

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have experienced greater deprivation due to lack of social state mentality that exacerbated the systemic vulnerabilities. What we have done for years in Turkey as a social welfare state? Every woman, child or disabled over the age 65 are financially protected through social security. Let’s say today I am fired, I lost my job, I shouldn’t be worried about making ends meet in my immediate future. The employment agents of state institutions, business coaches, and social service personnel should assist. They should ease my anxiety and help me find a job or education opportunities. Let’s take the system in Germany, for example. If a German says that I am unemployed, an employment coach is assigned to help; or for example a woman and child are left homeless, then they are placed in a home. I mean they have an established system to help those who are vulnerable. Indeed, during this (COVID) period, Europe faced challenges as well, but at least there was an effective social welfare system there. Given that we do not have a system, we tried to do it ad hoc. Of course, as a local government we do have a system; we even have a slogan: woman and children are first and foremost. We provide support for women and children with no discrimination. During the COVID, we initiated an economic program. We tried to reach everybody in the community. If the state (the central government) had pursued such a policy, we could have been in a much better situation. Small business owners were in big trouble too. They admit that their businesses have failed and cannot be recovered in one year. COVID will not be over in a year. But they are not helped by the state. Why? For example, in England, I know, we read from the media (and my relatives live there) that the English government has supported small business. My husband has many relatives in London, and they have restaurants. They said that the government supported them. Every month the government paid them between 3000 to 10000 pounds.

Another problem related to “planning” is the “lack of systematic preparation” for such events. Since Istanbul (along with most of Turkey) sits on major fault lines, the city has earthquake response and recovery systems. In contrast, the city does not have any plans to handle other types of disasters (including pandemics). Lack of preparation for a systematic response has created not only a sense of panic among the providers and recipients of public services, but also opportunities for unfair business practices that made vulnerable consumer-citizens even more vulnerable. I wish we had pandemic-response programs like we have for earthquakes. Currently, we have experts and logistics know-how to respond to an earthquake. Perhaps, a similar planning system could be developed for pandemic-related disasters. This is not the first time the world is experiencing a pandemic. So we could have been better prepared. We have experienced many small or big crises during the past few months that could have easily been prevented with better planning and preparation. The “mask crisis” is an example. People could not be provided with face masks. There were insufficient hand sanitizers and disinfectants. Black markets emerged. The disinfectant market grew exponentially with may unregulated producers with inferior products threating public health and safety. The prices increased 10 times. A simple mask was sold for 10 TL. People were affected by these developments very negatively. Why consumers could not acquire these basic products. In my opinion, this is a marketing problem. If the state (government) had the foresight, all these negative outcomes could have been prevented.

In addition, certain political, regulatory, and bureaucratic procedures became barriers to the design and delivery of social services during the pandemic. For example, as our informant explains, current regulations allow at most 10% of the total municipality budget to be allocated for social services. In other words, although the need for social services has increased tremendously during the pandemic,

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municipalities (i.e., the local administration) were not allowed to allocate more than 10% of their budget for such services. Political bickering and bureaucratic rules and regulations have prevented municipalities from allocating more resources for desperately needed social services.

25.3.2 Catalytic Institutions that Facilitated the Delivery of Social Services As noted at the end of the previous section, the current regulations have the potential to reduce the effectiveness of the social services provided by the municipality. There was a clear supply–demand imbalance: on the one hand, an increased number of community residents were experiencing financial distress, hence, were seeking assistance. On the other hand, the regulations provided little flexibility in budget allocations for desperately needed services. However, as predicted by Shultz et al. (2017), when “catalytic institutions” work together toward the same goal, the needed services can be made available to vulnerable community residents. More specifically, as will be detailed next, the municipality has collaborated with several NGOs and businesses to create programs to facilitate the delivery of existing aid services as well as design and implement new aid services. “Stay Safe” (“Sen Güvende Kal” in Turkish) is an NGO whose mission is to bring together chefs and their suppliers to provide daily warm meals to people in need (Gastronomi-Turkey, 2020). By cooperating with this NGO, MK has been able to provide meal services to thousands of people, including the families who worked in the informal sectors of the economy and lost income, and those elderly who failed to receive housekeeping or cooking services because of the quarantine. MK has become the centerpiece of this new service initiative [called Hot Meal Delivery (HMD)] and brought together gastronomy experts, dietitians, well-known chefs of Istanbul, and food suppliers (businesses) from across Turkey. The HMD initiative provided opportunities for the business owners to donate bulk amounts of food supplies knowing that their donations are being used for a good cause. The NGO provided the cooking (labor) and knowhow (e.g., nutritional information) services, as well as its own network of chefs and food suppliers around Istanbul. The municipality provided kitchens and a system for the distribution and delivery of meal packages. In addition, and very importantly, MK has brought to the table the trust needed for donors all around Turkey to donate food supplies. By establishing this network, the municipality has been able to offer HMD services with minimal resources. The close cooperation among the catalytic institutions (namely, MK, the NGO, and the business community) served to overcome the budget restrictions imposed by government regulations. Importantly, this cooperation helped to feed thousands of community residents amidst a deadly pandemic. Moreover, one of the most successful social aid initiatives during the pandemic has been the Emergency Food Parcel Assistance Program (FPA). In a noticeably

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short period of time, thousands of households residing in the Kadıköy Municipality districts have been supplied with parcels containing staple food items. Like the HMD initiative, the FPA program could not be effectively run without the collaboration of NGOs and the business community. For example, most grocery store chains have prepackaged the parcels for individuals to purchase on behalf of other community residents who need those groceries but cannot afford them. The stores priced the bundled parcels reasonably to encourage donor-citizens to purchase more parcels. After purchase, the supermarket stored the parcels until they were picked up by MK’s social workers and delivered to the needy. Given that the vehicles owned by the municipality were not sufficient to distribute the parcels, another business (a Rent-a-Car company) assisted in this effort for free. The NGOs contributed to this initiative by transferring the monetary donations to the municipality. The funds received from the NGOs were used to purchase and distribute more parcels to needy community residents. We have a very good example of solidarity. Kadıköy residents contributed more than hot meals and dry food. NGOs donated generously. Business people donated. Companies donated. Others include the . . .Group, foundations such as . . . Schools, and other NGOs located in this neighborhood (the actual names of the organizations have been concealed). The Kadıköy Municipality handled logistic because of the travel restrictions imposed by the curfew. Given that our employees are civil servants, they were allowed to travel during curfew hours. NGOs supported us through buying dry food and supply parcels. A rent-a-car firm provided us with vehicles for free. We distributed food using these vehicles. NGOs raised money for us.

Normally, like most new products, the parcel purchase/delivery services require time for publicity. However, certain macro/cultural factors facilitated the rapid diffusion of this new service. Traditionally, Turkish people help the needy people particularly during the period of the Holy Month, Ramadan. To facilitate giving to the needy, supermarket chains started to offer food parcels over the last two decades or so. These parcels are made available in the stores just before the month of Ramadan. When the pandemic started to adversely impact the financial well-being of the community residents (although it was not the Ramadan period), the food parcels reappeared in the stores. Given that both businesses and consumers were aware and accepting of this program, the parcels were quickly adopted, thus facilitating diffusion. We had very good cooperation. A lot of donations were made, approximately 6000. Normally, during the Ramadan dry food parcels are prepared. These parcels are labelled “Ramadan Parcel.” But during COVID all the supermarkets re-started parcels program. At . . . grocery, for instance (the actual name of the grocery was concealed), you place an order online for one parcel, and they prepare it. Food parcels were made available as if it was Ramadan. You may purchase them to donate to the one who is in need maybe to his home. What is inside the parcel? Basic food items necessary for one month’s consumption. After a while, groceries started to prepare reasonably priced dry food parcels because people demanded to help others. For instance, . . . (the grocery store management) told us that you bought the parcels, we could deliver to the one in need. This is not something they do normally but even the supermarkets were willing to do whatever they can to help people.

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These examples point out that certain macro-level structural (i.e., cultural) characteristics of the Turkish society may also account for the successful execution of aid services during the pandemic. As predicted by Shultz et al. (2017), macro factors facilitate quality of life (in distressed and flourishing communities) by bridging supply with demand via catalytic institutions. The COVID-19 pandemic resulted in changes in vulnerabilities. As one of our informants noted, compared to their neighbors, some people who live on the same street (and at times in different units of the same building) become more vulnerable. Elderly neighbors, for example, although they are financially stable, and even welloff, could not hire help for household chores (e.g., shopping, cooking, and cleaning). As a result, they have become “food-vulnerable.” The younger neighbors, although not needing assistance in doing household chores, may need financial assistance because of unemployment. Given the prolonged pandemic, these community residents have become dependent on staple food aid to feed their families. Before the pandemic, neither of these groups were considered “food-vulnerable,” but they have become so during the COVID-19. Those who have not been affected by the pandemic (i.e., those who continue earning a sufficient income and remain physically healthy) were motivated to help their neighbors. However, social workers in MK noticed backlash resulting from the publicity of the food program. As one of our informants noted, the recipients of the program did not want their neighbors to know that they are in need and did not feel comfortable when their identities were revealed. Similarly, the donor-neighbors did not want their identities revealed either. Consequently, the municipality established a “micro-level” indirect channel between the donors and recipients. Those who want to help their neighbors anonymously purchased food parcels from a nearby supermarket, the supermarket delivered the parcels to the storage unit of the municipality, and MK personnel delivered these parcels to the needy.

25.3.3 Positive Externalities Created As MK tried to meet the increased demand for social services, the cooperation between various catalytic institutions has resulted in positive externalities that generated additional future benefits for the community at large. One example of positive externality seems to be the strengthening of trust-based bonds among various constituencies: the public (i.e., citizens and NGOs), private (i.e., the business community), and governmental entities (i.e., MK). Another example of a positive externality is an extension of the first: trust-based commitments developed through the COVID relief programs provided opportunities for MK to offer new services to further elevate the well-being of the community at large. During the COVID-19 pandemic, MK has emerged as an entity entrusted by other local institutions and the public. For example, although NGOs had financial resources, they could not transfer their resources to other groups charged with program implementation. Similarly, businesses who were willing to donate

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operation capacity, inventory, or other resources could not do so because of the bad publicity NGOs have received nationally. There were highly publicized cases of fraud by well-known national aid organizations. As such, many donor businesses and individuals have been reluctant to make these donations for fear that the donations would not reach the people in need. In this context, MK has become an entrusted institution in Turkey that served as a conduit of resources. As one of our key informants notes, both institutions (e.g., NGOs and businesses) and individuals perceived the municipality as a trusted partner in the administration of various social programs. They trust us. For example, the elderly or people who needed caregiver support have turned to the municipality for assistance. Even if it is paid service, the elderly have turned to the municipality, because they trust us. Trust is a very important thing. I mean if you are business owner, you give us your goods for free. These goods are delivered to those who are in need. For instance, there was a poultry firm. They emailed me a saying that they will be very happy to send their donations to elderly people in need. Again, a cacao and coffee supplier of . . .and. . . (the actual names of the companies have been concealed) made a generous donation to us during the pandemic. They first tried to communicate with the Metropolitan Municipality of Istanbul but could not reach the right personnel. They turned to us. Our mayor asked me to meet with them. We met. They are a big company in fact, both locally and globally. They made a generous donation, and we put it to good use. We, of course, took those donations and established a system to deliver the donations to needy people. The donors told us that we run a very good operation. They felt they can trust us, and that they will cooperate with us from now on. They have supported other projects after the completion of the initial project. This period provided us with an opportunity to foster bonds with many constituencies. For instance, our mayor gave “thank you” certificates to donor residents. In addition, he dined with business owners who made donations. Doing so strengthened trust. For instance, a young entrepreneur who established a village cooperative to produce carcass meat reached to our chefs and asked how he could help. They said the project is affiliated with Kadıköy Municipality and directed him to us. This is good solidarity. Our being a state organization created trust. By the way, you know of many recent fraud cases. People and organizations collected donations and then disappeared or misused the money. We were always very open and transparent. We shared information through social media. We brought in mukhtars (neighborhood representatives). We described what we did through WhatsApp groups. Everything we have done was conducted in a transparent manner that strengthened trust.

As noted above, trust is imperative to effectively administer social aid programs. From the supply side of the economic equation, trust serves as the backbone of a healthy established marketing system involving government, NGOs, and business. From the demand side, trust is essential for vulnerable community residents to disclose their needs to social workers and receive aid services with no scorn and stigma. Trust-based transactions among the different entities involved in the marketing system result in deeper commitments and enhanced relationships (Layton, 2011). MK is a success story. The municipality was able to forge new partnerships, resulting in enhanced service delivery. In addition to the current services, new services were designed and implemented. Collaboration among the municipality, NGOs, and the business community resulted in increased assortments and choice,

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which in turn generated better living conditions for vulnerable community residents (Shultz et al., 2017). We now have many new projects, such as new housing and shelter opportunities for women. The Hot Meal program was an independent project, but during COVID it become a joint project involving many partners. We have new projects too. Some of our old projects that we ran independently have become joint projects (e.g., AÇEV). We still have our own projects, but we like to cooperate with other entities and not restrict ourselves. We have learned to work with other groups and found it more rewarding for all. In the first 6 months of 2021, we plan to administer online rather face-to-face services. This is a challenge for us. Because as I said before, we are an institution that deals with people. As such, communicating face-toface has been essential. A person comes first to the municipality when s/he has a problem. From paying his/her taxes to repairing her/his roof. However, many public services will now be performed virtually, and we will use our networking experiences we were able to establish during the COVID to do this.

25.4

Putting It All Together

The COVID-19 crisis has posed many challenges for communities worldwide. However, like other crises, it has also provided us a unique opportunity to observe markets and examine the obstacles and facilitators that played a significant role in community well-being amidst the pandemic. This chapter provided a detailed account of how a particular municipality (Municipality of Kadıköy-MK) in Istanbul–Turkey dealt with the challenges produced by the pandemic. The MK community managed marketing systems that designed, developed, and distributed an assortment of products and services to vulnerable community residents. As described in detail in the previous sections, MK managed to provide needed social services. MK officials managed three key catalytic institutions: government (MK), NGOs, and local and national business communities. These catalytic institutions have helped overcome obstacles at the national level—national government rules and regulations (see Fig. 25.1). The pandemic has created enormous economic and financial difficulties for communities and residents as businesses had to close, resulting in significant loss of jobs and income. Fundamental services (such as education) had to be delivered online. But deficiencies in information and communication technologies created conditions in which vulnerable people were made more vulnerable. In addition, certain political (e.g., the political conflict between the central government and municipalities) and legal (e.g., budget allocation restrictions imposed by law) conditions created obstacles for the development and delivery of services to community residents (the bottom part of the model shown in Fig. 25.1). However, MK officials managed to plan and implement marketing systems that overcame the many challenges caused by the pandemic. Moreover, factors such as the social/cultural capital, as well as income/wealth, location/access, and concerns on transparency and privacy (the right side of the model in Fig. 25.1), served as potential determinants that affect the demand for

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Fig. 25.1 Facilitation of community well-being in Kadıköy, Istanbul, in the presence of COVID-19. (Adopted from Shultz et al. (2017) “Towards a Systemic Framework to Facilitate QOL in Distressed and Flourishing Communities”)

social aid services developed by the catalytic institutions. As explained earlier, perhaps the most significant factor affecting increased demand for social aid during the COVID-19 is qualitative and quantitative changes in the domain of vulnerability.

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First, the severity of the vulnerability experienced by already vulnerable groups has increased. Second, community residents who were not vulnerable before the pandemic have now become vulnerable. Meeting this increased demand has required the development of new marketing systems. To this end, through the cooperation among MK, NGOs, and the business, assortment of choices increased and made available to the people in need in the Kadıköy District of Istanbul (the left part of the model in Fig. 25.1). The marketing systems organized by the catalytical institutions were instrumental in maintaining the well-being of the community residents. Community well-being is “the combination of social, economic, environmental, cultural, and political conditions identified by individuals and their communities as essential for them to flourish and fulfill their potential” (Wiseman & Brasher, 2008). The case study reported in this chapter points out the important pillars that play key roles in community wellbeing: equity, connectedness, and livability (the top part of the model in Fig. 25.1). Social justice, diversity, and the empowerment of individuals are characteristics of an equitable community. To achieve equity, the basic needs of the community members (including health services, food, shelter, and security) should be met (also see Sirgy, 2011, for the relationship between satisfying developmental needs of community residents and community well-being). As reported in this chapter, the marketing systems established by MK have contributed to equity in the face of the COVID-19 pandemic. The systems were designed in such a way to treat residents with fairness and justice. People who needed financial assistance were identified fairly and based on equity with the help of NGOs. To achieve fairness, more flexible procedures were implemented. Moreover, MK has been instrumental in maintaining (and even improving) the community well-being through “connectedness.” In any community, connectedness can be fostered through the social networks that motivate civic engagement, encourage, and empower its members to participate in community programs, provide social support, and enhance social trust. As discussed with examples in this chapter, the marketing systems initiated by MK have facilitated active engagement by the community members to provide social services to people in need, resulting in enhanced community well-being. The pandemic provided MK the impetus to develop new systems (i.e., developed other projects with catalytical institutions) to improve the “livability” of community residents through additional programs related to education, housing (shelter), public safety, and access to culture and the arts. One of these programs, “Distribution of Computers,” involved giving children laptops and tablets to ensure that every child can attend classes online. Other programs include “Distribution of Hygiene Packs” and “Disinfection of Public Buildings.” These programs were designed to ensure that public services can be offered in safe environments. The “Art at Park” and “Live Online Concerts” programs were designed to ensure that community residents can still enjoy theater and other art-related performances. To reiterate, these projects were designed to further improve the “livability” of residents in the Kadıköy community. They were designed and implemented in collaboration with catalytical

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institutions. Future studies should examine the well-being consequences of these projects using rigorous research methods.

25.5

Concluding Remarks and Lessons for Future Crises

The reality of COVID-19 is the fact that “the virus does not discriminate.” This virus has threatened all people regardless of their status in the society. The high number of infected cases and the deaths reported in the developed economies also support this reality. Nevertheless, as the pandemic prolongs, it has become clear that, although the virus does not discriminate, its impact on vulnerable people worsens the quality of life of these people. Therefore, developing relief programs to meet the basic needs of the vulnerable should be (and in many cases has become) the primary responsibility of all nations. Protecting the most vulnerable in a pandemic can be effective through the cooperation between public and private entities. When these entities bring together their resources synergistically, innovative projects and programs that meet the needs of the vulnerable can be developed, as demonstrated by the MK case study.

References Bianet. (2020, August 28). Turkish Medical Association requests a meeting with Health Minister— English (bianet.org). https://bianet.org/english/health/229818-turkish-medical-associationrequests-a-meeting-with-health-minister Blocker, C. P., Rut, J. A., Sridharan, S., Beckwith, C., Ekici, A., Goudie-Hutton, M., Rosa, J. A., Saatcioglu, B., Talukdar, D., Trujillo, C., & Varman, R. (2013). Understanding poverty and promoting poverty alleviation through transformative consumer research. Journal of Business Research, 66(8), 1195–1202. Bloomberg. (2020, March 27). TÜSİAD’dan Erdoğan’a mektup (theworldnews.net). https:// theworldnews.net/tr-news/tusiad-039-dan-erdogan-039-a-mektup Çakmaklı, C., Demiralp, S., Kalemli-Özcan, S., Yesiltas, S., & Yildirim, M. A. (2020). COVID-19 and emerging markets: An epidemiological model with international production networks and capital flows. No. w27191. National Bureau of Economic Research. Demiralp, S. (2020, May 26). The economic impact of COVID-19 on Turkey. Middle East Institute (mei.edu). https://www.mei.edu/publications/economic-impact-covid-19-turkey Füssel, H. (2007). Vulnerability: A generally applicable conceptual framework for climate change research. Global Environmental Change Part A: Human and Policy Dimensions, 17(2), 155–167. Gastronomi-Turkey. (2020, April 13). Şefler bu kez “Sen Güvende Kal” diye pişiriyor. Gastronomi Turkey by Rafine. Gastronomi Turkey. Gastronomi Haberleri. Gastronomi hakkında her şey. https://www.gastronomiturkey.com/haber/sefler-bu-kez-sen-guvende-kal-diye-pisiriyor-h1104 5 Hessler, U. (2020, August 17). Why the Turkish lira is in free fall. Business. Economy and finance news from a German perspective. DW. https://www.dw.com/en/erdogans-credit-binge-fuelslira-depreciation/a-54524078

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ILO. (2020, April 30). Informal economy: More than 60 per cent of the world’s employed population are in the informal economy (ilo.org). https://www.ilo.org/global/about-the-ilo/ newsroom/news/WCMS_627189/lang%2D%2Den/index.htm Layton, R. (2011). Towards a theory of marketing systems. European Journal of Marketing, 45(1/2), 259–276. Macdonald, B., & Hülür, G. (2020). Well-being and loneliness in Swiss older adults during the COVID-19 pandemic: The role of social relationship. The Gerontologist, 61(2), 240–250. Moody’s. (2020, March 26). Turkey’s economy most vulnerable in G20 to COVID-19, Moody’s says. Ahval. https://ahval.me/turkey-economy/turkeys-economy-most-vulnerable-g20-covid-1 9-moodys-says Park, A. J. (2020, May 6). Emerging markets suffer massive capital outflow amid COVID-19 (koreatimes.co.kr). https://koreatimes.co.kr/www/biz/2020/05/488_289082.html Shultz, C., Deshpandé, R., Cornwell, T. B., Ekici, A., Kothandaraman, P., Peterson, M., Shapiro, S., Talukdar, D., & Veeck, A. (2012). Marketing and public policy: Transformative research in developing markets. Journal of Public Policy and Marketing, 31(2), 178–184. Shultz, C., Rahtz, D., & Joseph Sirgy, M. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), The handbook of community well-being (pp. 403–422). Springer. Sirgy, M. J. (2011). Theoretical perspectives guiding QOL indicator projects. Social Indicators Research, 103, 1–22. UNESCO. (2020, May 15). “There is nothing like neighborhood”: Kadıköy Municipality’s support to the elderly in the face of the pandemic. https://en.unesco.org/news/there-nothingneighbourhood-kadikoy-municipalitys-support-elderly-face-pandemic United Nations-Turkey. (2020, April 2). The social and economic impacts and implications of COVID-19 are different for women and men! United Nations in Turkey. https://turkey.un.org/ en/39770-social-and-economic-impacts-and-implications-covid-19-are-different-womenand-men. Ünker, P., & Bellut, D. (2020, April 10). Domestic violence rises in Turkey during COVID-19 pandemic. Europe. News and current affairs from around the continent. DW. https://www.dw. com/en/domestic-violence-rises-in-turkey-during-covid-19-pandemic/a-53082333 UNPD-Turkey. (2020, June). Covid-19 resilience and response (undp.org). https://www.tr.undp. org/content/turkey/en/home/projects/COVID-19-response.html UN-Women. (2019). Progress of the world’s women. Digital library. UN Women—Headquarters. https://www.unwomen.org/en/digital-library/progress-of-the-worlds-women UN-Women. (2020, April 2). Press Release. The social and economic impacts and implications of COVID-19. UN Women—Europe and Central Asia. https://eca.unwomen.org/en/news/ stories/2020/4/press-release-the-social-and-economic-impacts-and-implications-of-covid-19 Wiseman, J., & Brasher, K. (2008). Community wellbeing in an unwell world: Trends, challenges, and possibilities. Journal of Public Health Policy, 29(3), 353–366. Wu, B. (2020). Social isolation and loneliness among older adults in the context of COVID-19: A global challenge. Global Health Research Policy, 5(27). https://doi.org/10.1186/s41256-02000154-3

Ahmet Ekici (Ph.D., University of Nebraska-Lincoln) is an Associate Professor of Marketing at Bilkent University, Ankara-Turkey. His main research areas are macromarketing (quality of life, consumer well-being, developing markets, poverty, and ethics); public policy and marketing ( food safety, sustainable consumption, institutional trust, vulnerable groups, and poverty); and relationship marketing (role of trust in both consumer and organizational settings.) His refereed articles have been published in a variety of journals including Journal of Macromarketing, Journal of Business Ethics, Industrial Marketing Management, Journal of Business Research, Journal of Public Policy and Marketing, Social Indicators Research, Applied Research in Quality of Life, and Journal of Consumer Affairs.

Chapter 26

A Solidarity–Care Ethics and Human Flourishing Approach to the COVID-19 Pandemic: A UK Perspective Haseeb A. Shabbir, Michael R. Hyman, and Alena Kostyk

Abstract The COVID-19 pandemic illustrates that standard assessments of human well-being fail in the face of substantial social disruptions. To overcome this problem, we focused on two human flourishing frameworks: the Shultz et al. (Handbook of community well-being research (pp. 403–421). Springer, 2017) macromarketing framework and the Shabbir et al. (Journal of Macromarketing, 41(2), 181–193, 2021) solidarity–care framework. As these frameworks share commensurable theoretical assumptions, we fused them. We then used the fused framework to evaluate how the United Kingdom’s COVID-19 responses affected community flourishing. Specifically, we examined the effect of two competing social forces—Brexit and the Black Lives Matter movement—on pulling Britons toward a flourishing or distressed community. Keywords U.K. pandemic response · Solidarity–care ethics · Human flourishing · Brexit · Black Lives Matter movement

26.1

Introduction

Amid the backdrop of the COVID-19 pandemic, human well-being has declined while economic and social inequality has increased (Keeley, 2015; Vanham & Harris, 2021). For example, many well-being indicators—such as indices of

H. A. Shabbir Department of Logistics, Marketing, Hospitality and Analytics, Huddersfield Business School, The University of Huddersfield, Huddersfield, England, UK e-mail: [email protected] M. R. Hyman (*) New Mexico State University, Las Cruces, NM, USA Institute for Marketing Futurology and Philosophy, Las Cruces, NM, USA A. Kostyk Adam Smith Business School, University of Glasgow, Glasgow, UK e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_26

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happiness and life satisfaction, mental and physical health, meaning and purpose, close social relations, and financial and material stability (Sirgy, 2012)—have declined markedly in the United States since the COVID-19 pandemic began (VanderWeele et al., 2021). Some marketers attribute this phenomenon to obscured or ignored structural socioeconomic inequalities revealed by an existential societal threat (e.g., Hyman et al., 2020). The nexus between social and economic needs within a COVID-19 context suggests many questions. Answering the question, “Do we just have to make a hellish trade-off between medical health and economic health?” (Friedman, 2020) means contrasting the “economy first” priority in countries such as the United States and the United Kingdom with the “health first” priority in countries such as New Zealand and South Korea, and re-evaluating the economic health versus disease-free population tradeoff (Latemore, 2020). Although the Global Health Security (GHS) Index ranked the United States and the United Kingdom as the best-prepared nations to cope with a pandemic, high COVID-19 fatality rates badly disrupted both societies (Abbey et al., 2020). In contrast, the GHS Index deemed most African nations the “least prepared” and many Asian countries “average prepared,” yet countries such as Malawi, Pakistan, and Vietnam were lauded for successful pandemic management. Although no common denominator thoroughly explains the lower COVID-19 incidence rates in some countries, an early lockdown with concomitant social restrictions, compliance with the World Health Organization’s (WHO) directives, and unified messages from governments, businesses, and NGOs, seemingly played an important role. For example, the WHO praised Pakistan for its national policymakers cooperating with WHO advisory teams from the pandemic’s onset (Junaidi, 2020). Vietnam was lauded for fostering a sense of national identity that encouraged its people’s antivirus behaviors (Ivic, 2020; Le, 2020; Tran, 2020). The African Center for Disease Control, an initiative created in conjunction with the African Union, has swiftly tackled pandemics at a continental level since 2015 (Aïdi, 2020). As early as January 2020, it asked member states for enhanced surveillance of Severe Acute Respiratory Infections (SARI) and vigilance in confronting pneumonia case clusters (Aïdi, 2020). These examples suggest that well-regarded global rankings like the GHS Index may fail to predict national pandemic responses and successes. To properly assess well-being and ensure the rights requisite to human flourishing, global social movements such as the Economy for the Common Good call for replacing Gross Domestic Product with Common Good Product, which prioritizes biodiversity while eliminating structural inequalities and climate change (Economy for the Common Good, 2021; Pogge, 1999). This high valuation of human flourishing encourages a constructive critique of the status quo and respect for cultural autonomy (Pogge, 1999). It roots human flourishing in universal health, productivity, respect, and freedom for all humans (Ruger, 2006, 2020; Sen 1999). Structural inequalities, which reflect “a cascade of iterative and cumulative processes. . . [characterized by] mutual interdependencies and shared vulnerabilities,” are anathema to such flourishing (Ruger, 2020, p. 47).

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Melding the macromarketing model of human flourishing in Shultz et al. (2017) (henceforth SRS) with the solidarity–care ethics framework in Shabbir et al. (2021) (henceforth SHK) can provide a new perspective for assessing how the COVID-19 pandemic affected human flourishing. Two features of UK society at the pandemic’s onset—Brexit and the Black Lives Matter (BLM) movement—suggest that the United Kingdom provides an excellent test bed for assessing this fused perspective’s value. This chapter proceeds as follows. After discussing the theoretical lens for this project, we present the fused SRS–SHK framework. Then, we illustrate the value of this new framework for modeling human flourishing within the United Kingdom’s COVID-19 response.

26.2

Introduction to SRS and SHK

26.2.1 Overview of the SRS Model In SRS, a flourishing community is characterized by “shared values, cooperating to ensure clear evidence of positive physical, economic, environmental, and social well-being, which empower constituent members in their efforts to affect further prosocial outcomes for stakeholders of the community” (p. 403). Solidarity, which is crucial to such communities, focuses on governments, businesses, NGOs, and citizen-stakeholders as catalysts to nudge the sociocultural ecosystem in an adaptive direction (SRS). Central to SRS’s argument is the centrality of a market-based system “that delivers appropriate goods and services valued and demanded by the community” (p. 34) and ensures the flourishing of consumer-citizens based on the catalysis required for antidisruption resilience. When product assortment, availability, and quality are high, catalytic institutions can help market-based systems create community well-being. SRS’s framework focuses on the dynamic institutional interplay that strengthens the market and societal forces needed for human flourishing during an existential disruption. This nexus intersects with consumer-citizenship behaviors and macro-factors that influence flourishing (Fig. 26.1).

26.2.2 Overview of the SHK Framework The solidarity–care ethics continua in SHK assumes three intensity levels—caring about and solidarity for, caring for and solidarity with, and care giving and solidarity with the “other”—as successive levels concomitant with human flourishing. A flourishing approach’s viability during a disruptive pandemic depends on society’s ability to operate along solidarity–care ethics axes (Hyman et al., 2020; SHK). SHK stresses the solidarity–care ethics synergies across micro-, meso-, and macro levels

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Fig. 26.1 SRS’s framework to facilitate QOL in distressed and flourishing communities. (Source: Shultz et al., 2017, p. 412)

Macro Factors Geo/Environment Population Political/Legal Economic Social/Cultural Education Administration Infrastructure Technology

Goods/Services Assortment Amount Quality Choice

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that encapsulate the consumer citizenship, catalytic institutions, and macroenvironmental factors needed for human flourishing. SHK recognizes the effect of two competing worldviews, national identification versus collective narcissism, on COVID-19 policy compliance (Van Bavel et al., 2020). Although national identification effects are substantial, collective narcissism has a lesser but meaningful effect (Federico et al., 2020; Van Bavel et al., 2020). An ascending solidarity– care ethics nexus entails resilience and human flourishing, and a descending nexus entails vulnerability and a distressed community (Fig. 26.2).

26.2.3 How SRS and SHK Are Similar Table 26.1 summarizes the similarities and differences between SRS and SHK. Both frameworks assume the temporal and transitory nature of human flourishing, which SHK attributes to the “ecology model’s often-overlooked chrono dimension that considers past strategies and their effect” (p. 188). SRS and SHK contend community well-being is dynamic, with nonlinear progression and regression, and values and cultural norms affect the ability to assess flourishing (SRS, p. 407; SHK, p. 188). Both SRS and SHK posit that personal well-being should be conceptualized in a community well-being context as personal flourishing coincides with community flourishing. Although SRS grounds this conceptualization in positive psychology that highlights the importance of people’s interrelationships (p. 406), and SHK grounds it in care ethics (p. 182), both frameworks share a “human flourishing” focus. Accordingly, SRS and SHK acknowledge that shared values and cooperation are critical to a community’s flourishing (SRS p. 407; SHK p. 183). Both frameworks assume that communities and their members exist within systems comprising extensively and continuously interacting subdomains and events, with actions within one subdomain potentially affecting other subdomains. Underpinning SRS and SHK is the need to evaluate multiple layers of influence and their intersection between community subsystems (SRS p. 409; SHK p. 184). Furthermore, a community’s social, cultural, and political structure co-determines its ability to diminish or flourish during existential disruptions like a pandemic. Hence, government, business, and NGO rhetoric can shape flourishing during crises.

26.2.4 How SRS and SHK Differ To properly meld two theoretical perspectives, scholars must ensure that unlike underpinnings do not create an internal contradiction (Skipper & Hyman, 1987). Fortunately, SRS and SHK seemingly rely on different but compatible underlying assumptions. Table 26.1 shows nonuniform theoretical grounding, focus, number of continua modeled, crisis mitigating or exacerbating influences, and change agents. SRS

Fig. 26.2 Solidarity–care ethics nexus from SHK. (Source: Shabbir et al., 2021, p. 184)

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Table 26.1 Assumptions of SRS and SHK frameworks Assumptions Similarities People and their community flourish concomitantly Flourishing in communities is temporal and transitory Shared values and cooperation are vital to a community’s flourishing Relationships with others are critical to personal well-being Values and cultural norms affect flourishing assessments Community well-being is dynamic, with nonlinear progression and regression A community’s social, cultural, and political structure co-determines its ability to diminish or flourish during an existential disruption A hierarchical relationship exists between features that distinguish distressed from flourishing communities Communities and their members exist within systems comprised extensively and continuously interacting subdomains and events, with actions within one subdomain possibly affecting other subdomains Government, business, and NGO rhetoric can shape flourishing during crises Community-based agents can devise programs and policies that influence various internal and external factors related to flourishing Differences Derived from positive psychology and Maslow’s needs hierarchy Derived from phronetic polysemic marketing and care ethics Grounded in the logic of connecting persons to their community Grounded in an ecology model with micro, meso, and macro levels Focus on market systems Focus on the role of inclusivity and addressing structural inequalities Community well-being exists on a continuum from more distressed to more flourishing Community well-being relative to juxtaposed solidarity and care continua Consumer-citizens and market-based interactions between companies and consumers are catalysts for human flourishing during crises The polysemous nature of crisis sociopsychology influences the direction, structure, and ensuing equilibrium from crisis-induced disruptions Catalytic institutions (i.e., government, businesses, NGOs, and citizenstakeholders) are change agents Social marketers and public policymakers are change agents

SRS

SHK

X X X X X X X

X X X X X X X

X

X

X

X

X X

X X

X X X X X X X X X X X X

contends that community well-being exists along a distressed-to-flourishing continuum. Drawing from Maslow’s need hierarchy theory, SRS assumes a hierarchical relationship across community flourishing levels, with satisfying lower-level needs (e.g., low pollution, disease, and crime incidence) prerequisite to satisfying higherlevel needs (e.g., high work productivity, income, and educational attainment) (SRS, pp. 404–405). In contrast, SHK derives from phronetic polysemic marketing (which requires transparency and inclusivity), conceptualizes community well-being relative to juxtaposed solidarity and care continua, and assumes a hierarchical relationship across solidarity and care levels, with higher-level community well-being (e.g.,

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attentive commitment to the “other”) prerequisite to lower-level well-being (e.g., attentive companionship with the “other”) (SHK p. 184). Whereas SRS’s framework is compatible with the community vulnerability factors presented in Füssel (2007), SHK is grounded in an ecology model (Bronfenbrenner, 1979). Füssel (2007) posits a 2  2 matrix of internal socioeconomic factors (e.g., household income, social networks), internal biophysical factors (e.g., topography, landcover), external socioeconomic factors (e.g., national policies, economic globalization), and external biophysical factors (e.g., severe storms, earthquakes). The COVID-19 pandemic crossed all cells, emanating from an external biophysical source, requiring management at the external socioeconomic level with national pandemic governance policies, and influencing internal socioeconomic and external biophysical factors. In contrast, the ecology model relies on personal (micro), sector or organizational (meso), and worldview (macro) levels to map interventions designed for prosocial change. The ecology model’s micro and meso levels are akin to Fussel’s internal factors, and its macro level is akin to Fussel’s macroenvironmental stressors (Füssel, 2007). SRS stresses the consumer-citizen and market-based interaction between firms and consumers as catalysts for human flourishing during crises. For SRS, market systems operate as “an adaptive network(s) or a matrix of individuals, groups or entities” (p. 28), which depend on society’s “temporal sensibilities and institutional anxieties” (Watts, 1999, p.10) or the nexus of personal somatic pain to state polity and its representational global pain (Aaltola, 2012). SRS notes that a community’s social, cultural, and political structure co-determines society’s ability to diminish or flourish during an existential disruption. In contrast, for SHK the polysemous nature of crisis sociopsychology influences the direction, structure, and ensuing equilibrium from crisis-induced disruptions (see Hyman et al., 2020). Unlike SRS’s focus on marketing systems, SHK highlights social inclusivity and structural inequalities as traditional marketing systems failed many marginalized communities during the COVID-19 crisis (SHK p. 181). SRS and SHK indicate that community-based agents can devise programs and policies that influence internal and external factors related to flourishing. However, SRS assumes this agency for catalytic institutions (i.e., government, businesses, NGOs, and citizen-stakeholders) (p. 413), and SHK assumes this agency for social marketers and public policymakers (p. 181). Although additional scrutiny is warranted, these differences seemingly introduce no incommensurate assumptions. Thus, an SRS–SHK fusion incorporating catalytic institutions and their effect on moderating solidarity–care ethics trajectories, either by decreasing community vulnerability or increasing community resilience, seems viable.

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Fig. 26.3 Fused SRS–SHK framework

26.2.5 The Fused SRS–SHK Framework Figure 26.3 depicts the fused SRS–SHK framework, which includes a two-way interaction between consumer-citizen communities and catalytic institutions. This interaction can shift along the collective narcissism (characterized by actions, policies, and messaging that reduces solidarity and care) versus national identification (characterized by actions, policies, and unifying inclusivity messaging that boosts solidarity and care) axis. This new framework captures the dynamics of community well-being as either descending from or ascending toward human flourishing. The framework also incorporates the continuous two-way interaction between community and macro-factors (as described in SRS). We now illustrate this fused framework’s value within the context of the United Kingdom’s response to the COVID-19 pandemic. This crisis represents a disruptive event that affected Britons’ well-being substantially, with catalytic institutions implementing various policies and programs meant to decrease community vulnerability and increase community resilience.

26.3

The UK Context

What makes the UK context especially valuable for investigating solidarity–care ethics practices is the duality of two macro-level social forces at the pandemic’s beginning: Brexit and the BLM movement. Although collective narcissist appeals that played to antimigrant and refugee sentiments fomented Brexit, the BLM

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movement’s effort to dismantle structural and systemic inequalities celebrated diversity, equity, and inclusion, thereby embracing a core tenet of national identification: the welfare of minority in-groups. Thus, the United Kingdom provides a unique backdrop for how identity politics can exacerbate social disruptions and discontinuities caused by a public health crisis. The COVID-19 pandemic’s onset coincided with a symbolically existential social change: Brexit. Despite a successful referendum in June 2016, Britons continued to debate incessantly about whether to remain in or vacate the European Union (EU). As a result, the pandemic began before the United Kingdom finalized its EU exit strategy. Although many experts warned Brexit would bewilder and disrupt UK businesses, consumer markets reacted positively to Brexit (The Economist, 2020). In early 2020, consumer confidence and well-being analysts claimed that “Brexit’s delivery” mitigated looming uncertainty (Mintel, 2020a). With consumer confidence indices at record high levels due to high employment, above-inflation wage rises, and improving opportunities for young workers, many Britons planned lavish summer vacations (Mintel, 2020a). Brexit was a milestone for UK consumer markets (Mintel, 2020a). However, believing objectively considered evidence rather than irrational cultural and xenophobic sentiments instigated it is a “positivist illusion” (Dunin-Wasowicz, 2017; Miller et al., 2016). Symbolic messaging and the public’s emotions are vital to coping with pandemic-related social disruptions and discontinuities (Hyman et al., 2020). Highly inclusive, polysemic messaging from public policymakers can spur transcendental collective momentum for securing the public cooperation needed to mitigate a pandemic’s negative consequences. Unifying collective well-being-centered appeals, rather than individualistic appeals, can succeed (SHK). By reflecting an internal (i.e., Remainers versus Leavers) versus external (i.e., the European macro-community) split, Brexit is unification’s converse. Polysemic messaging focused on collective responsibility and intra-community relationships starkly contrasts Brexit’s symbolic meaning. Regardless, the divisiveness of UK society created a wasteland for the solidarity-centric messaging needed to tackle pandemic-induced disruptions (SHK). The BLM movement created an opportunity to transcend Brexit’s underlying xenophobic tropes and embrace national identification. It reflected introspection across internal and external socioeconomic levels within internal biophysical sources linked to health disparities among marginalized (e.g., Black, Asian, and minority ethnic; aka BAME) communities (Füssel, 2007). The ecology model also calls for introspection about antiracial attitudes, meso or sector-wide support for black causes, and a more expansive historical sociocultural worldview related to the structural inequalities legacies of postcolonial Western societies. It elicits a sense of national identity that recognizes the value and dignity of in-groups within the wider in-group, thus directly challenging Brexit-related rhetoric as national or collective narcissism denigrating immigrants, asylum seekers, and refugees.

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The United Kingdom’s COVID Response

Brexit and the BLM movement challenge UK society’s response to a collective threat like the COVID-19 pandemic and have implications for the solidarity–care ethics nexus. Catalytic institutions such as government, businesses, and NGOs helped shape the UK marketplace during the pandemic (SRS). However, critics derided the United Kingdom’s COVID-19 response for confused messaging, delayed actions, and exacerbated structural inequalities (Balmford et al., 2020; Hyman et al., 2020; SHK; Wardman, 2020). Unlike Brazil, Russia, and the United States, and in contrast to Pakistan, South Korea, New Zealand, and Vietnam, the United Kingdom’s response risked normalizing necropolitical practices (i.e., use of social and political power to dictate how some people may live and how other people must die) or relegating subpopulations to a nonflourishing existence (Mbembé & Meintjes, 2003, Mbembé & Corcoran, 2019; SHK). The UK context circumscribes the ideological parameters of a catalytic institutional arrangement (SRS). These institutions exhibited behaviors across the solidarity–care ethics continua, with different behaviors characterized as enhancing or detracting from intra-community solidarity and care (SHK). Sustained flourishing and high quality of life depend on the intra-communal support that ensures positive outcomes for the greatest number of community members (Hyman & Kostyk, 2019; SHK; SRS). Like the catalytic institutions, and per the consumer demand component of SRS’s framework, UK consumers behaved positively and negatively along the solidarity–care ethics continua. However, consumers and catalytic institutions progressed indirectly across SHK’s solidarity–care ethics levels. Instead, as outlined by SHK, frequent setbacks followed by recoveries reflected continual adjustment and movement between levels in an overall negative direction. Table 26.2 summarizes some exemplar practices of catalytic institutions and consumers in the United Kingdom during the COVID-19 pandemic.

26.4.1 Solidarity–Care Ethics Level 1: Solidarity for and Caring About the “Other” At this level, solidarity manifests as advocacy and caring about the other and pledging to repair the other’s world. Unfortunately, UK policymakers delayed implementing the COVID-19 lockdown and compliance interventions advocated by the World Health Organization during the pandemic’s initial and perhaps most critical stage. The mantra “We’re following the science” and arguments based on the scientifically dubious notion of “behavioral fatigue” became common justifications for avoiding the unpleasant behavioral changes needed to contain COVID-19 (Mahase, 2020). Instead, UK politicians and health-care administrators embraced a radical policy meant to create herd immunity by encouraging the controlled spread of COVID-19 among low-risk persons (i.e., younger people with no comorbidities

Govt ( )

Govt (+)

Solidarity-care level 1: repairing others’ world Solidarity for: 1. Misguided 1. Reassured advocacy high-risk business “herd immucommunity nity” proposal about early as a solution, relief packbreaching ages guidance 2. Early from WHO commitment 2. THRCC to vaccine suspended research 6 months before the outbreak 3. Leadership apathy/ confusion about COVID-19 compliance Caring about: 1. Reliance on 1. Honeyattentive reha“war” metamoon periods bilitation with phors adds to for loans, the “other” misguided mortgages, collective rents, etc. narcissism 2. Scotland: sentiments willingness 2. Competito support tive media postreporting with COVID-19 EU–Brexit

Solidarity-care level Digital transformation contingency readiness

1. Workers reassured; flexible workingfrom-home planning 2. Willingness to support post-COVID19 flexible working hours

Reactive furloughing polysemic silence of tiered packages, e.g., consultants, artists, etc., excluded

Business (+)

Polysemic compliance with Brexit despite collaborative COVID-19 projects with the EU

Business ( )

Lack of social marketing around roots of or structural inequalities of beneficiaries

Polysemic silence on state cuts to civic sector

NGOs ( )

Digitalization and virtual fundraising transformation

Communicated impact to beneficiaries

NGOs (+)

Consumer noncompliance with social distancing measures

COVID-19 denying, antilockdown protests

Consumers ( )

Table 26.2 Role of catalytic institutions across solidarity-care levels during the United Kingdom’s COVID-19 response

Consumer trend of “localism”-intention/ behavior to support local businesses

Social media sharing of calls supporting local businesses

Consumers (+)

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Caring for: attentive companionship with the “other”

1. Poorly coordinated PPE procurement 2. Rejection of structural racial causes of BAMECOVID-19 incidences

1. NHS clap momentum building 2. Nation’s healthfocused messaging, supporting and reopening wellness and sport centers Polysemic solidarity with Brexit, resulting in poorer knowledge exchange

effect inter4-day work ference on week cross COVID-19 casualties 3. Two-tiered welfare system for relief packages Solidarity-care level 2: promise, presence, and assurance Solidarity with: Dominic Inability to 1. Humanizhumanizing Cummings collectivity ing NHS as dehumanized solidarity position Britthe British ish business as anchor public global vis-a2. Queen’s vis reflecting solidarity its diversity message and externally as language sector identity 1. Digitalization leading to greater creativity and innovation for sustained performance 2. Increased stakeholder re-orientation and collaborative networks 3. Travel

1. Recognizing the role of empathy and kindness in workplace well-being2. Morrison’s Quiet Hour

1. Continual reliance on donor-centricity 2. Overreliance on appeal and utility-based modes of fundraising Poor auditing of COVID19’s impact on beneficiaries Social solidarity networks and grassroots community centricity; greater interest in the societal mode

Portraying beneficiaries and fundraisers as heroes

Stocking up on groceries

A Solidarity–Care Ethics and Human Flourishing Approach to the COVID-19. . . (continued)

Supporting NHS workers via food delivery platforms (e.g., “Buy a lunch for an NHS worker”)

26 561

Govt ( )

Govt (+)

Caregiving: attentive commitment with the “other”

Stopped mass community testing on March 12

1. Job retention scheme 2. NHS volunteer scheme for Astra-Zeneca as “people’s vaccine” 3. “Eat Out to Help Out” financial support scheme

Solidarity-care level 3: duty of care Solidarity as: Slow “lock1. Vaccine prioritization protecting down” delayed until for most vulnerable March 23 2. Calls for “Shop Out to Help Out” campaign

Solidarity-care level

Table 26.2 (continued)

Silence/tokenism on structural inequalities facing minority workers

Polysemic silence on child wellbeing issues as failure to recognize longterm selfsufficiency

Business ( )

Sector reports on structural DEI inequalities

Brands reoriented toward social innovation/ causes

companies continue to promote reassurance messages (allow cancellation/ changes for any reason)

Business (+)

Failed to collaborate on challenging systemic structural inequalities in education/ social marketing Failed to raise the plight of BAMECOVID-19 casualties

NGOs ( )

Democratization of social impact knowledge

Greater democratization of knowledge dissemination, e.g., Charitysowhite

NGOs (+)

Consumers ( )

1. Eat Out to Help Out “movement” 2. Staycations trend

Proactive environmentally friendly habits induced by the pandemic

Consumers (+)

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like heart disease or diabetes) continuing to lead their “normal life.” Spurred by the Great Barrington Declaration signed by 65,000 people globally, including leading UK scientists, achieving herd immunity became a popular goal in Sweden, the Netherlands, Brazil, and India. However, trying to establish pre-vaccine herd immunity to COVID-19 would cause many preventable deaths in the United Kingdom; assuming a 75% infection rate and a 1% fatality rate, roughly 500,000 Britons would die from COVID-19. Confronted with these grim statistics, Britons widely condemned this public health strategy, which has since been linked to eugenics (e.g., Jones & Helmreich, 2020; Laterza & Romer, 2020). Herd immunity was widespread for managing epidemics in the 1930s, an era Alison Bashford refers to as the “eugenics half-century” of Western public health management (Bashford & Levine, 2010). Solidarity–care ethics level 1 suggests that public policymakers should actualize public protection during a pandemic by promulgating messages from credible sources like the World Health Organization. A commitment to credible sources should induce an adaptive solidarity–care ethics trajectory. Solidarity–care ethics level 1 was evident in UK policymakers’ assurances to the business community about preliminary relief packages and job retention schemes, honeymoon periods for loan repayments by consumers and businesses, and other interventions. During the pandemic’s early stages, many major consumer goods producers relied on unifying themes in their marketing communications, such as “We’re all in this together.” Although such messaging superficially appears unifying, it could have the unintended negative consequence of “obscuring the extreme forms of inequality which are exacerbated in the crisis” (Sobande, 2020, p. 1034). By commodifying “we” and thus solidarity and care ethics in the United Kingdom , “we” can become “nefariously weaponised by brands with an interest in painting a picture of places, and even the world, as being free from discrimination and differences between people, in order for them to target a broader market demographic than usual” (Sobande, 2020, p. 1036). Although capitalism and consumer culture can provide insights into COVID-19related corporate communications, solidarity and care ethics pertain to the United Kingdom’s tightening embrace of the NHS. As the UK government finalized its lockdown, it tried to persuade the public to protect the National Health Service (NHS) with its “Stay home, protect the NHS, save lives” slogan. This polysemous framing has the earmarks of a prototypical solidarity–care ethics message (Hyman et al., 2020; SHK). By melding self-identity with national identity, protecting the NHS traversed all layers of the solidarity–care ethics nexus. Businesses applauded grassroots and community initiatives to provide relief or reduce the NHS’s burden. Seemingly, the United Kingdom had acquired a collectivist spirit, with socialpreneurship increasingly embraced by organizations wanting “to do their part” and momentum building toward advancing the solidarity–care ethics trajectory. Although health and NHS-related charities benefitted from record donations, state funding increases did not cover COVID-19-induced public needs. In response to a civil sector request for an additional £4.3 billion to stave off a heightened demand for social services, the UK government announced a relief package of only £750

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million. Sadly, the civil sector was tardy and muted in advocating for its beneficiaries. The CharitySoWhite movement reminded civil servants that “silence is not an option” (CharitySoWhite, 2020). Despite a focus on relieving immediate financial damage to the less fortunate— relying, for example, on innovative online fundraising—efforts to raise awareness about long-term damage resulting from the government’s skimpy relief package were inadequate. Amid this polysemous silence from the civil sector, grassroots movements stressed the disproportionate incidence of COVID-19 within a BAME community characterized by essential workers and overcrowded living conditions. Against the backdrop of the BLM movement, nonprofit organizations recognized the need to shift from utility and appeal-based approaches to more society-oriented approaches.

26.4.2 Solidarity–Care Level 2: Solidarity with and Caring for “the Other” At this level, solidarity and care for the “other” manifest as humanizing others, promises, assurances, and presence. In the United Kingdom, an excellent example is Queen Elizabeth’s national address on COVID-19. Unlike the UK government, Queen Elizabeth counseled Britons about the need for “coming together to help others” (solidarity) and humanizing communities (care) with the reminder that “we will be with our friends again; we will be with our families again; we will meet again” (BBC News, 2020). The Queen further reified her nation’s mood by celebrating NHS workers’ efforts, complementing the government’s pro-NHS campaign. The Queen’s message of solidarity and care—only the fourth time she had addressed the nation (excluding her annual Christmas addresses)—was momentous, and her use of “we will meet again,” which played on the popular World War II anthem, was a masterstroke (Hazell & Morris, 2020). Unlike her government’s misuse of war rhetoric to frame its COVID-19 policy, the Queen’s message drew on public memory by emphasizing the situation’s direness while avoiding populist and lazy wartime rhetoric (Benziman, 2020). The heritage afforded to Britons by their monarchs provides a betwixt fusion of change and continuity, that is., an “omnipresence of time” (Balmer, 2011, p. 1390). Pandemic imagination comprises a “configuration of temporal sensibilities and institutional anxieties” (Watts, 1999, p. 10). To overcome these anxieties, the convergence of the past, present, and future—a Kairos moment—renewed or transformed a pandemic-weary public (Gomel, 2000; Kermode, 2000). This Kairos moment, which humanized the NHS, came from the Queen’s speech. Unfortunately, a reversal ensued shortly after with the Cummingsgate scandal, which thwarted Britons’ acceptance of their government’s COVID-19 policies (Wardman, 2020). UK government leaders’ hypocritical defense of an official who breached the COVID-19 lockdown policy violated procedural justice and led many

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Britons to believe “special people could ignore the rules everyone else must obey” (SHK). Rather than sustaining the Queen’s Kairos moment, public trust in the government declined precipitously. An exercise in national identification soon morphed into collective narcissism. What previously had bound people of all political stripes soon mimicked the divisionary identity politics prevalent in the United States. During this period, businesses impeded these political shenanigans. Once initial COVID-19-related relief packages ameliorated their economic concerns, businesspeople entered the solidarity–care ethics nexus’s second level, with greater awareness of staff well-being and calls for empathy- and kindness-based policies. For example, the Morrisons supermarket chain advocated for autism awareness; specifically, it instituted “quiet hours” to help sensitive customers avoid post-lockdown crowds (Pengelly, 2020). At this level, attentive companionship is a way to care for the “other.” Hence, UK businesses shifted to more attentive care during the COVID19 pandemic through stakeholder reorientation and collaborative networks. Consumers also exhibited care for local communities through their intentions and behavior to assist local businesses’ post-COVID-19 recovery. In June 2020, almost one-third of UK adults reported shopping more locally since the pandemic’s start (Mintel, 2020c). However, some UK consumers and catalytic institutions failed to develop such companionship and exhibited behaviors incompatible with caring for the “other.” For example, hoarding food during the pandemic is contrary to community-focused thinking, yet one in five Britons was still stockpiling groceries in early 2021 (Duckett, 2021). Because Cummings was the chief architect of the UK government’s Brexit campaign, his resistance to taking responsibility for breaching the lockdown rules may have increased Brexit’s salience to British businesses and many Britons, especially “community leavers.” Although the Queen crystalized national identification for all, Cummings reminded Britons of Brexit’s isolationism fueled by collective narcissism and manifested as populism (Blyth, 2016). Collective narcissism correlates strongly with a politically conservative sentiment, and its activation may have induced a “white silence” toward black suffering in the wake of the BLM movement and the BAME community’s disproportionate COVID-19-related suffering. Although innovative and creative in its fundraising practices, civil servants remained silent about the United Kingdom’s commitment to auditing structural and systematic inequities facing BAME beneficiaries. Thus, they continued to favor a culture of false generosity, which orientates charity and fundraising toward fixing social symptoms rather than social problems (SHK). Exposing structural and systemic problems would confront the United Kingdom’s colonial heritage, and the polysemic nature of pandemic sociopsychology can make civil or helping agencies prone to ethical failings during health-care crises (Aaltola, 2012; Motta, 2004).

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26.4.3 Solidarity–Care Level 3: Solidarity as and Caring as Giving for the “Other” At this level, solidarity and care for “others” manifest as protection, changed personal habits, and revised business practices. For example, British consumers reported that environmental protection and proactive environmentally friendly habits had become higher priorities since the pandemic’s beginning (Mintel, 2020c). This reprioritization represents a shift toward the “duty to care” for planetary health, reflecting ascension toward a flourishing community (SHK). Regarding personal habits, the UK government’s “Eat Out To Help Out” campaign represented shopping and dining out as a duty to support the local economy and community. Consumers’ focus on staycations during the holiday season reflects a similar duty-to-care sentiment about local tourism (Mintel, 2020b). These changes in the interaction between consumer-citizens and businesses as catalytic institutions suggest increases along the solidarity–care ethics continua (SHK). Per the fused SRS–SHK framework, these care and solidarity increases bolster community resilience by strengthening relationship ties and improving local economic outcomes. Examples of revised business practices include charities and retailers auditing their practices for decolonization, such as the National Trust or the #standagainstracism campaign organized by British retailers (Channel 4, 2020). Several leading brands reoperationalized their depiction of minorities using Kantor and the Unstereotype Alliance’s progressive imagery metric (Barker, 2020). Many businesses adopted more substantial community-centric support for local causes affected by COVID-19 (Cipriani, 2020). These positive responses notwithstanding, many consumers and catalytic institutions failed to acknowledge their duty to care for others. For example, some UK businesses failed to actualize their public relations pronouncements about supporting the BLM movement; rather than auditing their operations for systemic racism, they capitalized on anti-racism as “woke washing” and continued ignoring salary inequities based on gender and ethnic minority status (Vredenburg et al., 2020). Despite contrary industry-level reports highlighting rampant institutional racism (e.g., the Equality and Human Rights Commission report on racism in higher education), the UK government’s recent Sewell report concluded that the United Kingdom is free of institutional racism (Chakrabortty, 2021; Commission on Race and Ethnic Disparity, 2021). This conclusion likely buttressed organizational and industry practices that neglected, delayed, or obfuscated the severity of the solidarity and care needed for the most vulnerable and marginalized communities affected by the COVID-19 pandemic.

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Discussion

This chapter describes a fusion of the SRS and SHK frameworks. A practice-based perspective on SHK’s solidarity–care ethics continua shows that SHK complements SRS’s seminal work. Interactions between ecosystem members often embody routinized behaviors (Reckwitz, 2002). Practice theory deals with the dynamic unfolding of such behaviors and focuses on the context in which they occur (Feldman & Worline, 2016; Schatzki, 2002). If practices develop along a trajectory and operate as organized nexuses (Schatzki, 2002; Schau et al., 2009), micro–macro levels can fuse into an organized co-dependent entity. For example, communal practices like wearing face masks can create co-constructed value, and panic buying represents routinized behavior that can co-construct or deconstruct value (Echeverri & Skålén, 2011). The solidarity–care ethics nexus is a practice-based approach that is more “concerned with diachronic (streaming over time) social practices than with synchronic (snapshot in time) individual acts” (Jennings, 2018, p. 554). SRS’s and SHK’s focus on vulnerable consumers and the deconstruction of care ethics suggest that identifying the facilitating and hindering solidarity–care ethics practices in pandemic management is warranted (Hyman et al., 2020; Parsons et al., 2021). “The link between values, practices and the process of value co-creation is of interest to TSR [Transformative Service Research] as a whole but particularly relevant in the case of vulnerable users who may be excluded from the mainstream marketplace due to poverty, ill health, or other factors” (Parsons et al., 2021, p. 795). We restricted our analysis to the United Kingdom and specifically to SRS’s catalytic institutions, which require a viable market system for flourishing to manifest. Given their polysemous and systemic nature, we identified and aligned specific practices of each catalytic institution with the solidarity–care ethics nexus presented in SHK. Although SHK identified practices, it focused on global adaptive and maladaptive practices. Once we identified a basic architecture of solidarity–care practices, we evaluated SRS’s proposition of a viable market-based system as critical for the flourishing of societies facing disruptions. During an existential crisis like a pandemic, human flourishing rests on the ideological matrix that frames catalytic institutions (SRS). If this matrix heads toward collective narcissism, then a polysemous spillover effect across key institutional composites, including how consumer-citizens behave, will occur. Given the polysemous sociopsychology that characterizes pandemic imagination, the catalytic system’s cultural worldview can affect government agencies, businesses, NGOs, the civil sector, and consumer-citizens (Aaltola, 2009; Watts, 1999). “[C]ommunities tend to flourish when institutions of the marketing system are accessible—particularly housing, healthcare, education, jobs, and markets” (SRS, p. 31). The COVID19 pandemic has amplified the potential role of the solidarity–care ethics nexus in enhancing human flourishing and mitigating structural and systematic inequalities (Drury et al., 2020; Nolan, 2021; Scott & Martin, 2021). The dynamics of flourishing during the COVID-19 pandemic reveal the competing role of ideological constraints conceived by SRS. Considering collective

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narcissism’s versus national identification’s effect on compliance with COVID-19 policy (Van Bavel et al., 2020), vulnerability and resilience depend on which ideological grounding becomes most salient to the catalytic system. The United Kingdom faced a unique mix with Brexit, the underlying xenophobic tropes that nurtured it, and the opportunity provided by the BLM movement to transcend structural, systemic, and institutional inequalities by committing to and celebrating diversity, inclusiveness, and equity. Similar criticisms of high-incidence COVID-19 countries about fermenting collective narcissism and thus fueling overconfidence in anti-COVID-19 compliance measures within prevailing populist groups (Pevehouse, 2020) have been levied against countries such as Brazil, India, Russia, and the United States (Maak et al., 2021; Mankoff, 2020; Roy, 2020; Sternisko et al., 2020). We recognize the limitation of being unable to evaluate the evolving practices highlighted in Table 26.2 or to provide a more comprehensive breakdown. Instead, we illustrated how the solidarity–care ethics nexus could reflect vulnerability if descending or resilience if ascending, thus augmenting SHK’s original framework by stressing a practice-based approach toward attaining human flourishing during crises (SRS). Critically, we highlight the role of ideological constraints in governing the solidarity–care ethics trajectory’s direction and strength.

26.6

Conclusion

We discussed the concept of human flourishing as inseparably tied to community flourishing and the complexities that arise when considering this perspective. As exemplified by the inadequate pandemic responses by countries highly ranked on the Global Health Security Index, we contend that standard well-being assessments are inadequate for evaluating community flourishing or distress. Perhaps more systemically complex communities have more complex intra-communal vulnerabilities that put their well-being at higher risk during a disruptive event (Pottebaum & Kanbur, 2004). We propose a fused SRS–SHK framework that enables analysis of this complex community structure and the relationships between consumer-citizens and catalytic institutions. We evaluated these relationships from a solidarity and care ethics perspective, with increasing solidarity and care concomitant with flourishing. We conceptualized these relationships as constantly evolving and devolving rather than static, showing the simultaneous pull toward flourishing and distress (SRS). The United Kingdom’s COVID-19 response provided a helpful context for applying the fused framework. Although we could not fully explore the framework’s temporal aspect due to the pandemic’s recency, even the short period illuminated the competing forces pulling the United Kingdom toward increased or decreased solidarity and care ethics. The United Kingdom began the COVID-19 pandemic with these rivaling systemic forces exemplified by Brexit and the BLM movement. In response to the pandemic, different British catalytic institutions and consumers

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opined and acted positively and negatively, simultaneously impelling the UK community toward flourishing and distress.

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Haseeb Shabbir is a senior lecturer in marketing at the University of Hull in Hull, UK. Passionate about marketing ethics, peace marketing, and fundraising, his work has also appeared in leading marketing journals such as Journal of Service Research, Journal of Advertising, Journal of Advertising Research, Psychology & Marketing, European Journal of Marketing, Industrial Marketing Management, and Journal of Business Ethics. Haseeb’s research interests span ethics in advertising and not profit marketing. In recognition of his commitment to fundraising research and education, Haseeb was appointed as one of the national examiners for the Institute of Fundraising. Michael R. Hyman recently founded the Institute for Marketing Futurology and Philosophy. After four decades as a professor at several state universities, he decided to emulate his childhood

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heroes: the great scientists and inventors of yesteryear who sought eureka moments while toiling away in personal workshops. His roughly 125 academic journal articles, 60 conference papers, 4 coauthored/co-edited books, 30 other academic contributions, and 50 non-academic works attest to his writing compulsion. He is a Journal of Business Ethics section editor and a Journal of Marketing Theory and Practice associate editor. His research interests include marketing theory, marketing ethics, marketing futurology, consumer advertising, survey research methods, and philosophical analyses in marketing. Now a loyal New Mexican, he splits his time between Las Cruces and Cloudcroft with his wife, four sons, three dogs, and three cats. Alena Kostyk is a lecturer in marketing at the University of Glasgow in Glasgow, UK. Before entering academia, she spent nearly 10 years working in the private sector, which inspired her academic investigations. Her work has appeared in the Journal of Business Research, European Journal of Marketing, Journal of Consumer Behaviour, and International Journal of Market Research. Her research interests include innovative research methodology and consumer decision-making in futuristic environments and marketplaces. Having lived in four countries over the past decade (Russia, the United States, France, and the United Kingdom), she is acutely aware of environment-related influences on consumer behavior.

Chapter 27

A Matter of Trust: The COVID-19 Pandemic in the United States amidst Political and Media Polarization, and a Narcissistic Presidency Don R. Rahtz

, Clifford J. Shultz II

, and M. Joseph Sirgy

Abstract This chapter offers a systemic exploration of the COVID-19 pandemic in the United States. The authors focus on key catalytic institutions responsible for community well-being. These institutions and their stakeholders were vulnerable to major shocks. Their responses to the crisis were greatly affected by a politically polarized population, a significant portion of which had lost trust in the government and its institutions. We explore how a weakened public health system, the federalist structure of the nation, a politicized citizenry, and a president who failed to lead in a national crisis with a coordinated response left communities throughout the United States, one of the most advanced countries in the world, to suffer one of the highest infection rates. We examine Operation Warp Speed (OWS), the successful development of three successful COVID-19 vaccines, and challenges associated with vaccine distribution and vaccination acceptance and administration, including the impact of the political environment and misinformation that created a distrustful and vaccine-hesitant segment of the population, which in turn fueled a national surge of the deadly virus. The authors conclude with lessons learned and implications for policy and future research. Keywords COVID-19 · United States · Public health · Government · Community · Leadership · Pandemic

D. R. Rahtz (*) Mason School of Business, College of William & Mary, Williamsburg, VA, USA e-mail: [email protected] C. J. Shultz II Quinlan School of Business, Loyola University Chicago, Chicago, IL, USA e-mail: [email protected] M. J. Sirgy Pamplin College of Business, Virginia Tech, Blacksburg, VA, USA WorkWell Research Unit, Faculty of Economic and Management Sciences, North West University, Potchefstroom Campus, South Africa e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_27

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Introduction

If the people cannot trust their government to do the job for which it exists—to protect them and to promote their common welfare—all else is lost. —Barack Obama (2006)

On January 20, 2020, teams from the United States Center for Disease Control (CDC) began screening passengers arriving from Wuhan, China, at three airports with the largest number of flights from Wuhan: San Francisco International, John F. Kennedy International, and Los Angeles International. On January 21, 2020, the CDC confirmed a Washington State resident was the first COVID-19 case in the United States; this person had arrived from Wuhan. By the time of discovery and diagnosis of this infection, the United States had evolved into a nation with a politically, socially, and economically polarized citizenry that had seemingly lost trust in its government and media. Polls consistently indicated only about 20% of Americans trusted the government (Pew Research Center, 2020). Traditional media trust was at 46% and social media trust was at 27% (Edelman, 2021). Reuters collected data from around the world and compared the media ratings across a dozen countries. In a cross-country comparison, the United States came in 12th place: only 29% of the US population believed the media could be trusted “most of the time.” Comparatively, in the first-place country, Finland, 65% of its population believed the media could be trusted “most of the time” (Reuters, 2021). Sadly, Americans’ trust in their government and media was not the only thing that had eroded. While trust in these institutions ebbed, the country’s other catalytic institutions had also been (d)evolving into entities whose original noble purposes of equitable service to the nation and the citizenry had been remade or distorted by these same political, social, and economic drivers. The stress on catalytic institutions and the resultant inequities foisted upon some segments of society are apparent in both the private and public health-care sector. When the novel coronavirus—SARSCoV-2—arrived, this situation and other structural aspects of the United States, including its federalist political system, provided a fertile environment for this virus and the COVID-19 disease it causes to spread and harm, resulting in a deadly and devastating pandemic. This chapter offers a systemic exploration of the COVID-19 pandemic in the United States during a period of political polarization, growing public distrust in government, controversial media and communication more generally, ineffectual policy, their effects on the health system, and ultimately the health and well-being of people, communities, and the nation. We begin with an examination of the catalytic institutions involved and a model that highlights the structures and systemic interactions of these institutions vis-à-vis the response to the COVID-19 pandemic. We conclude with some lessons, policy implications, and opportunities for further research.

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Catalytic Institutions and Greater Community Responses to the Pandemic

Catalytic institutions are key actors in the structure, performance, and ultimately the success or failure of a given society or community. Shultz et al. (2017) note that these actors manifest in three institutional forms: government, business, and nongovernment organizations (NGOs). Within these three major forms, other institutions play significant and interactive roles in the performance of a given community or society. An increasingly intertwined and complementary (or conflicting) set of entities/processes throughout the layers of these institutional players influences or determines the quality of life (QOL) for a community, and the segments and individuals who comprise that community, society, or nation. We suggest in Fig. 27.1 where catalytic institutions in the United States would fit in terms of their interactions with various communities and the nation as a whole, before, during, and after the COVID-19 pandemic. These interactions led to (1) preparations (or nonpreparations) for (2) reactions focused on mitigating myriad negative impacts during the pandemic, and (3) the building of both tactical and strategic responses focused on recovery from the pandemic and building resilience into the system for the current and future needs of the communities and nation. What becomes clear: several institutions and operators in this system can influence or determine the success or failure of a response to crisis, in this case a pandemic. In particular, the structure of the greater system—and the communications across and within the macro and micro factors, and catalytic institutions—also can determine if malevolent and/or benevolent actors are successful in their efforts, ultimately to affect national QOL. Additionally, we point out the inclusion of two additions to the model posited by Shultz et al. (2017). These additions were added after examining the manner in which certain actors were involved in activities within the Catalytic Institutional framework in ways that did not appear at times to be “constructive engagement” (Shultz, 2015). These actors instead sought to interfere with the system’s synergistic responses via deliberate misinformation, disinformation, and counter initiatives. Accordingly, (1) Executive Branch and (2) Infodemic are explicitly included in the model. As Fig. 27.1 illustrates, both elements have the ability to influence information flows and interactions among catalytic institutions and the macro and micro factors, as well as the consumption/demand and other behavior within the community to respond to and thus to manage, mitigate, or end COVID-19 threats. In the following sections, we provide a deeper dive into the most relevant elements, for the purposes of this study, and briefly explore the aspects related to the vulnerability and resiliency of the United States as the COVID-19 pandemic emerged and spread.

Iniaves Informaon Misinformaon Disinformaon

Allies and Operaves

• • • •

Leadership and Direcves

Presidenal

Execuve Branch

Government Public Health System Media Businesses NGOs

Catalyc Instuons:

Potenal Determinants Health and wellness, Locaon, Market literacy and Access, Trust in Catalyc Instuons, Income/Wealth/Capital Situaonal Commonalies Polical Affiliaons Racial Affiliaons State of Residency (Red State Blue State)

INFODEMIC: Throughout the Enre System

morbidity stascs such as rate of infecon in selected country (or community)

Micro-Factors: Cizens Served/Underserved

COVID-19

Consumpon/Demand In various sectors of State or Community for: healthcare, Pandemic related products and services, Behaviors, etc.

Fig. 27.1 COVID-19 in a federalist United States in a time of political and media polarization and a narcissistic presidency

P Culture Physical infrastructure, Broadband Access Populaon Polical/Legal Economic Social/Cultural Educaon Administraon Scienfic Community, Technology, etc.

Polical structure Federalism Polarizaon

Macro-Factors:

Quality of Life in relaon to various life domains such as health & safety, financial wellbeing, social wellbeing, environmental well-being, work well-being, leisure well-being, etc. of people in the selected country (or community)

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Macro Factors System Impact: Federalism and Political Polarization

We begin with the founding fathers and a nod to James Madison, long viewed as the architect of America’s federalist system of democracy. Briefly, federalism occurs when/where the sovereign power in a country is divided between the national and state (local) governments. Huberfeld et al. (2020) observed that in the United States federalism played a major role in the response to COVID-19 and contributed to wasted time and lives lost. The authors state that federalism . . . . will play a profound role in shaping the long-term health and economic impacts of COVID-19, including our nation’s ability to mount a response and plan for the future. (p. 951)

Note that ethnic and economic disparities affect who is exposed to SARS-CoV-2, who contracts COVID-19, and who is likely to die from it. Rozell and Wilcox (2020) furthermore argue that although these disparities essentially exist across the entire country, the very nature of federalism exacerbates this problem in the United States by laying bare the impact of underinvestment in the public health infrastructure—in some states and not others—through funding of programs such as Medicaid (Michener, 2021). Huberfeld et al. (2020) also suggest that the arrival of the virus during an election year gave the incumbent Republican presidential candidate a motivation to undermine the pandemic efforts in states led by Democratic governors. Political polarization has accelerated significantly in the United States during the twenty-first century. Opinions vary on what that process exactly is or means (e.g., Baldassari & Bearman, 2007). However, in the United States, the polarization seems to have shunned a “middle-centrist neutral ground”; it has become instead what McCoy et al. (2018) consider a threat to democracy itself. This situation creates a mentality among factions of “us” versus “them” driven by a rising polarizing rhetoric (exacerbated by social media and partisan pundits) where there is no place for dissent within the group. Similarly, Baldassari and Gelman (2008) state: It is the alignment of opinions under a single identity, rather than the radicalization of opinion, that “crystalizes interests into opposite factions” and threatens to undermine social cohesion and political stability. (p. 18)

In such a setting, when political leaders espouse opinions contrary to reality, members of that group nevertheless express opinions about, and carry out behaviors supportive of, the dogma that connects faithful members to their “clan.” Such obeisance is playing out in the United States during a deadly pandemic. This “fidelity” has greatly contributed to the staggering death toll of Americans: over 600,000 people, at the time of this writing. Many segments of society simultaneously have lost faith in American institutions, including science, news media, public governance, and democracy itself. Eichengreen (2020) offers a sobering assessment of the dangers that polarization can wreak upon a country during a pandemic as it becomes another form of infection. Consider that, in the United States, if a political leader from one party—

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or even a credible person/expert perceived to be aligned with one party—endorses a mitigation strategy (e.g., wearing masks) members of the opposing party quickly reject the strategy “instinctively and automatically” (p. 373). This partisan outcome has been borne out in numerous studies (e.g., Allcott et al., 2020; Bruine de Bruin et al., 2020; Makridis & Rothwell, 2020) that report significant differences between the political camps, specifically in terms of attitudes and behaviors regarding infection risk, severity of disease, and mitigation strategies in response to COVID-19. Intertwined in this dysfunction are the media (a catalytic institution in Fig. 27.1), which have created, facilitated, and/or supported the polarization. Social media and an active mainstream media are conduits to valuable information, shared online and offline, to protect and inform people; harmful disinformation and misinformation, however, also are shared.

27.4

Infodemic: Systemic Misinformation and Disinformation by a Complicit Media and the Executive Branch

The COVID-19 crisis is the first pandemic immersed in an accompanying Infodemic; that is, . . . an overabundance of information, both online and offline. It includes deliberate attempts to disseminate wrong information to undermine the public health response and advance alternative agendas of groups or individuals. (World Health Organization (WHO), 2020)

Furthermore: Misinformation costs lives. Without the appropriate trust and correct information, diagnostic tests go unused, immunization campaigns (or campaigns to promote effective vaccines) will not meet their targets, and the virus will continue to thrive. . . . Furthermore, disinformation is polarizing public debate on topics related to COVID-19; amplifying hate speech; heightening the risk of conflict, violence and human rights violations; and threatening long-term prospects for advancing democracy, human rights and social cohesion. (WHO, 2020)

This Infodemic and media have profoundly impacted the ability of our catalytic institutions to respond effectively to COVID-19. Misinformation and disinformation intentionally have been delivered through the system; often from the Executive Branch of the US government and, in particular, the president. Figure 27.1 reveals that the Executive Branch of Government has the ability to moderate and mediate information that flows to and from catalytic institutions. Peters et al. (2020) analyzed White House Press briefings from March 9 through mid-April 2020. Their content analysis identified 130 examples in briefings where then President Trump exaggerated facts or presented falsehoods concerning COVID-19. Chung and Jones-Jang (2021) found significant differences between individuals who used these briefings and conservative media to get information about COVID-19 versus individuals who use liberal media, health organization briefings, and traditional media. Especially

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noteworthy were differences in (1) perceived threat of the virus and (2) the behaviors employed to combat it. The first group had decreased intentions for preventive behaviors, the second group had increased intentions. Niburski and Niburski (2020) found that Trump’s promotion of unproven COVID-19 treatments also had a significant impact on conservative media coverage and advocacy (and other social media venues, e.g., Twitter) and Trump supporters who might also have purchased these products. Barrios and Hochberg (2020), using geospatial mapping data, uncovered complementary findings, suggesting that risk perceptions and actual behavioral choices are viewed through partisan lenses. In sum, Fig. 27.1 provides a synthesis of key elements and interactions affecting the US response to the COVID-19 pandemic. We submit dynamic interplay among structural elements and community characteristics of this large system determines whether the community (the United States) has in place, or can develop, the needed capabilities to demonstrate resiliency and to recover from this pandemic. All the factors and interactions in Fig. 27.1 and in the framework provided in Shultz et al. (2017) are important to understand the variables that must be addressed and/or managed to ensure the United States is resilient, recovers, and flourishes in ways that ensure well-being for Americans and perhaps the global community. The following section examines what we believe is the most directly relevant of the catalytic institutions and how the evolution of this catalytic institution, the US health-care system, played a significant role in the lead-up to and the response following the arrival of SARS-CoV-2 and the ensuing COVID-19 pandemic. Particular attention is paid to the Public Health System and its role in the response.

27.5

Evolution and Structure of the US Health System

The US Health System has evolved into a triumvirate of three major institutional sectors: (1) health-care providers comprising increasingly larger, privately owned nonprofit or for-profit systems; (2) private health-care insurers comprising increasingly larger, nonprofit and for-profit entities; and (3) corporations and businesses that offered their employees health-care benefits as part of compensation packages through large conglomerate insurers. Since the early 1970s, these three sectors moved swiftly toward a business model focused on cost containment and profit maximization for shareholders in the private sector, and reducing budgets in the public sector that had long supported the US Public Health System (e.g., Bodenheimer & Grumbach, 2020). This model has been quite successful in shortterm performance for shareholders and some users of the health services provided. In the long term, however, this focus weakened not only the Public Health System, but at times forced the nonprofits and for-profits to focus on more lucrative markets, offering products and services to those markets versus investing in systems and

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infrastructures that supported the greater public good, thus making the systems less resilient to unexpected, major shocks.

27.5.1 The Public Health System in Flux Comprehensive health planning (CHP) would seem to have some advantages during a pandemic. Peloquin (1971) proposed it in Missouri using a concept, human ecology, recognizing a person’s “relationship to his physical, biological, chemical, and social/psychological environments” (p. 1981). CHP involves political elements by which “constructive change and reform can be implemented” (p. 1980), including coordination of the state’s government and private sectors. Though 50 years old, recognition of both the complexity and political nature of planning and application still provides relevant lessons for responses to the current COVID-19 pandemic. Studies reaching back further, to the 1900s, draw a similar conclusion (Melhado, 2006). The CHP concept was built around public good and stewardship of research, public health, and community well-being with access for all communities—for example, all economic and racial groups—to needed services. Early planners, however, failed to grasp the social, economic, and demographic changes to the population over the past 100 years. They also did not anticipate the speed at which science and technology, migration of populations, and the cost of care and insurance would all accelerate and drive a focus on cost containment that continues to complicate the health-care landscape. The consolidation of health provider systems—and the growth of a profit-based system centered on cost reduction and market profitability, among other factors— has led to the subsequent retreat from nonprofitable communities. A massive gap now exists between the resources consumed by the health-care system and the “health” across the breadth of the US population (Mays et al., 2017). The United States spends huge amounts of money per capita, yet ranks near the bottom of health outcomes among other developed countries. Funding for public health has also declined significantly on a per capita basis from 2008 to 2018 (Alfonso et al., 2021). The United States clearly was experiencing a public health crisis, prior to COVID. Consider this assessment by Grogan et al. (2021): When the COVID-19 pandemic landed in the United States, and particularly once cases began to grow substantially in March, the entire health care system suffered, but the safety net was exceptionally hard hit. The “health care safety net,” an ill-defined term that encompasses public and some non-profit hospitals that take care of the poor and uninsured, was on the front lines of taking care of the bulk of individuals who had contracted COVID-19. These hospitals tended to suffer from a lack of adequate supplies and relatively low reimbursement in a system that was already financially weak. (p. 628)

The pandemic illuminated the inequities and costs the US health system has foisted on the uninsured, the poor, rural communities, and communities of color. This is especially true for those who exist in “health-care deserts.”

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Health-Care Deserts: Underserved Urban and Rural Communities

While some would argue good, solid business-decisions led to “health-care deserts,” many urban and rural communities were in a precarious state when SARS-CoV-2 hit them. Disregard—including reduced funding for the public health system—crippled strategic planning, the acquisition of critical materials, and training to execute appropriate responses to public health crises. As the virus spread, COVID-19 quickly ravaged the country, particularly citizens living in these deserts. LaVeist et al. (2011) point out that the community “place”—that is, the neighborhood—is a substantial indicator of health well-being; poorly served communities of color, which make up smaller percentages of the population, suffered significantly more in terms of infections and deaths than did economically well-off and white communities (e.g., CDC, 2020) (see Fig. 27.2). Akin to food deserts (e.g., Dubowitz et al., 2015; Smith, 2016), health-care deserts (Martin, 2019) refer to settings where access to health care is difficult due to proximity. Often included in these deserts, which lack medical practitioners and hospitals, is a paucity or absence of pharmacy services (Pednekar & Peterson, 2018). In urban settings, the “desert” can manifest as a lack of public transportation and/or distance. In rural settings, distance is more problematic as operational and staffed

Fig. 27.2 Distribution of COVID-19 deaths in the United States as of June 9, 2021. (Source: CDC, 2021)

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medical facilities may be hundreds of miles from the community, and thus residents are at much higher risk for poor health and well-being, generally, and especially when a community member requires emergency care due to injury or acute crisis (e.g., auto accident, cardiac arrest, COVID-19). Numerous health studies on urban deserts reveal that many health indicators (stroke, diabetes, obesity, survival of serious accidents, violence, etc.) are connected to a health provider’s presence in the community and timely access to care and treatment (e.g., Acevedo-Garcia, et al., 2020; Crandall et al., 2013; Holliday, 2020). Furthermore, primary care physicians seem to be largely absent in predominantly Black and/or low-income Hispanic metropolitan neighborhoods (Gaskin et al., 2012). Rural environments are similarly disadvantaged. Hospitals close across rural America at a staggering pace as the health-care industry continues to consolidate and focus on efficiency and cost-containment. Consider the following statistics. • About 60 million people in the United States live in rural regions and rely on local hospitals (Elison, 2021). • Over 180 rural hospitals have closed since January of 2005, of which 137 have closed since 2010 (Sheps Center, University of North Carolina, 2021). • Over half the residents in America’s rural areas are at increased risk of hospitalization and death if they are infected with COVID-19 (Kaufman et al., 2020). • Refusal by some Republican governors to expand Medicaid has had a direct effect on racial inequality regarding access to health insurance; Black residents in rural areas are in event greater danger from COVID because many states have not expanded Medicaid coverage (Andrews, 2014). • The refusal of certain states—for example, South Carolina—to accept Medicaidexpanded coverage has accelerated COVID-19 cases and deaths in the Black population. While making up only 27% of the population in the state, Black residents in April of 2020 accounted for 41% of the cases and 56% of the deaths. This public health failure, which disproportionately harms a minority group more likely to rely on the public health system, is further evidence of the heightened risk COVID-19 poses in the absence of robust and accessible public health care (Zahnd, 2021).

27.5.1.2

The Public Health Imperative

A robust public health structure is critical for a resilient health system (Benjamin, 2020). Social media and the Internet are tremendously valuable when providing access to credible scientific information regarding health care; they are dangerous when used to spread misinformation and disinformation. Building strong public health systems therefore is crucial to supporting health equity across all groups, particularly for vulnerable and at-risk populations. For example, the expansion of Medicaid in Kentucky, a policy enacted by a Democratic governor, is hugely

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popular with lower-income residents, improving their well-being and, for some, altering political loyalties in a traditionally Republican state (Covert, 2019). Failures and inadequacies—and some successes—necessitate a reexamination of the role and structure of public health in the United States. The Association of Schools and Programs of Public Health (ASPPH) maintains “public health protects and improves the health of individuals, families, communities, and populations, locally and globally” (https://www.aspph.org/discover/). Some observers moreover have called for a model that encompasses QOL and well-being (e.g., Darrow, 2015). These ideas are the norm in many countries and are gaining momentum in the United States as a growing number of community leaders and citizens, state legislatures, Congress, and (from January 20, 2021) the White House embrace—and advocate investing in—public health. While the road to public health can be partisan and fraught, there is a generally shared desire to achieve it in the most effective and costefficient manner possible. Fiscally conservative politicians often focus on controlling financial costs, while public health advocates that favor QOL-oriented programs focus on effectiveness, broader and longer-term costs, and cost savings associated with the health and well-being resulting from comprehensive public health care. Figure 27.3 provides a framework that informs how public health infrastructure can offer an integrated and synergistic approach to community and national QOL. Catalytic institutions for public health must actively contribute to a fully integrated system that supports strategic planning, evaluation, and adaptation to change/

Fig. 27.3 Public health framework for health systems strengthening. (Source: Bloland et al., 2012, p. 3)

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threats with timely and effective responses, all of which require funding and other forms of support. Some trends, however, portend(ed) disaster. Approximately 21% of local health departments reported budget reductions in 2017 (Davis, 2020). The White House pandemic office was shuttered, and PREDICT (an early warning system), which had identified more than 1000 viruses around the world (including 160 coronaviruses), was terminated. The United States failed in its early reaction to COVID-19 largely due to the decisions made by the Trump administration, but the foundations of that failure are believed to be deeper in the system (Frieden et al., 2021). Estimates indicated that per capita spending of $32 per year was needed to promote and protect all Americans, but the level of spending fell far short, at $19 per person (DeSalvo et al., 2019). Preparation and the ability to monitor and accurately assess any public health threat, and then deploy appropriate medical countermeasures (MCMs), was/is critical to timely success (Measer et al., 2018). The success of that response “will depend on the trust and the demands of the public” (p. s524), whether in the United States or elsewhere. Further to this point, citizens’ confidence in the health system is vital to their trust in and compliance with recommendations from the health system and government (Chan et al., 2020). Conversely, inattention to and lack of strategic funding for such interconnected systems likely will reduce awareness, confidence, trust, and effective response to public health crises—at significant and potentially devastating cost to individual QOL and community and national well-being. Business and the private sector are also integral to this system. They accordingly were expected to monitor an evolving situation; to be alert and to refresh response plans, in preparation for the possibility of the pandemic’s spread (Koonin, 2020), and to cooperate and collaborate with other catalytic institutions, as policies evolved. The arrival of SARS-CoV-2 and the explosion of COVID-19 cases however overwhelmed a weakened public health system and revealed a population, media, business landscape, and government sharply divided along political and ideological lines. Much of the population was skeptical, or even dismissive of science, and had become mistrustful of the institutions, traditional media, and national, state, and local government authorities. The United States had become fertile ground for the virus’ spread and destruction.

27.6

When the Needs of the Few Outweigh the Needs of the Many

The leadership of the Executive Branch is paramount to the well-being of community and citizenry, who seek guidance, assurance, protection, and solace—especially during a crisis such as a deadly pandemic. As seen in Fig. 27.1, the Executive Branch influences the flow of information and resources between and within all the macro and micro factors, and the catalytic institutions. Effective leadership intersects with effective communication (e.g., Cunningham et al., 2020), in ways that “build and

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maintain a team, group, or organization” (Hogan and Judge 2013, p.37). It encompasses abilities to build and maintain a coalition of people, groups, and organizations. In the case of governance for the United States, those elements are multilayered and vary in responsibility and jurisdiction. Open communication is critical; note also that “what is not said, is often more destructive than what is said” (Collard, 2002, p. 10). Throughout history, effective leaders have inspired individual followers and entire nations through hard work, understanding and strategic thinking, often combined with confidence and charisma in the face of crisis (e.g., Bhaduri, 2019; Bussy & Paterson, 2012; Kielkowski, 2014). They influence and facilitate individual and collective efforts, and inspire personal sacrifice to achieve shared objectives (Yukil, 2012). Presidents Lincoln, Roosevelt, Kennedy, H. W. Bush, and Obama come to mind as leaders who rose to the national challenge when faced with daunting political, social, and economic crises. Beilstein et al. (2020) summarize well the immense impact that a leader, in particular the head of state, potentially has in the battle against the COVID-19 pandemic: During acute phases of a pandemic, a nation’s fate lies in the hands of the responsible political leader, who needs to act quickly. Most Western European countries battling COVID-19 have bypassed normal legislative channels, calling on laws governing national emergencies in order to avoid delays deemed unacceptable. Therefore, a nation’s well-being has largely been dependent on the leadership skills of its executive authority. (p. 2)

Political leadership in the context of the Shultz et al. (2017) framework is embedded in macro factors and catalytic institutions, with the potential to influence and be responsible for all factors. The model introduced as Fig. 27.1 in this chapter seeks to embed leadership into the moderating effect of the catalytic institutions on both the spread and mitigation of the COVID-19 disease and the impact of the pandemic on consumption and related sectors across society. Cunningham et al. (2020) suggest that (t)he ability to effectively communicate any dangers or necessary precautions as well as the ability to calm fears and avoid mass panic are crucial for public health leaders in the digital age. (p. 23)

Businesses leaders use several heuristics or “rules of thumb” (ROT) to make decisions. Those rules “should be in perfect alignment with the higher-level values that serve as the leaders’ moral and professional compass” (Walumbwa et al. 2014, p. 290). One would assume they are applicable during the COVID-19 pandemic. Walumbwa et al. offer a typology to facilitate ROT decision-making; it includes two primary breakouts: destructive ROT and constructive ROT. They argue that top CEOs are able to adapt their ROT to most settings to address the needs in them. Constructive ROTs are applied to specific situations based on experiences and the leader’s moral compass. Destructive ROTs tend to be derived from destructive, emotionally based personal feelings (e.g., revenge, lust, avarice) when making major decisions. Appropriate adaptation is crucial during a crisis; emotional, selfish, or vengeful responses likely will lead to disaster.

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27.6.1 US Political Leadership During the COVID-19 Pandemic The leadership skills of the “executive authority” to protect and nurture the nation’s well-being are clearly evident in what is today’s United States. Unfortunately, the political leadership by President Donald Trump revealed a misguided “strategy” of denial, misinformation, and even politicization of proven strategies and tactics for mitigating the spread of SARS-CoV-2 and the management of COVID-19 (e.g., Lin, 2020). A staggering number of decisions made by the Trump administration—to downplay the severity of the pandemic, to shift responsibility and blame to individual states—defied reason and science, thus leaving the country with patchwork reactions to a pandemic that required a coordinated national response. States found themselves competing against each other for resources (e.g., personal protective equipment) across sectors. At the same time, the president was battling or belittlingly anyone with expertise regarding mitigation and scientific knowledge, including members of his own administration who did not adhere to his framing of the crisis (Rutledge, 2020). The most damning reports regarding the political nature of this strategy came from President Trump himself, in which he stated and confirmed in interviews his intent to “downplay” the severity of the threat confronting the nation (e.g., Woodward, 2020). Trump’s plan to deflect political cost or blame related to the pandemic away from the presidency—by shifting mitigation efforts (e.g., lockdowns and mask-wearing) to states and away from federal purview—was also affirmed in the Woodward interviews. Leadership also was instrumental to the efficacy or failure of response management in individual states (e.g., Cuomo in New York, DeSantis in Florida, etc.). Our focus in this chapter however is primarily national. Below, we further examine national leadership in response to the COVID-19 pandemic, in two distinct, yet related areas: mitigation efforts and vaccine research.

27.6.2 National Mitigation Efforts National mitigation efforts clearly were negatively impacted by a failure of leadership. Countries with successful pandemic responses tend to have a strong state capacity, social trust, and leadership. The United States was wanting on two of the three requirements, especially leadership; specifically, American underperformance during the pandemic has several causes, but the most significant has been a national leader who has failed to lead. (Fukuyama, 2020, p. 32)

Comparatively, the Obama administration had established the National Security Council Directorate for Global Health Security and Biodefense, following the 2014 Ebola outbreaks in Africa. Its mission was to provide a unified, funded, and speedy response to any future outbreak of contagious diseases to stop the outbreaks from

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becoming epidemics—or worse, pandemics. In 2018, the Trump administration cut the funding and eliminated the Directorate. A few months earlier, Trump shut down a “pandemic early warning system” that was also a foreign aid program named PREDICT, established in response to the 2005 avian flu emergency (Davis, 2020). While some of the personnel in these programs were retained in government positions, the focus and resources ceased to focus on preparation and marshaling forces for a swift and coordinated strike against any looming outbreak or pandemic. Trump’s policy change tragically presaged the COVID-19 disaster for the United States. The Trump White House had been given notice of imminent pandemic in early 2020, when Peter Navarro, Trump’s Trade and Economic Advisor, informed the president via a memo dated January 29, 2020. That memo indicated the coronavirus pandemic could cost the United States trillions of dollars and put millions of Americans at risk of illness or death (Haberman, 2020). Not until March 13, 2020, however—after the World Health Organization (WHO) declared COVID-19 a global pandemic—did the White House issue a national emergency declaration by Trump. This act included measures such as travel bans from Europe. No national lockdowns were ordered; decisions regarding responses simply seemed to have been handed to individual states. Fast forward to October 2020, as Boyd (2020) observed, Trump’s early representations of the COVID-19 crisis as “a hoax” and his strong reluctance to listen to medical advisers sent the United States into an inevitable “death spiral.” By mid-February 2021, the CDC reported that the United States led the world in COVID-19 infections (over 28 million) and deaths (over 496,000). The actual death toll from COVID-19 was/is likely higher. We are hard-pressed to find a reasonable explanation for these grotesque numbers beyond the Trump administration’s strategy to play down the threat and to pass mitigation efforts to individual states, with no unified federal strategy and implicitly no responsibility or blame. In essence, E Pluribus Unum became E Unibus Plura. Without a national strategy and tactical consistency, individual states became competitors for the same resources; their communities fell prey to a highly infectious contagion aided by disjointed and in some respects disingenuous efforts to stop it. Crossing a state line could change the entire public safety landscape, statewide and in individual communities (e.g., Lyu & Wehby, 2020). Several states began to base mitigation decisions on political goals rather than science (e.g., Allcott et al., 2020). Governors of individual states became the leaders of the pandemic response, following the desertion from leadership by the president and much of the federal apparatus. Governors whose states bordered each other began to create their own national and regional alliances, in recognition of the need to coordinate responses across political boundaries and to consider the geographic, economic, and social relationships that facilitated collaboration. For example, the governors of New York, Connecticut, and New Jersey coordinated planning and shared resources. Medical ventilators and other critical equipment were shipped from states with surpluses to states across the nation whose hospital intensive care units (ICU) faced critical shortages (e.g., Capitol Ideas, 2020).

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27.6.3 The Vaccine: Operation Warp Speed The US government played a key role in the partnership of funding and facilitation of vaccine development and testing in cooperation with the private sector. Operation Warp Speed (OWS) was the name given to this endeavor. OWS was not a company or an agency . . . but rather a mechanism to coordinate among private companies and an array of U.S. government bodies: the Department of Defense, HHS, the Food and Drug Administration, the Centers for Disease Control and Prevention, and beyond. More than 600 people in HHS and 90 people from the DOD are involved. “It’s a coordination activity that helps to cut through the bureaucracy faster,” says Paul Stoffels, chief scientific officer at Johnson & Johnson. OWS has awarded more than $12 billion in vaccine-related contracts and has an overall budget of as much as $18 billion. (Baker & Koons 2020)

Figure 27.4 illustrates the government’s efforts to accelerate the entire process, from research and development to clinical trials, mass production, and distribution of the vaccines. The usual time to complete the entire process would have been over 6 years (73 months). Working with the industry and by heavily subsidizing the drug manufacturers, the timeline was cut to 14 months. This was a stunning marshaling of government resources in search of a vaccine against COVID-19. In comparison, the polio vaccine took Jonas Salk and his team over 7 years to develop. Some observers (e.g., Baker & Koons, 2020; Yoders et al., 2020) view OWS as President Trump’s only constructive contribution to the fight against COVID-19, an

Fig. 27.4 Operation Warp Speed process. (Source: U.S. Department of Defense Website, 2020)

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exception to the otherwise poor management of the pandemic. This success in light of so many failures is perhaps explained by the fact that the process was fundamentally something the president understood: make a product and sell it, especially if doing so was helpful to Trump. He therefore was driven by his desire to have the vaccine delivered before the November election. White House staffers described President Trump flying into a rage when it was announced a week after the 2020 election that the Pfizer vaccine was ready for submission for approval by the CDC. While the successful and speedy development of the vaccines was impressive, the follow-up system to distribute and “get the vaccine into the arms” of the population was again thrust upon the States. The federal government, under Trump’s edict, was essentially removed from this critical stage. Vaccines were shipped in various quantities to each state with no clear directives on the system or protocols to be used regarding vaccine distribution and vaccination priority. The approach to the states again was E Unibus Plura. This lack of guidance from the federal government led to a series of bottlenecks, and shortages in vaccines, personnel, supportive infrastructure, and of course life-saving vaccinations. In mid-2020, biotech companies and health organizations around the world were already debating the distribution plan for vaccines (Wechsler, 2020). They were also discussing how to ensure equitable distribution in the United States. The National Institutes of Health (NIH) and the CDC had called for an expert panel to assess allocation priority and equity. Newswires reported on the US Council of Mayors cooperating to develop distribution plans for the vaccines in early December. “In the coming months, we will be working to coordinate with state and local government as well as the private and public sectors to support the delivery, storage and administration of these vaccines” (PR News Wire, 2020). The reporting did not include tangible or credible evidence that the White House had worked on a distribution plan other than a statement that they had one. A few weeks into the vaccine rollout, the number of Americans actually vaccinated was disappointing (Hopkins & Campo-Flores, 2021). Twelve million doses were shipped from Moderna and Pfizer, but less than 2.8 million vaccinations were administered. Claire Hannan, Executive Director of the Association of Immunization Managers (representing the state immunization officials) explains this paradox: There may have been an expectation from Operation Warp Speed or others that we’d give everyone the vaccine overnight. . . . It was a logistics equation for them. If you have been in vaccines for a long time, you know that is the easy part. Getting it into actual arms is the hard part. (Hopkins & Campo-Flores, 2021: Wall Street Journal Online)

While the CDC had issued a set of regulations for vaccination priorities that included health-care workers and residents in long-term care facilities—part of the 1A grouping to be first—the actual decisions were again left to the individual states. In Florida, for example, Governor Ron DeSantis extended eligibility to all people over 65, regardless of the situation or even residency in Florida. Chaos ensued. People filled long vaccination lines—some camped overnight—and waited hours to be vaccinated. Medical tourism thrived as people from around the country and overseas flew to Florida for vaccinations, despite staffing shortages. The federal and state health-care systems were ill-prepared to respond effectively. This, in turn, created logistical, human resources, and statewide population nightmares.

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On the day Joseph Biden was sworn in as the 46th president of the United States, he, his administration, reputable news sources, and eventually the public at large were startled to discover that there was no distribution plan for the COVID-19 vaccine or that any plan had been developed or even worked on (e.g., New Day CNN, 2021).

27.6.4 The New Leadership Effect An election for president in the United States is traditionally followed by a “Transition Period” during which the incoming administration receives detailed briefings from the departing administration, across institutions that constitute the federal government. In times of crisis, such as the COVID-19 pandemic, these briefings become even more important and are critical to the nation’s well-being. They historically are civil exchanges of information; in 2020, the briefings failed to materialize in what could be called a normal or timely manner as the members of Biden’s Transition Team were repeatedly ignored or rebuffed. The General Services Administration delayed recognizing the Biden presidency for 3 weeks after the election, denying access to federal resources and intelligence. Such a delay during a pandemic that had already killed hundreds of thousands of Americans could be reasonably interpreted as a direct threat to national security and dereliction of duty (Breslow, 2020). Deliberate obstruction continued for weeks, following President Biden’s victory on election night, through an insurrection, and up to his Inauguration, January 20, 2021. Indeed, not until Biden was sworn in as president and commander in chief was the Biden Team able to implement key actions planned for a massive rollout and distribution of the vaccine “to get shots in arms.” These key actions, shown in Table 27.1, were reported in Modern Healthcare (2021) 2 days earlier, on January 18.

27.7

The Damage Done: Vaccine Miracle-cum-Nightmare of Doubt and Resurgence

The scientific and technological advances that emerged as COVID vaccines truly were miraculous, producing literally a one-shot (or two-shot) solution to end a global pandemic. Unfortunately, while science and medicine have to be crucial to the mitigation and defeat of the COVID-19 pandemic—and the prevention or mitigation of future pandemics—partisanship seems to have infected a segment of the population, slowed vaccination rates, and has exposed an alarming distrust of science itself. Bolsen and Druckman (2015) have addressed this Politicization of Science, evident “when an actor emphasizes the inherent uncertainty of science to cast doubt on the existence of scientific consensus” (p. 746) for purposes of championing a political

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Table 27.1 Biden’s key action plans for vaccination rollout • Use the defense production act: Invoking the law would allow the president to require companies to manufacture items deemed crucial to national security such as masks, personal protective equipment, and materials to produce more vaccines. Biden’s plan will use the law if needed to increase vaccine production • Create or expand federally run vaccination sites: President-elect Joe Biden has proposed using sports stadiums to operate federally run vaccination centers to help meet the demand that has overwhelmed many health-care providers and state and local public health departments. Biden will also call for establishing community mass vaccination centers and mobile vaccination units to reach individuals in remote areas • Increase coordination between state and local health departments: Experts think the federal government’s role will be based on setting targets and improving communication • Add 100,000 public health jobs: Biden said he will seek to hire 100,000 people to help with vaccine outreach and contact tracing • Free vaccine access: Biden said he will look to ensure everyone regardless of resident status will have free access to vaccines • Streamline the process: Some have reported that filling out consent forms can take up to 20 min Source: Johnson (2021)—Modern Healthcare

agenda. Such politicization during a crisis is truly disconcerting, as are the ill-informed or cynical populist rhetoric driving it and the disdain for science, scientists, and experts/expertise more generally. An epistemic concept, science, is being discarded or disregarded as society decides what is true, in a post-truth, biologically and digitally viral world. Science-based tools with capabilities “to block the spread of misinformation” and to maintain “epistemic integrity” are under threat (Ghinea, 2019; Nisbet et al., 2015). In such a world, scientific and medical advances that can save millions of lives and enhance well-being for all communities, locally and globally, are threatened, too. A pandemic can exacerbate doubt and mistrust of institutions, including government and science (See Fig. 27.1, and the Micro-factors citizens and consumption demand boxes). Emerging trends remind one of a nexus of totalitarianism and pseudo-science. The antivaccine movement, apparently built on discredited research positing links between vaccines and autism, is fueled by political actors both foreign and domestic that have turned vaccines into a “medical freedom” issue, embraced by right-wing extremism. Republican lawmakers have passed legislation aimed at “freedom” from forced vaccinations, even at the cost of illness and the spread of harmful (and sometimes deadly) diseases. Jones-Jang and Noland (2020) found that political cues had “notable persuasive impact on vaccine risk assessment.” COVID19 and the advent of “miracle vaccines” further stoked conspiracy theories and the antivax movement, and an eventual assault on science-based mitigation efforts— particularly mask-wearing and vaccinations—considered by some to violate personal freedom. This politicization has taken a toll beyond physical health and wellbeing; it has driven social and political upheavals across the country (see also Bartusevicius et al., 2021; Hotez, 2021). To be clear, resistance to science, facts, truth, and vaccines is a direct threat to the country’s coordinated efforts to restore (1) the health and well-being of the US

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population, (2) the economy and, ironically, (3) personal freedoms. Accordingly, the duly elected new president and vice-president, and their administration moved forward with an aggressive program of vaccine distribution. The results of this effort were impressive. Biden’s goal of 100 million “Shots in Arms” was achieved within the first 58 days of his administration. The promise of vaccinating all eligible adults was achieved by May 1, 2021. Over 316,000,000 vaccinations had been administered and 148,500,000 people were fully vaccinated by June 18, 2021. The vaccination rate unfortunately has slowed, and President Biden’s goal of 70% of the entire US population vaccinated by July 4th, fell short. The reasons are, again, tied to the interplay of catalytic institutions, a polarized and politicized population where mistrust of media and science is fueled by self-serving political leaders, businesses, and individuals who exploit these fears for personal or professional gain. Meanwhile, beliefs, policies, and behaviors toward vaccinations continue to morph and manifest in various ways as the nation faces a new, more transmissible and more deadly variant of the coronavirus. Consider the vaccination rates, when comparing counties across the United States that had voted for Trump against those that voted for Biden. As of July 6, 2021, “Trump counties” had a 35% vaccination rate. The rate for “Biden counties” was almost 47%. Vaccination rates are indicators of levels of protection or vulnerability. Figure 27.5 therefore may foretell yet another surge of the virus—what public health

Fig. 27.5 The US states closest to full vaccination. (Source: Buchholz, 2021)

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and government officials are calling a “Pandemic of the Unvaccinated”—as we prepare to send children back to school in the fall, and return to “normal.” If the current rates of vaccination continue in the 14 states that have the lowest rates as of early July, those states will not reach the 70% goal of vaccinated adults (a figure often touted to constitute “Herd Immunity”) until 2022, with North Dakota being the slowest to reach 70% and not until September 2022.

27.8

Lessons, the Future, and Policy Implications

We leave the reader with this transition point in the war against the COVID-19 pandemic, and the cases and deaths attributed to COVID-19 in the United States, August 21, 2021. The numbers are staggering: 39,279,057 total cases; 638,689 deaths (CDC, 2021). Many, perhaps most, of the infections and deaths could have been averted with a more robust and focused national strategic response to the crisis. The devastation also could have been much worse without Operation Warp Speed to develop the vaccines at such a rapid pace. A study from Yale University and the Commonwealth Fund modeled the expected deaths that would have occurred as of June 30, 2021, without the vaccine: an additional 279,000 deaths and 1,250,000 additional hospitalizations (Galvani et al., 2021). Our focus in this chapter has been on the structures and systems, and compelling facilitators within those structures and systems. The time frame ends with a change in political leadership during the run-up to and the most consequential time of infection, and strategic decisions related to the mitigation of COVID-19. We believe that it was important to explore the key issues related to catalytic institutions and their interactions as the pandemic unfolded. Several of the elements discussed here we most likely will revisit in our future work. Shultz et al. (2017) articulated factors, constituents, and interactions in communities, regardless of size or complexities. We have explored a number of issues related to the well-being and resilience of the greater US community. Figure 27.1 reveals significant opportunities for the Executive Branch and its allies to moderate and influence the interface and cooperation across American catalytic institutions. It should be noted that these institutions—in the wealthiest country in the world—are vast and formidable, though not without weaknesses and shortcomings, as we have seen. Among the obvious strengths: leading research institutions and health-care scientists; corporate might, wealth, technology, and skill; civic groups and NGOs known to mobilize and to serve during a crisis; integrated networks and systems to manage crises and institutions designed to predict and/or respond to crises (some of which had been dismantled, understaffed, or politicized by the Trump Administration), including pandemics. Indeed, the United States has typically responded well to outbreaks of various contagions, with measurable success, at home and abroad. The response failures to COVID-19 apparent in infections, deaths, ongoing suffering, and economic costs therefore are truly tragic as they were largely avoidable.

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One would have expected the Executive Branch, led by a sitting president, to “rally the nation,” to call upon its citizens and other vast resources, to stand together, to transcend differences and related trivialities or acrimonies, and to defend the country against current or anticipated threats, both foreign and domestic. Such empathic and communicative leadership has historically enhanced the overall system’s coordination and performance when responding to threats to the country and its citizens. Unfortunately, during the COVID-19 pandemic, we saw an Executive Branch leveraging and even stoking a system-wide Infodemic. That administrative body operated a communications program of mixed messages, which spread not only information, but also misinformation and disinformation through mainstream and social media. The misinformation/disinformation was seemingly dispatched to disrupt and to inhibit cooperation and coordination across layers of government and other institutions, while confronted with clear and present dangers. The effects when combined with a politically polarized population—a significant portion of which was deeply distrustful of government—created fertile ground for a pandemic to wreak havoc in a citizenry already struggling with a stressed and underfunded public health system. The promise and the peril of the response possibilities were illuminated by the conflicting messages and their sources, some of whom became household names. Medical doctors Anthony Fauci and Barbara Birx, as just two examples, were faces of the scientific community and public health system that appeared regularly in the media, sharing science-based guidelines for policy and practice. Their concerns and recommendations relative to ill-informed, misguided, or cynical postulations by some political leaders and their spokespersons were welcomed and embraced, or shunned and disparaged, depending upon the political leanings of the listener. This morass brings us back to leadership. We have chosen to distill the crisis, that is, the COVID-19 pandemic in the context of the United States—a country of bountiful resources—to the issues and dynamics illustrated in Fig. 27.1. In times of crisis, a nation’s leaders must shoulder the burden of both anticipated and unforeseen events; they must lead. In researching and constructing this chapter, the authors were repeatedly reminded that “Trust in one’s leaders” is one of the most powerful and transformational weapons in a government’s arsenal to protect and defend the populace from harm. Without this trust, even the best plans are doomed to struggle, if not fail. The United States is still engaged in that deadly struggle. But new political leadership also has reminded us: science matters; honesty matters; humility and compassion matter; systemic coordination, cooperation, and constructive engagement matter; leading-by-example matters; persuasive communication to inspire community, duty, and sacrifice matters; incentives (e.g., debt relief, free vaccines, vaccine lotteries, human services) matter; frontline workers, health-care workers, and indeed all of us matter. Catalytic institutions, policies, practices, and measures should be designed, maintained, and administered accordingly. Conflict of Interest The authors have no conflict of interest to disclose.

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Don R. Rahtz (Ph.D., Virginia Tech) is a marketing / marketing communications researcher and is the J.S. Mack Professor of Marketing at William and Mary (USA). His expertise is in integrated marketing communication programs, international competitive intelligence, cultural intelligence, marketing research, survey methodology, analysis, situational awareness, and market assessment. He has had a particular interest in Quality of Life (QOL), environmental issues, economic sustainable development, transitional economies, business/community interface evaluation, and health systems. Presently he serves on the Editorial Review Boards of the Journal of Macromarketing and Applied Research in Quality of Life. He is a regular reviewer for many of the international conferences and journals in the marketing (e.g., Academy of Marketing Science) and quality-of-life areas (e.g. Social Indicators Research). He has traveled and worked extensively in the developing and transitional world. He has worked on projects in South Asia, North Africa, and Southeast Asia with a particular focus on Bangladesh, Cambodia, Indonesia, Thailand, and Vietnam. Professor Rahtz has conducted a variety of workshops and seminars, and acted as a consultant to businesses in both the public and private sectors concerning the above topics, both in the United States and abroad. In addition, he has produced a number of publications regarding these topics that have appeared in books, academic journals, and the popular press. He is a founding member of the International Society for Quality-of-Life Studies (ISQOLS), where he has served on the Executive Board in a number of positions. He has served continuously as a Board Member of the Macromarketing Society for two decades. He has a long relationship with the International Society of Marketing and Development (ISMD) and currently serves on their board. Clifford J. Shultz II (Ph.D., Columbia University) is Professor and Charles H. Kellstadt Chair of Marketing at Loyola University Chicago. His scholarly focus is responsible marketing, policy, development, and community well-being in distressed and transforming economies, particularly countries and communities recovering from war and other systemic traumas in Southeast Asia, the Balkans, Latin America, and the Middle East. Research projects include peace-marketing initiatives in Afghanistan, Bosnia, Cambodia, Vietnam, Lebanon, Syria, Colombia, Myanmar, Nicaragua, and Iraq; social traps; the global refugee crisis; pandemics and other public health crises; sustainable

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agribusiness and tourism; food, water, and energy in the Mekong River Basin; plastics pollution; externalities of the FIFA World Cup; intellectual property rights; and constructive engagement for win-win socioeconomic development, social justice, and sustainable peace. Dr. Shultz has over 250 scholarly publications, including books, articles, chapters, and conference proceedings. He served two terms as editor-in-chief for the Journal of Macromarketing, as president of the International Society of Marketing and Development, and president of the Macromarketing Society; he currently serves as Associate Editor for the Journal of Public Policy & Marketing and the Journal of Macromarketing, and he serves on several editorial and policy boards. His professional distinctions include two endowed professorships, numerous research grants and fellowships, Fulbright appointments in Vietnam and Croatia, distinguished visiting professorships, best article awards, several commendations for outstanding research, teaching and service, and recognition for extraordinary and sustained contributions to the field of Macromarketing. Dr. Shultz has been invited to lecture, to make research presentations at universities and research institutes, and to counsel governments, NGOs, and businesses on six continents. M. Joseph Sirgy (Ph.D., U/Massachusetts) is a management psychologist and the Virginia Tech Real Estate Professor Emeritus of Marketing at Virginia Polytechnic Institute and State University (USA) and Extraordinary Professor at the WorkWell Research Unit at North West University— Potchefstroom Campus (South Africa). He has published extensively in the area of marketing, business ethics, and quality of life (QOL). His awards include the International Society for Qualityof-Life Studies’ (ISQOLS’) Distinguished Fellow Award, ISQOLS’ Distinguished QOL Researcher, Academy of Marketing Science’s (AMS’) Distinguished Fellow Award, AMS’ Harold Berkman Service Award, Virginia Tech’s Pamplin Teaching Excellence Award/Holtzman Outstanding Educator Award and University Certificate of Teaching Excellence, the EuroMed Management Research Award, and the Macromarketing Society’s Robert W. Nason Award. Best paper awards include articles published in the Journal of Happiness Studies, the Journal of Travel Research, and Applied Research in Quality of Life. His editorial responsibilities include co-founding editor of Applied Research in Quality of Life, editor of the QOL section in the Journal of Macromarketing, ditor-in-hief of the Journal of Macromarketing, editor of ISQOLS’/Springer’s book series on International Handbooks in QOL, Community QOL Indicators—Best Cases, Applied Research in QOL—Best Practices, and co-editor of Springer book series on Human Well-Being and Policy Making.

Chapter 28

The Vatican’s Response to the Coronavirus Pandemic: The COVID-19 Commission and Preparing the Future Nicholas J. C. Santos and Dominic H. Chai

Abstract The Vatican presents a unique case, as at one level, it is the smallest sovereign state in the world, while at another, it is the seat of the Roman Catholic Church, which has over a billion members. In this chapter, we focus on the COVID19 Commission that was charged with not just coming up with ways to mitigate the pandemic but also to prepare a post-pandemic future. Unlike most national government responses that were aimed at the well-being of their resident populations, the COVID-19 Commission was asked to consider the well-being of the entire human family. Using the systemic framework proposed by Shultz et al. (Handbook of community well-being research (pp. 403–421). Springer, 2017), we observe that the COVID-19 Commission functions as a catalytic institution facilitator getting together governments, businesses, as well as nongovernmental organizations to prepare a future that is aimed at the common good and one that ensures a higher quality of life for all. Keywords COVID-19 Commission · Vatican Dicastery for Promoting Integral Human Development · Common good · Preparing the future

28.1

Introduction

Vatican City State is the world’s smallest sovereign state that is home to just about 1000 people in an area that is less than 1 km2 (CIA World Factbook, 2021). However, it is the seat of the Roman Catholic Church, also called the Holy See. As Reese (1998, pp. 4–5) notes, “The Holy See is a unique organization because it pursues spiritual and secular goals at an international level.” The Pope as head of the

N. J. C. Santos (*) Heider College of Business, Creighton University, Omaha, NE, USA e-mail: [email protected] D. H. Chai Dicastery for Promoting Integral Human Development, Vatican City, Italy e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_28

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Holy See plays multiple roles to fulfill these goals. He is at the same time bishop of Rome, the monarch of the Vatican City State, and the supreme leader of the Catholic Church. According to data released by the Central Office of Statistics of the Church, the number of baptized Catholics in the world at the end of the year 2018 was 1.3 billion or just under 18% of the total world population (Salvini, 2020). This is about the population of India, which has the second-largest population in the world after China. In trying to understand community well-being in the context of the Vatican and the pandemic, it is important for us to first define what we mean by community. Such a delineation is necessary as a community, as far as the Vatican is concerned, is multilayered and intricate. There is the notion of community as defined by people living in a geographical place that share space and governance for functioning (Sung & Phillips, 2018). Thus, the Vatican City State, the Catholic Diocese of Rome, together with all the Catholic Dioceses around the globe, are communities of place in terms of governance. Each diocese is further subdivided into smaller governance places called “parishes.” The parish is where the members first experience the Catholic religion that they belong to and where “they worship, are educated in the faith, receive their sacraments, and form community” (Zech et al., 2017, p. 1). All parishes are complex social organizations, which combine varying elements of leadership, finances, worship styles, community outreach programs, and approaches to religious education; they “are populated by diverse generational cohorts and ethnic groups, each with their own concerns and traditions” (Zech et al., 2017, p. 1). While each parish might be different, it comes under the overall governance structure of the Vatican. Then, there is the notion of community that transcends geographical place and unites people across space along common interests (Bradshaw, 2008). Thus, all the members of the Catholic Church form a global faith community and are affected or influenced by directives from the Vatican. The Vatican’s response to the pandemic was multilayered. It had to deal with the pandemic in Vatican City, the local area that it was responsible for governing. Then, it had to provide direction to the dioceses and parishes and to the Catholic faithful around the world that looked to it for spiritual leadership. Finally, because of its recognition as a global force, it had a moral duty to use its authority to play a role in fashioning a global response. In terms of the local area, like other countries, the Vatican City State internal health-care system was impacted by the pandemic. However, it rapidly adapted to provide health assistance while maintaining high protective measures among its patients and employees as well as health-care workers (Arcangeli et al., 2021; Reuters, 2021). Also, similar to most other countries, it implemented mask mandates and social distancing requirements and suspended public services, dining, and closing its doors to tourists. As the Vatican depended on tourists for revenue through donations, museum ticket sales, and visits to various sites, the pandemic caused it to lose more than $100 million in revenue as of March 2021 (Cerullo, 2021). In our opinion, what makes the Vatican’s response distinctive is not so much what it did in its local governing area as much as its leadership at forging a global response. At the heart of that global response was the setting up of the Vatican COVID-19 Commission. In this chapter, we focus on this commission

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that was set up by Pope Francis and analyze it using the systemic framework that Shultz et al. (2017) propose. We begin by elaborating in detail the composition of the commission and its intended outcomes. We then situate it within the systemic framework of Shultz et al. (2017).

28.2

The Vatican COVID-19 Commission

In March 2020, Pope Francis established the Vatican COVID-19 Commission to be led by the Dicastery for Promoting Integral Human Development (DPIHD) (2021). The goal of the commission was to confront the challenges that the entire human family was facing on account of the COVID-19 pandemic (Esteves, 2020). However, the commission was not tasked with just dealing with the pandemic or preparing for a post-pandemic era but rather to prepare or create the future (San Martín, 2020). The commission was divided into five working groups, each focused on a specific aspect of the pandemic. These five working groups were (1) acting now for the future; (2) looking to the future with creativity; (3) communicating hope; (4) seeking common dialogue and reflection; and (5) supporting to care. We elaborate on each of these working groups below (DPIHD, 2021).

28.2.1 Working Group 1: Acting Now for the Future This group was tasked with engaging in dialogue with the local churches across the world to better understand the local context and needs so that the commission could provide contextualized support to local leaders. The group began by establishing communication channels with local church structures throughout the world as well as Catholic medical associations, religious congregations, etc. Numerous virtual meetings were held around the world to assess the existing medical and health infrastructure and identify the most pressing needs. Some of the challenges that the group identified in 2020 included food insecurity, unequal access to social protection, increase in poverty and unemployment, increased vulnerability among marginalized populations, etc. The group also found some local initiatives and good practices that were mitigating the pandemic. These included local churches combatting misinformation about the virus, church infrastructures and facilities being used to quarantine people and as COVID-19 treatment centers, churches engaging in political advocacy with national governments for legislation related to nutrition, housing, income support, etc. Working group 1, through the collaboration between DPIHD and Caritas International (CI), supported over 40 projects around the world and mobilized more than 4 million euros. These projects included COVID-19 prevention and preparedness programs in countries such as Argentina, Dominican Republic, Ghana, Iran, Iraq, Nigeria, and Yemen.

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28.2.2 Working Group 2: Looking to the Future with Creativity This group was tasked with convening a diverse group of experts to co-create creative, integral solutions to some of the systemic challenges faced today. The hope was to be able to provide regional and global decision-makers with solutions that could create “a more sustainable, inclusive, and resilient future” (p. 6). Four task forces were established on health, economy, ecology, and security and work. By the end of 2020, over 30 projects were being developed. These projects include “Food Security,” “Future of Work,” “Laudato Si’ Business Roundtables,” “Vaccine for All,” “Biodiversity & Water,” “Less Arms, More Health,” etc. The “Food Security” project proposes “a new agricultural development model that puts the poor and most vulnerable at the center.” The “Future of Work” project aims at correcting injustices in the world of work. The “Laudato Si’ Business Roundtables” project addresses the issue of building a regenerative economy that is inclusive and sustainable. The “Vaccine for All” project considers equity in vaccine development and deployment. The “Biodiversity & Water” project involves preparing “a Christian narrative on biodiversity that is scriptural, cosmic, ecological, scientific, creative, and ritualized.” The “Less Arms, More Health” initiative is a multilateral effort aimed at negotiating agreement between states to invest in security that comes from peacebuilding, poverty reduction, and health care instead of weapons. Collectively, these projects are beginning “to shape new economic, political, and social models for integral human development” (p. 7).

28.2.3 Working Group 3: Communicating Hope Working group 3 was aimed at shining a light on good works and thus communicating hope instead of despair. It brought professional communications expertise and the Vatican’s media infrastructure to inform the Pope, the Church, and the world of the work of the COVID-19 Commission. The Vatican News website featured a section called “COVID-19 Special: Beyond the Crisis” that published over 1000 articles in 36 languages in the year 2020. The Dicastery of Communications used varied communications channels and platforms to communicate the work that the commission as well as the local churches were doing during the pandemic. Three books were published by the Vatican’s publishing house Libreria Editrice Vaticana: To Heal the World: Catechesis on the Pandemic; Life after the Pandemic; and Strong in the Face of Tribulation.

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28.2.4 Working Group 4: Seeking Common Dialogue and Reflection This group, which was part of the Vatican’s Secretariat of State, was aimed at supporting diplomacy and global relations. The group shared weekly reports with the other working groups that sketched the evolution of the pandemic and its effects across six regions. These regions were sub-Saharan Africa, America, Asia, Europe, the Middle East and North Africa, and Oceania. In addition to these weekly reports, the group also compiled and published all of the interventions by the Permanent Representatives of the Holy See that were COVID-19 related.

28.2.5 Working Group 5: Supporting to Care This working group was set up to build a pipeline of resources that would financially support the commission’s work and its assistance to local churches. The group refurbished the preexisting Buon Samaritano Foundation to fund the commission. Between April 1 and September 30, 2020, the group had raised or committed over 7 million euros and US$1 million.

28.3

Quality of Life (QOL): The COVID-19 Commission as a Catalytic Institution Facilitator

The Vatican COVID-19 Commission was established by Pope Francis as a response to the pandemic but not just to alleviate immediate suffering. Rather, it was intended to also “usher forth the transformation of hearts, minds, and structures toward a new model of development that prepares a better future for all” (DPIHD, 2021, p. 1). As such, the commission was not just concerned with QOL in the present but also that of the future. Further, it was a gesture of the church’s concern and love for the entire human family and not just for a particular subsection of the global population (Esteves, 2020). In this section, we analyze the Vatican COVID-19 Commission’s role as a catalytic institution facilitator in enabling QOL using the systemic framework proposed by Shultz et al. (2017). Shultz et al. (2017) suggest that community well-being/QOL requires several macro–micro links that institutions such as the government, nongovernment organizations (NGOs), and businesses play a catalytic role in ensuring whether citizenconsumers in communities are served or underserved, thereby resulting in flourishing or distressed communities. Distressed communities tend to have a larger number of underserved citizen-consumers who are often disenfranchised (Shultz et al., 2017). Potential determinants of citizen-consumers being well- or underserved include location and access, income/wealth capital, social/cultural capital, and

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situational commonalities. These variables exist within macro factors such as geography/environment, population, political/legal/economic/social/cultural factors, administration, infrastructure, and technology. These macro factors are linked to the micro factors via the catalytic institutions of governments, businesses, and NGOs and the marketing system that emerges from these institutions. Shultz et al. (2017) hold that if communities are to flourish the three interdependent catalytic institutions, namely, government, NGOs, and businesses, must cooperate. A question that arises is: how does such cooperation come about? Shultz et al. (2017, p. 414) suggest that “through their choices and behaviors and their political activism, consumer-citizens can spur catalytic institutions, and ultimately best practices and community well-being.” While this might hold true for already flourishing communities, in distressed communities such spurring by disenfranchised and marginalized consumer-citizens might be challenging because these populations lack a voice and are at the mercy of more powerful players. It is here that the COVID-19 Commission plays a critical role as a catalytic institution facilitator, particularly on behalf of distressed communities and populations, bringing together governments, NGOs, and businesses to create a future that is equitable and just. The commission puts into practice Pope Francis’ call that we need to work collectively together with a special focus on the poor and marginalized. In his address to the 75th meeting of the General Assembly of the United Nations on September 25, 2020, Pope Francis (2020) said in reference to ensuring access to COVID-19 vaccines that “if anyone should be given a preference let it be the poorest, the most vulnerable, those who so often experience discrimination because they have neither power nor economic resources.” Shultz et al. (2017) point out that people in distressed communities tend to be preoccupied with meeting basic or survival needs, and therefore, community planners in these communities should have a comprehensive set of indicators that capture ill-being so that they can help the residents to meet these needs. However, the COVID-19 Commission, in alignment with Pope Francis’s thinking, goes a step further. While acknowledging that the pandemic has revealed the existence of a significantly large number of people who fall in the distressed community group, the solution of helping them meet their basic or survival needs might be an immediate requirement but is not adequate from a long-term perspective. According to Father Augusto Zampini, one of the heads of the commission, we need to look for economic models that will help create a fairer world and not go back to a world of inequalities led by an economy that kills (San Martín, 2020). The Economy of Francesco is one such initiative that Pope Francis has been instrumental in creating that is aimed at promoting the development of sustainable and more inclusive economic models. At the 3-day virtual gathering held in November 2020, Pope Francis challenged the more than 2000 young economists, entrepreneurs, and change-makers to reimagine a new economic model (Roewe, 2020).

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Conclusion

In this chapter, we have considered the response of the Vatican City State to the pandemic and evaluated this using the organizational framework that Shultz et al. (2017) provide. The Vatican provides a unique case study. On one level, it is the smallest independent state in the world, in terms of area and population. On another level, it is the seat of the Roman Catholic Church with over 1.3 billion people worldwide and its global reach is phenomenal. In the prologue to his book The Global Vatican, Ambassador Francis Rooney (2013, p. xvi) writes: Today, the church remains a single supranational force, operating effectively in more places and cultures than any other international body, with the possible exception of the United Nations. Actually, I would argue that the Holy See has the longer, deeper reach. Unlike the United Nations, which often imposes itself on local cultures from the outside, the Catholic Church is part of any place it is present, whether a Nigerian village, an Ecuadorian farming community, or a middle-class American suburb.

It is this global reach and influence that distinguishes Vatican City (Holy See) from the other countries in this volume. While the Vatican implemented measures to mitigate the pandemic in the geographical area of Vatican City State, much like the other countries, its sphere of concern extended to the global community. Acknowledging the structural inequities and injustices that the pandemic was bringing to the fore, Pope Francis asked the Dicastery for Integral Human Development to set up the COVID-19 commission with the objective of ushering a new model of development that prepares a better future for all (https://www.humandevelopment.va/en/vaticancovid-19.html). In this chapter, we focused on this COVID-19 commission, the various working groups that constitute it, and the work that it has begun. Using the Shultz et al. (2017) framework, we see how the COVID-19 Commission plays the role of a catalytic institution facilitator, bringing together governments, businesses, and NGOs to commit to action for a post-pandemic future that infuses dignity in the workplace, creates new structures for the common good, places solidarity at the heart of governance, and respects nature. While this is still a work in progress, the commission has created a QOL movement that is gaining momentum. Time will reveal the extent to which its efforts resulted in a global flourishing community.

References Arcangeli, A., Massimo, R., De-Giorgio, F., Soave, P. M., & Ercoli, L. (2021). The Vatican City State internal healthcare system response to COVID-19 pandemic: Prevention and control strategies. Applied Health Economics and Health Policy, 19, 141–144. Bradshaw, T. K. (2008). The post-place community: Contributions to the debate about the definition of community. Community Development, 39(1), 5–16. Cerullo, M. (2021, April 1). Vatican has lost more than $100 million from COVID-19 pandemic. https://www.cbsnews.com/news/catholic-church-vatican-lost-100-million-revenue-covidpandemic/

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CIA World Factbook. (2021, July 28). Holy see (Vatican City). https://www.cia.gov/the-worldfactbook/countries/holy-see-vatican-city/ Dicastery for Promoting Integral Human Development. (2021, February 4). 2020 year in review: Vatican COVID-19 commission preparing the future. https://www.humandevelopment.va/en/ vatican-covid-19.html Esteves, J. A. (2020, April 16). Pope creates coronavirus commission to respond to pandemic. Crux. https://cruxnow.com/vatican/2020/04/pope-creates-coronavirus-commission-to-respondto-pandemic/ Pope Francis. (2020, September 25). Video message of his holiness pope Francis to the seventy-fifth meeting of the general assembly of the United Nations. https://www.vatican.va/content/ francesco/en/messages/pont-messages/2020/documents/papa-francesco_20200925_ videomessaggio-onu.html Reese, T. (1998). Inside the Vatican. Harvard University Press. Reuters. (2021, January 2). Vatican City plans swift COVID-19 vaccination drive for residents. https://www.reuters.com/article/health-coronavirus-pope-vaccine/vatican-city-plans-swiftcovid-19-vaccination-drive-for-residents-idUSKBN2970ER Roewe, B. (2020, November 24). As economy of Francesco ends, pope calls on the young to chart a new development model. https://www.ncronline.org/news/earthbeat/economy-francesco-endspope-calls-young-chart-new-development-model Rooney, F. (2013). The Global Vatican: An inside look at the Catholic Church, World Politics, and the extraordinary relationship between the United States and the Holy See. Rowman & Littlefield. Salvini, G. (2020, September 28). Church Numbers in the World. La Civiltà Cattolica. https://www. laciviltacattolica.com/church-numbers-in-the-world/ San Martín, I. (2020, July 1). Vatican COVID-19 commission seeks to ‘prepare the future.’ https:// cruxnow.com/vatican/2020/07/vatican-covid-19-commission-seeks-to-prepare-the-future/ Shultz, C. J., Rahtz, D. R., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), Handbook of community Well-being research (pp. 403–421). Springer. Sung, H., & Phillips, R. G. (2018). Indicators and community Well-being: Exploring a relational framework. International Journal of Community Well-Being, 1(October), 63–79. Zech, C. E., Gautier, M. L., Gray, M. L., Wiggins, J. L., & Gaunt, T. P. (2017). Catholic parishes of the 21st century. Oxford University Press.

Nicholas J.C. Santos is an associate professor of marketing at the Heider College of Business, Creighton University, Nebraska, USA. His research interests include business ethics, business and society, Catholic social teaching, corporate social responsibility, marketing strategies, and ethical issues at the base-of-the-pyramid market, social innovation, and entrepreneurship. He has published widely in a number of journals such as Business and Politics, Journal of Business Ethics, Journal of Catholic Social Thought, Journal of Macromarketing, and Journal of Public Policy and Marketing and is an invited reviewer for a number of journals. Dominic H. Chai currently serves as the co-coordinator of the Vatican COVID-19 Commission’s Economy Taskforce at the Dicastery for Promoting Integral Human Development. He received a BA from the University of California, Berkeley, an MA in theological studies from Loyola University Chicago, and a PhD from the London School of Economics. He has held faculty positions at Manchester Business School, Seoul National University, and Birkbeck, University of London. His research interests include examining companies as communities and their contribution to the common good.

Chapter 29

Vietnam in the Combat Against COVID-19: Responses of the Government and Cooperation Among Stakeholders Nguyen Thi Tuyet Mai and Mai The Cuong

Abstract The COVID-19 pandemic has had a profound impact on global socioeconomic life. Vietnam, a developing country in Southeast Asia, has been considered a successful example of controlling the pandemic and achieving good results on the fronts of disease prevention and economic growth, both of which are facilitating community well-being. In this chapter, we examine Vietnam’s experiences in containing the COVID-19 pandemic in 2020, focusing on the cooperation among stakeholders, following the Systemic Framework to QOL in Distressed and Flourishing Communities proposed by Shultz, Rahtz and Sirgy (The handbook of community well-being (pp. 403–421). Springer, 2017). Specifically, we first present an overview of the COVID-19 pandemic situation in Vietnam with the main phases and timeline. We then discuss the impacts of the COVID-19 pandemic on its citizens and businesses. The main part of the chapter features the cooperation among stakeholders in Vietnam during the COVID-19 pandemic aiming at achieving the dual goals of disease control and economic development. Finally, the challenges, the lessons learned, and the implications for policymakers in coping with the COVID-19 pandemic as Vietnam moves forward are discussed. Keywords COVID-19 pandemic · Cooperation among stakeholders · Systemic Framework to QOL in Distressed and Flourishing Communities · Vietnam

29.1

Introduction

The virus SARS-CoV-2 first appeared in Wuhan (China) in December 2019, and then spread to other countries around the world, including Vietnam. In March 2020, the World Health Organization (WHO) called COVID-19 (i.e., Coronavirus Disease 2019) a global epidemic. This pandemic has affected all aspects of socioeconomic life; up to now, it has not shown signs of stopping and is still evolving complicatedly

N. T. T. Mai (*) · M. T. Cuong National Economics University, Hanoi, Vietnam e-mail: [email protected]; [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_29

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around the world. This global crisis is challenging all countries to quickly find ways to end or at least control the COVID-19 pandemic, while also ensuring economic development and social security for their people. Vietnam is a developing country in Southeast Asia, which is bordered by China in the North, and Laos and Cambodia in the West. Vietnam has the third largest population in Southeast Asia (after Indonesia and the Philippines), with more than 97 million people. The first cases of COVID-19 infection in Vietnam were discovered in January 2020. On January 31, 2021, while the whole world had more than 102 million infection cases and more than 2.2 million deaths (WHO, 2021), Vietnam was/is considered a successful example in the combat against COVID-19. Indeed, the country’s management of the crisis has been impressive, with relatively low figures of 1817 infected cases and 35 deaths (Ministry of Health, 2021a, 2021b). At the early stage of the pandemic in Vietnam, the Vietnamese government implemented prompt and decisive measures to prevent the outbreaks of COVID-19. However, since the third quarter of 2020, the government has implemented strategies toward achieving simultaneously two goals: continuing to fight the COVID-19 pandemic and promoting economic growth. In 2020, Vietnam became the fourth largest economy in Southeast Asia (after Indonesia, Thailand, and the Philippines), and was one of few economies in the world to achieve a positive growth rate (2.91%) (General Statistics Office, 2020a). It is expected that the Vietnamese economy should rebound in 2021 with a growth rate of more than 6% (World Bank, 2020a). Vietnam’s efforts in managing and containing the pandemic have gained high praise for their effectiveness in controlling the outbreak of COVID19 cases (e.g., Mekong Development Research Institute and United Nations Development Program, 2020; Trevisan et al., 2020; World Bank, 2020b). These efforts also help to build a positive image and brand of Vietnam as an attractive destination for foreign investment and are a catalyst for economic development. The practices regarding this remarkable story of Vietnam have attracted much attention from scholars and policymakers (e.g., Hartley et al., 2021; Huynh, 2020; Institute of Social and Medical Studies and United Nations Development Program, 2020; Mekong Development Research Institute and United Nations Development Program, 2020; Tran et al., 2020). This chapter examines how Vietnam has been confronting the COVID-19 pandemic and has become a successful example of containing the spread of SARS-CoV2 and the outbreak of disease, while at the same time achieving economic growth. The focus of the chapter is the cooperation among all stakeholders in the battle against COVID-19 in Vietnam, following the Systemic Framework to QOL in Distressed and Flourishing Communities suggested by Shultz et al. (2017). In addition to the secondary data sources, this chapter also employs primary data from interviews with Vietnamese citizens and NGOs’ representatives as well as observations from the field study. Following the introduction, the remainder of this chapter is divided into five main sections: (1) an overview of the COVID-19 pandemic situation in Vietnam; (2) the pandemic’s impacts on Vietnamese citizens and businesses; (3) the government’s responses and the cooperation among stakeholders in the combat against SARS-CoV-2 and the COVID-19 illness it causes;

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(4) challenges, lessons learned, and implications for policymakers; and (5) conclusion.

29.2

Overview of the COVID-19 Pandemic Situation in Vietnam

The COVID-19 pandemic in Vietnam can be divided into six phases, up to the end of January 2021. • Phase 1—the first cases of COVID-19 infection (January 23, 2020–February 25, 2020): The first case of a person infected was detected on January 23, 2020. In this period, all the initial 16 confirmed cases were related to Wuhan, China. • Phase 2—the cases entered Vietnam from abroad (March 6, 2020–March 19, 2020): The 17th case was reported on March 6, 2020. This case was a female Vietnamese returning from England. The other 68 cases were people returning from European countries and the United States. • Phase 3—social distancing for the first time (March 20, 2020–April 21, 2020): The 86th and 87th cases were reported on March 20, 2020. These cases were two nurses from Bach Mai Hospital. It was difficult to trace the original source of the infection. On March 22, 2020, the Vietnam government suspended foreigners’ entry into Vietnam, and Vietnamese returning home from abroad must spend 14-day quarantine period in centralized areas. Social distancing was applied for the first time, from April 1 for 15 days. • Phase 4—social distancing for the second time in Danang city (July 7, 2020– September 4, 2020): The 416th case was reported in Danang city. The source of the infection was unknown. In this city, new cases of infection were detected and increased in the community. Other provinces started reporting cases related to people returning from Danang city. Social distancing was then applied in Danang city. • Phase 5—new normal activities (September 5, 2020–January 27, 2021): COVID19 prevention and economic development are both objectives of the government. • Phase 6—the “new wave” of COVID-19 infection (from January 28, 2021, and ongoing): After almost 2 months without any virus transmission, two cases of COVID-19 in the community—from a new variant of coronavirus—were confirmed on January 28, 2021; specifically, a person working at a company in Hai Duong province and an employee of Van Don international airport, living in Quang Ninh province. By day’s end, the total confirmed cases was 91, the biggest daily number in Vietnam since the beginning of the pandemic (Vietnam News, 2021). To respond to the “new wave” of COVID-19, the prime minister has required all ministries, functional units, and localities to quickly prepare scenarios and measures to act more drastically and faster to stop the spread of SARS-CoV-2 and COVID-19.

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A detailed timeline of the pandemic and related initiatives in Vietnam for the prevention and control of COVID-19 is provided in the Appendix.

29.3

Impacts of the COVID-19 Pandemic on Vietnamese Citizens and Businesses

Like many other countries around the world, Vietnam has been negatively affected by the COVID-19 pandemic. The following section focuses on the impacts of COVID-19 on the quality of life (QOL) of Vietnamese citizens and also its impact on businesses.

29.3.1 Impact on Citizen QOL Citizen QOL is multidimensional, including economic, environmental, and social elements (Nguyen et al., 2014). The COVID-19 pandemic has significant impacts on all aspects of Vietnamese citizens’ QOL. When COVID-19 suddenly appeared in Vietnam, many people were very worried about the possibility of infection. People lined up to buy face masks and hand sanitizers. The price of these goods increased exponentially and beyond control in many places. In Hanoi, the capital city of Vietnam, when the first case of COVID-19 infection in the community was officially announced on the night of March 6, 2020, the early morning of the next day people rushed to supermarkets and traditional markets to buy and to stock-up on essential goods. Purchases of essential items surged overnight, leading to a shortage of goods in many places (To Uyen, 2020). However, thanks to the timely responses of the government and businesses, by March 8, 2020, the commodity market in Hanoi was almost back to normal. The supply of goods at supermarkets and traditional markets was quite plentiful, the price of goods was stable, and consumers’ purchasing power returned to normal. With regards to employment and livelihood, the pandemic has caused a negative impact on the jobs of many workers in Vietnam. According to General Statistics Office (2020b), as of September 2020, the employment of 31.8 million people aged 15 and over was negatively affected. Among this group, 68.9% experienced a decrease in income; nearly 40.0% had to reduce working hours or take time off work; and about 14% had to temporarily stop working. The general unemployment rate was 2.26%, and the unemployment rate of the working-age group in urban areas was 4.46%, the highest rate since 2011. Different groups’ employment and livelihood, however, are differently affected by COVID-19. The biggest group losing jobs includes those people working for tourism, restaurants, hotels, and traditional retail industries. According to International Labour Organization’s (2020) estimation,

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18.1% of workers who were mainly working for small and medium enterprises (SMEs) and household businesses lost their jobs in 2020. The COVID-19 pandemic has significantly and adversely impacted the vulnerable groups of society. In 2020, among the 1.3 million people who lost jobs, half were women. People who work for the informal sector have also been heavily affected. Many people, after losing their jobs due to the pandemic, have had difficulty in finding employment since learning new skills may be challenging—especially for older people and low-skill workers. According to the Institute of Social and Medical Studies and United Nations Development Programs (2020), which assessed the impact of the pandemic on vulnerable groups living near the border of Vietnam and China, many citizens in this region cannot maintain their normal livelihood. Due to the COVID-19 outbreak and implementation of strict regulations to contain the pandemic, such as closing the border and implementing social distancing, many people must stay at home and cannot go to work as before (e.g., as hired laborers in China or trading across the border). Some people have become farm-laborers as temporary livelihood. This has a largely negative impact on their living standard due to the physical demands of the work and income decline. The epidemic has also negatively affected citizens’ social-cultural life. Many cultural and performing arts activities have been postponed or canceled because of COVID-19. The novel and dangerous epidemic, which appeared quickly and has spread rapidly around the world, has caused fear and worry among the people. To prevent a disease outbreak, many drastic measures have been taken in Vietnam, such as travel restriction, social distancing, school closures, zoning off and blocking off the areas where infected people were detected, and quarantining in centralized areas. These have disrupted many people’s lives and are the sources of daily stress.

29.3.2 Impact on Businesses COVID-19 has had a significant impact on businesses. During the year 2020, 101,700 enterprises suspended business activities for a certain period, stopped operation, or waited for dissolution procedures, and many firms have cut their labor force and reduced production (National Economics University and Japan International Cooperation Agency, 2020). The pandemic, however, has affected various industries and fields at different levels. The travel and hospitality, food and beverage, and logistics have been most affected. Textiles and garment, and real estate industries are considered to be moderately impacted by COVID-19, while industries such as finance, banking and insurance, and information technology have been less negatively affected and have even benefited in some cases during the pandemic. According to General Statistics Office (2020c), more than 80% of firms in the tourism and food and beverage industries have been severely affected. The year 2020 was very difficult for Vietnam’s tourism industry. There were only 3.8 million international visitors in 2020, a decrease of 78.7%, and only 56 million domestic

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tourists, down 34.1% compared to the year 2019. This situation resulted in total revenue of only 17.9 trillion VND (approximately US$776.5 million) from tourism and traveling services, down 59.5% compared to the prior year. The findings from a survey of enterprises in the travel and hospitality, and food and beverage industries conducted by the National Economics University and Japan International Cooperation Agency (2020) also showed that the labor force in these businesses was reduced by 46.73% in 2020 compared to the average number of 2019. The negative impact of labor force size reduction may have lasting effects. Many workers who lost their jobs due to the pandemic, including those with high skills, have already learned new skills and moved to new jobs. When the firms can resume operations or expand their business after the epidemic, they will have difficulties to find and hire qualified employees. The impact of COVID-19 has also varied by firm size. Smaller firms cut more of their labor force than did the larger-size firms did; that is, the micro-sized firms with fewer than 5 employees cut 44.8% of their labor force, while firms with more than 200 employees cut only 3.18% (National Economics University and Japan International Cooperation Agency, 2020). Although the COVID-19 pandemic has affected all businesses across a spectrum of industries, the impact has varied. Some businesses appear to be thriving. Firms in the pharmaceutical industry and firms engaged in e-commerce, for example, may see more opportunities and benefit from the pandemic. Even in the most negatively impacted industries such as food and beverage, a number of companies operating online or moving to internet platforms have done well.

29.4

Responses of the Government and Cooperation Among Stakeholders During the Pandemic

In the combat against the pandemic, many measures and activities have been taken by the government at the national and local levels, and by other stakeholders in society. Best practices in successfully preventing and controlling COVID-19 outbreaks in Vietnam demonstrate the government’s decisive and effective responses, the consensus of society, and cooperation among stakeholders.

29.4.1 Responses of the Government The Vietnamese government’s responses to COVID-19 reveal two coordinated approaches: it (1) imposes preventive policies to stop the virus’ spread, while (2) simultaneously stimulating economic activities, to mitigate the negative impact on people and to ensure social security. In terms of preventive policies, the government’s responses are fast, aggressive with strong political commitment, and consistent from central government to local

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governments. Consistency of policy implementation is observed from central government to local governments (i.e., provinces, districts, communes, and villages). Since the early days of the pandemic, the whole political system has committed to give the highest priority to manage this situation. The prime minister and deputy prime minister in charge of public health have given directions and participated daily in the National Steering Committee for COVID-19 Prevention and Control. Intensive communication from government bodies to people is implemented. Television and newspapers provide daily updates about cases/outbreaks, progress, and policies. Messages are also conveyed by local authorities to citizens in communes and villages. Government implemented early policies to prevent the spread of the virus. When a case of infection is not yet confirmed, a preventive process is applied. If the case is confirmed, the infected person (F0) and related people (F1, F2, F3) are quickly traced and treated in accordance with designated guidelines. The government closed borders and banned flights from infected regions. Quarantine has been applied to all people who enter the country from countries recognized as pandemic risks. Social distancing periods of 15 days have been applied to areas where confirmed cases were found. In the sixth phase, a 21-day social distancing period is applied. The government has also applied the closure of nonessential businesses, services like gyms, restaurants, events, and even closure of the schools for the safety of students if a high risk of infection is identified (Tran et al., 2020). Prevention measures, control processes, and the health-care system continue to be upgraded. Guidelines for the prevention and control of COVID-19 are regularly updated. Facilities and equipment for testing and treatment are upgraded and newly provided to enhance the capacity of the health-care system. In terms of economic development, the government has implemented policies to promote economic activities, mitigate negative impact, and ensure social security. The government has extended the date to pay land tax and land rental fee for businesses. It has reduced 15% of the land rental fee and 30% of corporate income tax. It also encourages banks and credit organizations to support businesses and people, including (1) ensuring the liquidity from credit organizations; (2) reduction of loan interest rate for businesses and people; (3) restructuring of loan payment terms from credit organizations to businesses; and (4) credit programs from commercial banks with an interest rate 2% lower than the rate prior to COVID-19. Public investment becomes one of the most important tasks to ministries and local authorities in order to promote public expenditure. The government provides direct support to about 20 million laborers whose jobs were cut or reduced due to COVID-19.

29.4.2 Responses of Businesses In terms of ownership, businesses in Vietnam can be categorized into state-owned enterprises (SOEs), domestic private enterprises, and foreign direct invested enterprises (FDIs). Some industries (e.g., garments and footwear) are dominated by SOEs and domestic private enterprises. Some industries (e.g., electronics and home

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appliances) are dominated by FDIs. The degree of backward and downward linkages with international markets and channels also has different impacts on enterprises. Responses of businesses to the COVID-19 pandemic are subject to the industry that enterprises are in. Vulnerable industries are travel and hospitality, mining, transportation, and logistics. Some industries, which are not much affected or even grew in the pandemic, are pharmaceutical, communication, banking, insurance, and finance (General Statistics Office, 2020b). For vulnerable businesses in which revenue is declining or there is no more revenue, job cuts or even business closures are witnessed. Other businesses have entered “hibernation” mode. To cope with COVID-19 pandemic, many companies have restructured the organization and maintained only necessary activities such as maintenance. They have also negotiated with banks and lenders to restructure loans. At the same time, they have necessarily applied for exemptions and reductions of tax, social insurance, and other financial obligations. A number of companies have sought to transform the way of doing business, applying new technology and using Internet platforms. To ensure safety for workers, businesses have applied strict measures to disinfect the workplace, provided employees with the detailed guidance on COVID-19 prevention, and required workers to wear face masks and to wash hands, frequently. Some companies have also applied a policy of assigning groups to work from home (WFH). WFH has become a familiar term in Vietnam during the pandemic for many companies and their employees.

29.4.3 Responses of NGOs Nongovernmental organizations (NGOs) are defined as religious institutions, aid groups, community groups, and social service providers, which largely make contributions to communities where governments or businesses cannot or will not (Shultz et al., 2017). NGOs in Vietnam can be divided into two groups: international NGOs (INGOs) and local NGOs. Vietnam has relationships with more than 1000 INGOs of which 500 INGOs have regular activities in Vietnam as of July 2018 (MOFA, 2018). Each NGO has its own objectives, interest, and subjects. NGOs are focusing on different sectors—for example, education, economic development, social issues, and natural resources preservation—and in different geographical areas. NGOs have their stable sources of funding, including governments, organizations, businesses, and individuals. In principle, NGOs are not financially affected by COVID-19 since the commitment for financial support to activities of NGOs is high. NGOs’ activities have been affected in the way that some activities related to traveling and meetings are not exercised as planned because of social distancing. However, the need for support of NGOs continues to increase. The coordination of NGOs with government and businesses is implemented under two main forms: operation and funding. In terms of operation, NGOs work closely with government authorities, businesses, and communities to ensure the

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participation of stakeholders, smooth implementation of activities, and achievement of projects’ goals. In terms of funding, NGOs have diversified funding from individuals, organizations (businesses), and even from governments. The following section presents two cases of NGOs in Vietnam, which have maintained their activities during the COVID-19 pandemic.

29.4.3.1

Case 1: Plan International Vietnam During the COVID-19 Pandemic

Plan International Vietnam (https://plan-international.org/vietnam) is an INGO focusing on helping vulnerable and ethnic minority groups. The interest areas of Plan International Vietnam are (1) quality and inclusive education; (2) nutrition and health services; (3) building resilience to the impacts of natural disasters and climate change; (4) creating safe cities with access to good jobs; and (5) preventing all forms of violence and harmful practices. Plan International receives funding for its activities from different global sources ranging from businesses to individuals and governments. Plan International Vietnam has implemented a project named “Quality Pre-Primary and Primary Education for Ethnic Minority Students in North and Central Region.” This project aims to improve the learning environment and to encourage a smooth transition of ethnic minority children from preschool to primary school through capacity building of preschool and primary school teachers and parents, as well as the construction of infrastructure. In the first year and the second year, the project worked on capacity building of preschool and primary school teachers, and the establishment of a local network of parents and local people to support schools. It also began to create tools to improve the quality of “New Professional Teacher Meeting (New PTM)” in the second year. In the third year, it will continue capacity building of the teachers, local networking, and establishment of child-friendly infrastructure, and to complete and disseminate the tool of New PTM. The objective is for children from the ethnic minority groups in Lai Chau and Kon Tum province to receive quality preschool and primary school education within an adequate education environment. One of the key drivers for the project’s success is coordination among stakeholders. Plan International Vietnam has worked closely with local authorities and schools, including Departments of Education and Training in Kon Tum and Lai Chau, Bureaus of Education and Training in districts, communes, and various schools in target areas. The project has also received encouragement and support from local villages and parents. Although the project ended in September 2019, the NGO still set a goal for project results to be spread in a sustainable way. In 2020, under COVID-19, the activities continue with funding from other sources. Core teachers continue to disseminate useful information about their experiences to other teachers. “Teaching of teachers” is more effective with flexibility and adaptations of the approach equipped by the project. The New PTM method has been officially applied nationwide in Vietnam by the Ministry of Education and Training since April 2020.

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Case 2: Seed to Table

Seed to Table (http://seed-to-table.org/english.html) is an INGO focusing on (1) promoting ecologically sound agriculture practices and utilizing local resources; (2) conserving the natural resources and the cultural heritage of local communities to underwrite the livelihoods of local people; (3) processing food by using local resources and creating jobs in rural areas; and (4) creating networks among people in rural and urban locations. Seed to Table has implemented the Project for Improving Livelihood of Small-Scale Farmers and Developing Environmental-Friendly Community by Applying Organic Farming and Food Processing and Providing Environmental Education for Children. Under COVID-19, although it was not difficult for Seed to Table to ensure financial budgets for its activities in Vietnam, in 2020 such activities as traveling and meetings with stakeholders were not carried out during periods of social distancing. Seed to Table could not hold its closing conference with the project’s stakeholders in Ben Tre province. The NGO understands this conference is an important event because lessons learned and follow-up activities are expected to be discussed during the meeting. To successfully implement the project, the NGO discovered that ongoing willingness and enthusiasm among partners, at all levels and endeavors of the project, are critical. Therefore, its post-project follow-up activities have been carried out to help farmers practicing organic farming. It has worked closely with Ben Tre Provincial Agricultural Extension Center, Districts Agricultural Extension Centers, Commune People’s Committees, cooperatives, and farmers. Seed to Table helps farmers to find markets for their products by making connections and facilitating the coordination of buyers in Ho Chi Minh City with farmers and cooperative. Its intervention to help farmers practicing organic farming has even helped farmers to increase income, despite COVID-19; indeed, farmers enjoy selling products at higher prices in response to increasing demand for organic food. This NGO continues to receive requests for support from local authorities and farmers in several other provinces, including Dong Thap, Tra Vinh, An Giang, Long An, and Dong Nai.

29.4.4 Responses of Citizens Vietnam is a socialist country with the dominance of many Confucian values. People in Vietnam promote the primacy of collective goals (collectivism) in which the society’s goals are more important than individuals’ and respect for authority and social rites is important (Nguyen & Mai, 2019). During COVID-19, people in Vietnam have behaved in a disciplined way, strictly followed guidelines from authorities, and have been collaborative with one another toward the goal of beating the pandemic.

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Most people in Vietnam follow COVD-19 news through television, mobile phone messages, and social networks. According to the findings from a survey by Mekong Development Research Institute and United Nations Development Program (2020), 97% of interviewed people considered the pandemic was either serious or extremely serious. Vietnamese people share a high consensus on the government’s policies on preventing COVID-19. The percentage of wearing face masks, washing hands frequently, and reducing daily face-to-face contact is in turn 99%, 93%, and 92%, respectively (Mekong Development Research Institute and United Nations Development Program, 2020). Due to COVID-19, many people have lost jobs, or their incomes have declined. A number of people have decided to reduce their consumption. However, some people have discovered creative ways to deal with the pandemic to keep their living standard and even to make a better life (e.g., moving to new jobs such as shippers or learning and capturing opportunities to do business in e-commerce sector).

29.4.5 Cooperation Among Stakeholders Vietnamese authorities and the people more broadly consider the prevention of and fight against the COVID-19 pandemic is analogous to waging a war. To win this battle requires the involvement of the entire political system and the coordination of all forces in society. It has been strongly suggested that improved governance and responsiveness of central and local Vietnamese governments have contributed to the country’s effective responses to the COVID-19 pandemic (Mekong Development Research Institute and United Nations Development Program, 2020). In the early days of the epidemic, Vietnam National Steering Committee on COVID-19 Prevention and Control was established by Decision No. 170/QD-TTg of the Prime Minister (on January 30, 2020). The committee is headed by Deputy Prime Minister Vu Duc Dam, and its members include three deputy ministers from the Ministry of Health, a deputy head of the Commission for Mass Mobilization, a vice president of the Vietnam Fatherland Front, and leaders from other related ministries and organizations. The National Steering Committee is responsible for directing and coordinating all government agencies and other relevant bodies for preventing and controlling the pandemic. The Steering Committees on COVID-19 Prevention and Control were also established at different levels from country level to province level, district level, and commune level (Vietnam Government Portal, 2020a). Under the National Steering Committee, there are several delegations for examining and supporting the implementation of measures to prevent and control the pandemic. A typical delegation of the Steering Committee consists of leaders and officers from Ministry of Health, Institutes of Hygiene and Epidemiology, Hospitals, Border Department, Border Guard Command, Immigration Department of Ministry of Public Security, Department of Employment, and Ministry of Labor, Invalids and Social Affairs (Ministry of Health, 2021a, 2021b). The steering committees at all

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levels have made great efforts to follow closely the progress of COVID-19 pandemic and have given decisive and timely directions to prevent/end this crisis. Coordination of institutions consisting of government, businesses, and NGOs plays a vital role in facilitating marketing systems that bring QOL to communities (Shultz et al., 2017). It was noted by the prime minister of Vietnam that even without the COVID-19 pandemic the coordination among the relevant institutions in Vietnam already has been exercised. In response to the demands of society, leaderships from institutions in Vietnam have addressed the following issues: (1) entrepreneurial spirit of Vietnamese youth, especially young people in rural and mountainous areas; (2) development of social housing for low-income people, housing for workers in industrial zones; (3) prevention and overcoming consequences of natural disasters that Vietnam faces annually, including tropical depressions and storms, floods, droughts, landslides, thunderstorms and lightning, cyclones, saline intrusion; (4) increasing education quality comprehensively in terms of curriculum, textbook, pedagogical methods, and teaching facilities; (5) a quality health-care system, which is easy to access and affordable. Special emphasis is directed toward children, the elderly, and people with difficult circumstances; (6) social security for the poor, the disabled, and the elderly; and (7) services to protect women and children, especially girls, from abuse (Vietnam Government Portal, 2020c). In 2020, in addition to the COVID-19 pandemic, Vietnam also had to face the situation of “storms after storms,” “floods after floods” occurring continuously in the central provinces. The coordination among institutions under “pandemic plus natural disaster” continues (1) to provide basic goods and services to people (e.g., housing, food, clothing, and medical treatment) and (2) access to education, especially for children and students in the central region. The Red Cross Association at all levels and the Fatherland Front launched the movement “good leaves protect torn leaves,” calling on organizations, businesses, and individuals to support vulnerable people in society. Donations are in the form of money and non-cash contributions like “Rice ATMs,” “Face mask ATMs,” and phone text messages (Le, 2020). The inventor of the famous “Rice ATM” machine during the COVID-19 pandemic was Mr. Hoang Tuan Anh, Director of Green Space Company, which distributes electronic key PHGLock in Ho Chi Minh City (Vietnam News Agency, 2020). Later, many other Rice ATMs and Mask ATMs have appeared to serve vulnerable people, free of charge (see Fig. 29.1). An important factor driving success in the combat against the COVID-19 pandemic is the consensus and cooperation of citizens. The history of Vietnam is associated with many wars. Many Vietnamese people are perhaps still obsessed with the pains of war, and thus have a strong will to overcome difficulties to cope with the epidemic. People generally are willing to comply with strict regulations on wearing masks, washing hands frequently, as well as making medical reports, avoiding crowds, and limiting going out upon request. The findings from the interviews with people who have been in quarantine after returning to Vietnam from countries in which SARS-CoV-2 has rapidly and widely spread, causing great harm, suffering, and death, show that they admire and appreciate the caring attention of the service forces involved (e.g., the army, the militia, the medical team), even

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Fig. 29.1 Rice ATM where COVID-distressed people can obtain rice, free of charge. (Source: Vietnam News Agency, 2020)

though these forces initially may have some confusion in dealing with problems related to a very new but dangerous epidemic. In the process of quarantine, Vietnamese people generally seem to adapt more easily to the new living situation and to comply with the quarantine rules, compared with some foreigners, who often find it more difficult to accept strict quarantine regulations. Communication has shown the importance of guiding information and providing people with knowledge of effective COVID-19 epidemic prevention and control. Effective communication activities require the active participation of all parties and citizens in society. Communication messages related to COVID-19, such as the epidemic’s development and prevention methods, have appeared on different media in various forms (e.g., posters, television sports, Zalo messages, electronic boards, songs) that are designed in an easy-to-understand, easy-to-remember, and eye-catching manner. For example, the “5K” message from the Ministry of Health (i.e., wearing mask, disinfection/washing hands, no gathering, declaring, and keeping distance) can be seen throughout hospitals, schools, trade centers, factories, offices, and residential areas (see Fig. 29.2). It is also easy to recognize messages regarding COVID-19, methods of prevention and containment and hand sanitizer are available in lifts and gates at the public areas such as the apartments and universities. Figure 29.3 captures the images in a lift at the National Economics University in Hanoi. In another attempt to convey a persuasive message about fighting COVID-19, musician Khac Hung has composed the song “Ghen Cô Vy,” which is featured in the Health Ministry’s communication campaigns. The song performed by two famous

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Fig. 29.2 Message 5K “Live safely with COVID19 pandemic.” (Source: Duong Hai, 2020)

Fig. 29.3 COVID-19-related messages and hand sanitizer in a lift at the National Economics University. (Source: Author photos)

V-pop singers, Eric and Min, has inspired many people to strictly adhere to antiepidemic measures. The song and accompanying dance have “gone viral”, in the best sense of the term. Among many examples of this phenomenon, during Last

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Week Tonight with John Oliver, a program on the American HBO network, Mr. Oliver blended humor and seriousness in his effusive praise of this Vietnamese initiative to combat the pandemic: https://www.youtube.com/watch?v¼D3 pAEPCVp2g (Oliver, 2020); on March 2, 2020, “Ghen Cô Vy”—described as “insanely catchy”—also appeared on a digital site for Billboard magazine (Aniftos, 2020). The original version, with English subtitles, has over 84 million views, at the time of this writing: https://www.youtube.com/watch?v¼BtulL3oArQw (Ministry of Health, 2020). The lyrics moreover have been translated into several other languages; the official English version, including sign-interpretation for people with hearing impairment, can be accessed at https://www.youtube.com/watch? v¼nKu_hIyoEAc (Ministry of Health, 2020). Further to the Ministry’s initiatives, and accolades from Oliver and Billboard, the song and accompanying dance have inspired numerous interpretive performances and challenges on various social media. Both the song and dance have been adopted by corporations and professional groups for promotional messages, which have generated millions more views, thus keeping the prevention of COVID-19 top of mind and helping to ensure people remain vigilant in the fight against SARS-CoV-2.

29.5

Challenges, Lessons, and Implications for Policymakers

The COVID-19 pandemic is ongoing and shows complicated developments, globally. Vietnam has been considered a successful example of containing the pandemic to date; the country has confronted many challenges in protecting the antiepidemic achievements and maintaining economic growth. In the last months of 2020 and the beginning of 2021, concerns have increased about the risk of COVID-19 outbreak due to the threat of illegal immigration into Vietnam across the borders. There are also concerns when witnessing crowded festivals in big cities. These concerns increased further during Tet Holiday—that is, Lunar New Year celebration—in mid-February 2021. Such events raise questions about casual attitudes toward COVID-19 and its dangers among a number of citizens and/or some neglect by the authorities at all levels toward the pandemic. In the last days of January 2021, two COVID-19 epidemic zones were detected in two provinces; the number of infected people in the community has increased rapidly. The total number of confirmed cases increased from 1549 on January 25 to 1817 on January 31, 2021. The government subsequently has identified the danger of a new variant of the coronavirus, which is more virulent and can spread very quickly. Such an event increases risks and dangers and could prolong the pandemic. The government therefore has redoubled its focus on preventive measures to stop the spread of all forms of the virus, in the best interests of individual QOL and societal well-being. In order to win the battle against the unpredictable COVID-19 pandemic and to manage successfully future health crisis, it is necessary to review and draw lessons

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from experiences and effective practices. Some lessons learned from Vietnam’s experiences in responding to and controlling effectively and successfully the COVID-19 epidemic thus far—and policy implications drawn from them—are shared below. Drastic and Timely Responses The government plays a very important role in providing fast and decisive directions and issuing timely policies and regulations to deal with the pandemic, systemically, throughout this public health crisis. With regards to COVID-19 disease, it is important to quickly detect cases of infection, rapidly trace and test the cases related to the outbreak areas, and strictly implement isolation. Early and quick detection of SARS-CoV-2 can prevent its large-scale spread and accordingly can enable effective mitigation and control of COVID-19. During the “new wave” of infections and illnesses, early 2021 in Vietnam, the government has emphasized “speedy actions” as critical to preventing outbreaks. Coordination Among all the Stakeholders in Society Consensus and cooperation of citizens as well as coordination among all stakeholders is considered vital to the success of containing and controlling the COVID-19 pandemic. Policymakers must gain the consensus, attention, and participation of all members and institutions in society, and mobilize all resources from the whole society to defeat the virus and end this health crisis. Intensive and Effective Communication About the Pandemic and Its Progress Communication plays a very important role in disseminating information regarding the pandemic and the measures to contain it among all members of society. In general, communication activities regarding the pandemic in Vietnam have been quite effective. The messages regarding COVID-19 and how to prevent and control it can be seen nearly everywhere in public and commercial spaces, in person, offline, and via online channels. Communication campaigns emphasize the seriousness of the pandemic and the importance of the combat against COVID-19, with persuasive slogans such as “fighting the epidemic is like fighting against the enemy” and “staying home is patriotism.” Citizens therefore have been inspired to comply with regulations, similarly to the wartime that many people have experienced. However, vulnerable groups, including the poor, less-educated people, and minority communities—who are most affected by the pandemic—are less able to access the COVIDrelated information. Thus, policymakers need to improve measures to ensure everyone has equal access to information about the pandemic (UNDP, 2020). Maintaining Macroeconomic Stability, Following Dual-Goal Approach When developing policies to deal with the pandemic, policymakers need to take into account factors that ensure sustainable success. Enhancing effectiveness of supportive packages for citizens and businesses is necessary. The support should be allocated to the appropriate people; the policies, procedures, and benefits should be clear and transparent (National Economics University and Japan International Cooperation Agency, 2020; United Nations Development Program Vietnam, 2020). Priority for support should be given to vulnerable groups who have lost their livelihoods, who are often low-skill laborers, people working in informal sector, women,

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elderly, and people/communities comprising minority groups who typically reside in remote regions. International Cooperation Since the COVID-19 pandemic is global, cooperation among countries in the regions and worldwide is necessary to successfully fight the SARS-CoV-2 pathogen. One of the important cooperation activities in the near future perhaps is coordination in vaccine production and supply, and public health generally. In the longer term, international cooperation is important to overcome the negative consequences of COVID-19 and continue developing the economy.

29.6

Conclusion

In 2020, in response to the COVID-19 pandemic, Vietnam successfully implemented the dual goal of both effective epidemic control and mitigation, and socioeconomic development. According to Vietnam’s General Secretary and President Nguyen Phu Trong, Vietnam is one of the 10 countries with the highest GDP growth rates in the world and one of the 16 most successful emerging economies in 2020 (Nguyen & Nguyen, 2021). However, the year 2021 remains full of challenges since the COVID-19 pandemic continues in countries around the world, with various rates of infection and variances in policy. The danger of another outbreak remains constant. Vietnam, together with other countries around the world, must continue to fight fiercely against the SARS-CoV-2 virus and COVID-19 to ensure safety, better life for people, and community well-being. To become a winner in a long-run battle against the pandemic, Vietnam, a developing country with many difficulties and challenges, needs to make effective use of the lessons learned, be ready to respond to new situations, promote internal strengths through cooperation among all stakeholders in society, and at the same time effectively cooperate with the international community. Acknowledgments The authors express sincere thanks to the key informants for sharing their experiences and perspectives regarding the COVID-19 pandemic in Vietnam.

Appendix

Timeline of the COVID-19 pandemic in Vietnam Phase 1 December 31, 2019 Wuhan Municipal Health Commission reported cases of “viral pneumonia” in Wuhan (WHO, 2020)

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January 23, 2020 Vietnam discovered the first case of infection. The first two confirmed cases are Chinese nationals (father and son) working in Ho Chi Minh City. January 23, 2020–February 25, 2020 16 initial confirmed cases including 11 cases in Son Loi commune, Vinh Phuc province were detected The commune was isolated from February 12 to March 3 February 1, 2020 Prime Minister Nguyen Xuan Phuc signed Decision No. 173/QD-TTg on the declaration of infectious epidemic in Vietnam (Vietnam Government Portal, 2020b) Flights to mainland China, Hong Kong, Macau, and Taiwan were suspended by Vietnam’s Civil Aviation Authority (Dezan Shera & Associates, 2021). Hong Kong, Macau, and Taiwan were removed from the list on February 2, while mainland China remained suspended February 12, 2020–March 5, 2020 No newly reported case for 22 consecutive days Phase 2 March 6, 2020 The 17th confirmed case was reported in Hanoi. The case returned from England March 6, 2020–March 19, 2020 Total confirmed cases were 85. Most cases were those who entered Vietnam from abroad Phase 3 March 21, 2020 Immigration was stopped March 28, 2020 Bach Mai Hospital was put into lockdown April 1, 2020 Social distancing was applied nationwide for 15 days April 15, 2020 Social distancing was continued in big cities and provinces including, Hanoi and Ho Chi Minh City April 15, 2020–July 24, 2020 No newly reported case for 100 consecutive days Phase 4 July 25, 2020 The 416th confirmed case was reported. There was no source of infection found July 26, 2020 418th confirmed case was reported. Da Nang General Hospital was put into lockdown July 27, 2020

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11 confirmed cases were reported in Da Nang July 28, 2020 Social distancing was applied in Da Nang city July 31, 2020 The first death case due to COVID-19 was reported Phase 5 September 5, 2020 Da Nang city removed social distancing requirements September 15, 2020 International flights have been reopened although there are still limitations on these flights September 24, 2020 New normal activities have been exercised. Economic development and COVID-19 prevention are the two parallel objectives Phase 6 January 28, 2021 Two infections in the community with a new variant of coronavirus were confirmed. The total infected cases were 91 at the end of the day, including 84 cases in the community and 7 imported cases (from abroad) confirmed by the National Steering Committee for COVID-19 Prevention and Control

References Aniftos, R. (2020, March 2). Listen to Vietnam’s insanely catchy coronavirus PSA. Billboard. Retrieved January 31, 2021, from https://www.billboard.com/articles/news/international/932 6879/vietnam-coronavirus-psa-video Dezan Shera & Associates. (2021). Vietnam business operations and the Coronavirus: Updates. UpToDate. Retrieved January 17, 2021, from https://www.vietnam-briefing.com/news/ vietnam-business-operations-and-the-coronavirus-updates.html/#:~:text¼As%20of%20 January%2015%2C%202021,deaths%20due%20to%20the%20pandemic Duong Hai. (2020). The Ministry of Health recommends “5K” to safely live with epidemics. UpToDate. Retrieved January 17, 2021, from https://ncov.moh.gov.vn/en/-/bo-y-te-khuyencao-5k-chung-song-an-toan-voi-dich-benh General Statistics Office. (2020a). Socio-economic situation in the fourth quarter and the whole year 2020. UpToDate. Retrieved January 29, 2021, from https://www.gso.gov.vn/en/data-andstatistics/2021/01/socio-economic-situation-in-the-fourth-quarter-and-the-whole-year-2020/ General Statistics Office. (2020b). Report on the impact of COVID-19 epidemic on labor and employment situation in the third quarter of 2020. UpToDate. Retrieved December 20, 2020, from https://www.gso.gov.vn/en/data-and-statistics/2020/10/report-on-the-impact-of-covid-19on-labour-and-employment-of-the-third-quarter-of-2020/ General Statistics Office. (2020c). Tourism in 2020 was dizzy due to Covid-19. UpToDate. Retrieved April 20, 2021, from https://www.gso.gov.vn/du-lieu-va-so-lieu-thong-ke/2021/01/ du-lich-nam-2020-lao-dao-vi-covid-19

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Hartley, K., Bales, S., & Bali, A. S. (2021). COVID-19 response in a unitary state: Emerging lessons from Vietnam. Policy Design and Practice, 4(1), 152–168. https://doi.org/10.1080/ 25741292.2021.1877923 Huynh, T. L. D. (2020). The COVID-19 containment in Vietnam: What are we doing? Journal of Global Health, 10(1), 1–3. https://doi.org/10.7189/jogh.10.01033 Institute of Social and Medical Studies and United Nations Development Program. (2020, July). Public health impact assessment of the Covid-19 pandemic on vulnerable groups living near the border of Vietnam and China [press release]. International Labour Organization. (2020). COVID-19 and the labour market in Viet Nam. UpToDate. Retrieved April 20, 2021, from https://www.ilo.org/hanoi/Whatwedo/Publications/ WCMS_742134/lang%2D%2Den/index.htm Le, T. T. H. (2020). Promote “soft power” in prevention and control of COVID-19 epidemics in Vietnam. Communist Review. https://www.tapchicongsan.org.vn/web/guest/van_hoa_xa_ hoi/-/2018/819609/phat-huy-%E2%80%9Csuc-manh-mem%E2%80%9D-trong-phong%2Cchong-dich-covid-19-o-viet-nam.aspx Mekong Development Research Institute and United Nations Development Program. (2020, December). Citizens’ opinions of and experiences with government responses to COVID-19 pandemic in Viet Nam: Findings from a phone-based survey [press release]. Ministry of Foreign Affairs. (2018). NGOs actively contribute to the development of Vietnam. UpToDate. Retrieved January 19, 2021, from https://baoquocte.vn/cac-ngo-gop-phan-tich-cucvao-su-phat-trien-cua-viet-nam-73799.html Ministry of Health. (2020). Ghen Cô Vy, [lyrics and artistic rendering by K. Hung, Min, Erik]. National Institute of Occupational Health and Environment. Retrieved January 20, 2021, from https://www.youtube.com/watch?v¼BtulL3oArQw Ministry of Health. (2021a). Mission No. 5 of the National Steering Committee for COVID-19 epidemic prevention and control works in Gia Lai and Dak Lak. UpToDate. Retrieved January 29, 2021, from https://moh.gov.vn/tin-noi-bat/-/asset_publisher/3Yst7YhbkA5j/content/-oancong-tac-so-5-cua-ban-chi-ao-quoc-gia-phong-chong-dich-covid-19-lam-viec-tai-gia-lai-vaak-lak Ministry of Health. (2021b). One new case of Covid-19 infection, nearly 18,000 people are in quarantine. UpToDate. Retrieved January 17, 2021, from https://ncov.moh.gov.vn/en/-/684742 6-742 National Economics University and Japan International Cooperation Agency. (2020, December). Assessment of policies to cope with COVID-19 and recommendations [Press release]. Nguyen, T. T. M., & Mai, T. C. (2019). The business system of Vietnam. In H. Hasegawa & M. A. Witt (Eds.), Asian business and management: Theory, practice and perspectives (3rd ed., pp. 250–264). Red Globe Press. Nguyen, M. P., & Nguyen, T. M. T. (2021, January 10). The position and perspectives of Vietnam. Nhan Dan Online. https://nhandan.com.vn/nhan-dinh/vi-the-va-co-do-kinh-te-viet-nam631311/. Nguyen, T. T. M., Rahtz, D., & Shultz, C. (2014). Tourism as catalyst for quality of life in transitioning subsistence marketplaces: Perspectives from Ha Long, Vietnam. Journal of Macromarketing, 34(1), 28–44. https://doi.org/10.1177/0276146713507281 Oliver, J. (2020). Vũ điệu rửa tay Ghen cô Vy của Việt Nam lên sóng truyền hình M~y [trans. Vietnam’s “Jealousy Co Vy” hand washing dance aired on US television]. This Week with John Oliver. Retrieved January 20, 2021, from https://www.youtube.com/watch?v¼D3pAEPCVp2g Shultz, C., Rahtz, D., & Sirgy, J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate well-being. In R. Phillips & C. Wong (Eds.), The handbook of community well-being (pp. 403–421). Springer. To Uyen. (2020, March 7). Capital people hustle to buy goods to hoard: Do not worry about lack of essential goods. Vietnam Online Financial Times. http://thoibaotaichinhvietnam.vn/pages/xahoi/2020-03-07/dan-thu-do-un-un-mua-hang-tich-tru-khong-nen-lo-thieu-hang-hoa-thiet-yeu83443.aspx

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Nguyen Thi Tuyet Mai is currently Professor at the National Economics University, Vietnam. She holds a Ph.D. in marketing from the National University of Singapore, an MBA from Boise State University, USA and a BA from the National Economics University, Vietnam. Dr Mai’s research interests include macromarketing, consumer behaviors, knowledge-based management and entrepreneurship. Her research has been published in international journals such as Journal of Macromarketing, Journal of Public Policy and Marketing, Journal of International Marketing, Journal of Business Venturing, Journal of Marketing Theory and Practice, Journal of Asia-Pacific Business, Sustainability, and Young Consumers. Dr Mai has also published some books including Conspicuous Consumption in Vietnam, A Transitional Economy and book chapters such as The Business System of Vietnam in Asian Business and Management Theory, Practice and Perspectives (2009, 2014, 2019). Mai The Cuong is currently a Lecturer and Head at the Department of International Business, School of Trade and International Economics, National Economics University, Vietnam. He holds a BA and a Ph.D. in international economics from the National Economics University and an MBA

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focusing on marketing from the International University of Japan. He has taught international business, international procurement, and international marketing. He has designed and facilitated marketing and sales programs for enterprises in Vietnam. His papers have been published in books and journals such as Journal of World Economic Issues, Journal of Economics, Journal of Foreign Trade, and Journal of Economics and Development. He has co-authored and contributed to publications, amongst them Asian Business and Management (Palgrave Macmillan, 2009, 2014, 2019); The collection and usage of Marketing Information by Vietnamese SME (NEU Publishing House, 2007); and Improving Industrial Policy Formulation (Publishing House of Political Economy, 2005).

Chapter 30

Effective Interventions to Mitigate the Ill-Being Effects of COVID-19: Lessons Learned from Countries Around the World M. Joseph Sirgy

, Clifford J. Shultz II

, and Don R. Rahtz

Nothing has more strength than dire necessity. Euripides

Abstract This chapter discusses effective interventions to mitigate and moderate the ill-being effects of COVID-19 based on lessons learned from 28 countries, representing all continents affected by the pandemic. First, we focus on effective interventions in mitigating the spread of COVID-19. Second, we focus on additional health externalities and identified factors moderating effectiveness of interventions. Third, we then identify and discuss effective interventions in mitigating the adverse economic and social impact of the virus. Finally, we conclude with some thoughts regarding the Shultz, Rahtz, and Sirgy framework and its evolution. In doing so, we emphasize the imperative of constructive engagement by catalytic institutions in response to crisis and in ways that facilitate coordinated and cooperative initiatives to mitigate the distresses of pandemic, and potentially other crises. We contend that engaging constructively should fundamentally ensure that well-being is enhanced for as many stakeholders as possible, so that people, countries, and local and global communities can flourish.

M. J. Sirgy (*) Pamplin College of Business, Virginia Tech, Blacksburg, VA, USA WorkWell Research Unit, Faculty of Economic and Management Sciences, North West University, Potchefstroom Campus, South Africa e-mail: [email protected] C. J. Shultz II Quinlan School of Business, Loyola University Chicago, Chicago, IL, USA e-mail: [email protected] D. R. Rahtz Mason School of Business, College of William & Mary, Williamsburg, VA, USA e-mail: [email protected] © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 C. J. Shultz, II et al. (eds.), Community, Economy and COVID-19, Community Quality-of-Life and Well-Being, https://doi.org/10.1007/978-3-030-98152-5_30

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Keywords COVID-19 interventions · Public health interventions · Economic interventions · Constructive engagement · Health externalities · Catalytic institutions · Quality of life · Well-being

30.1

Introduction

The COVID-19 pandemic has exacted a heavy toll on communities, economies, and billions of people, the world over. In response to this global crisis, the authors/editors assembled a team of leading scholars from 28 countries, representing all continents affected by the pandemic. These scholars administered a systemic analysis of their focal country, guided by a framework to assess and ultimately to facilitate individual quality of life (QOL) and the well-being of communities and entire countries (Shultz et al., 2017). In this chapter, we synthesize and interpret the 28 studies, each of which offers lessons for discerning effective interventions to mitigate the ill-being effects of COVID-19. Our synthesis features overarching findings that tend to coalesce around themes, and successful ideas, policies, practices, and behaviors observed in several countries, or were compelling and unique contributions in an idiosyncratic context. This chapter is organized in four sections. The first section focuses on effective interventions in mitigating the spread of COVID-19. The second section focuses on factors moderating their effectiveness. The third section focuses on effective interventions in mitigating the adverse economic and social impact of the virus. Finally, we conclude with an Epilogue, some thoughts regarding the framework, including plausible additions and expansions introduced by Shultz et al. (2022); we emphasize the imperative of constructive engagement by catalytic institutions in response to crisis and in ways that facilitate coordinated, cooperative, and systemic initiatives to mitigate the distresses of pandemic, and potentially other crises, so that well-being is enhanced, and people, communities, and countries can flourish.

30.2

Interventions Deemed Effective in Mitigating the Spread of COVID-19

We highlight interventions assessed as effective in mitigating the spread of COVID19 and we break down this discussion by interventions administered by the public health system, government, and other catalytic institutions (see Table 30.1). We then identify factors we believe may have moderated the effectiveness of these interventions.

30.2.1 Interventions by the Public Health System Many effective interventions have been used by the public health system in various countries. They include social distancing, wearing masks and mask provisioning,

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Table 30.1 Effective interventions to mitigate the spread of COVID-19 Type of catalytic institutionsa Governmental • Public health system and other government institutions

• Mandates issued by governments at national, state, and local levels

Non-governmental (NGO) and businesses • Interventions requiring development, production, promotion, delivery, and administration of life-saving goods and services

a

See Shultz et al. (2017, 2022)

Mitigation strategies Public health system interventions • Social distancing • Wearing masks and mask provisioning • Lockdowns of communities and businesses • Quarantining and self-isolation • Testing for infection/immunity: Diagnostic and for antibodies • Sanitary practices • Vaccinations • Contact tracing • Crowd “hot spot” mapping • Plasma donation/plasma therapy • Hospital and health-system restructuring Mandates for enforcement and other governmental actions • Directives to ensure effective implementation of health interventions • Accelerated vaccine development and production • Financial and logistical support for hospitals and other healthcare organizations • Creation and coordination of alliances and initiatives • Testing site funding and staffing • Travel restrictions • Communication campaigns support and funding Medical infrastructure institutions • Including: Hospitals, clinics, testing labs, pharmaceutical companies, pharmacies, manufacturers, suppliers, and personnel across local and global value chains; international health bodies, e.g., WHO, UN for data collection, storage and tracking, and science-based information dissemination Business community • Including: Organizations reconfiguring workspaces and allowing remote work, implementing public health protocols in service and product delivery. Traditional and social media to provide information. Financial institutions loan programs and other economic support Communities, neighborhoods, and individual citizens • Including: Producing and providing masks, norm shaping, food and medicine programs; support for mental and emotional health

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lockdown, quarantining, self-isolation, testing, sanitary practices, vaccinations, contact tracing, hot spot mapping, plasma donation, and hospital restructuring. We will discuss how these interventions were effectively used in those countries we studied. Social distancing has been universally applied by the public health systems in the majority of countries. Social distancing is the practice of increasing the space between individuals and decreasing the frequency of contact to reduce the risk of spreading a disease. Social distancing strategies are customarily applied on an individual level (e.g., avoiding physical contact), a group level (e.g., canceling group activities where individuals will be in close contact), and an operational level (e.g., rearranging chairs in the dining hall to increase distance between them) [Center for Disease Control and Prevention, 2021)]. Wearing masks is considered effective in preventing people who have COVID-19 from spreading the SARS-CoV-2 virus to others. Most countries have applied this public health measure. Firstly, although the use of masks is an important method to stop the spread of infection, people cannot use masks if they are not available or do not have the means to purchase them. As such, many governments have facilitated access to masks. For example, in Singapore, the government developed an app called MaskGoWhere. The app helps people find nearest places to pick-up free masks (Lwin et al., 2022). Secondly, the construction and quality of the mask affects its efficacy; that is, the mask has properties that eliminate or greatly reduce the spread of infected, exhaled aerosol. N-95 and KN-95 masks have such properties, as they block greater than 95% of particulate. Three-layer knitted cotton masks comparatively block an average of 26.5% of particulate and thus are much less effective in controlling the spread of SARS-CoV-2. Thirdly, wearing the mask properly—tightly sealed over mouth and nose—also is important (Environmental Protection Agency, 2021). Lockdown is a restriction policy for people or community to stay where they are, usually due to specific risks to themselves or to others if they move and interact with people who may be infected. The term “stay-at-home” or “shelter-in-place” is often used for lockdowns that affect an area, rather than specific location. The first lockdown implemented as a preventive measure in response to COVID-19 was in Wuhan (China) in January 2020 (Driskell et al., 2022). The lockdown was very stringent. The city lifted its lockdown on April 8, 2020. Residents with a government-issued green QR code on their mobile devices were allowed to go leave home. By June of 2020, the city had screened the entire city for the virus and completed 9.89 million nucleic acid tests. Quarantining and self-isolation were also used worldwide. Quarantining applies when people are already exposed to the virus. It usually involves staying home for 14 days after last contact with an infected person. Self-isolation applies when a person is infected with the virus, even if no symptoms are evident. People remain in isolation until they are deemed unable to transmit the virus/infection. The vast majority of the countries we studied have applied quarantining and self-isolation measures to contain the spread of COVID-19. With respect to testing, again, the vast majority of the countries we studied applied testing, too. Two types of tests are available: diagnostic tests and antibody

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tests. Diagnostic tests (molecular and antigen) show if the person has an active COVID-19 infection. Samples for diagnostic tests are typically collected with a nasal or throat swab, or saliva collected by spitting into a tube. Antibody tests look for antibodies in the person’s immune system produced in response to SARS-CoV-2. Samples for antibody tests are typically blood from a finger stick, or blood drawn by physician or other medical personnel (Kubina & Dziedzic, 2020). Sanitary practices typically involve washing hands with soap and water regularly, using hand sanitizers, avoiding touching the face with unwashed hands, and cleaning surfaces and equipment with disinfectants. Again, sanitary practices have been used as an effective public health intervention worldwide. Vaccinating the public is deemed an effective public health intervention used by the majority of the countries we studied. For example, three vaccines were used in the USA, produced by Pfizer-BioNTech, Moderna, and Johnson & Johnson (Katella, 2021). In December 2020, Pfizer-BioNTech was the first COVID-19 vaccine to receive Food and Drug Administration (FDA) Emergency Use Authorization, after the company reported positive initial clinical trial data that showed the vaccine was highly effective. In August 2021, this vaccine received full approval for people ages 16 and older from the FDA for use in the USA. The Moderna vaccine was also authorized for emergency use in the USA, in December 2020. In mid-August, the FDA approved a booster dose of the Moderna vaccine for certain immunocompromised individuals. The FDA also granted emergency use authorization for Johnson & Johnson’s vaccine in February 2021. At the date of this writing (September 3, 2021), 53.3% of the population in the USA have been vaccinated. Achieving a high rate of vaccination is important to the fight against the spread of the corona virus. In that regard, epidemiologists refer to “herd immunity.” This concept refers to resistance to the spread of an infectious disease (e.g., COVID-19) within a population that is based on pre-existing immunity of a high proportion of individuals as a result of previous infection or vaccination. Epidemiologists believe that herd immunity can be achieved when 80–90% of the population become vaccinated. Contact tracing is yet another effective public health intervention used by several countries. The intervention involves tracing the footsteps of the infected to identify possible other infections and therefore to treat those who were exposed. In Rwanda, contact tracing was rapidly implemented in March 2020 contributing to the success of the public health interventions (Francis & Mugabo, 2022). For example, the healthcare workers assigned to this task established contact tracing of sex workers—“clients” were identified and tested through the contact tracing program. In Singapore, the government developed a “Trace Together” contact tracing app to identify people who come in contact with positive COVID-19 cases. Approximately 78% of residents have used this app (Lwin et al., 2022). With respect to the USA, Americans have to register to enter Canada from a particular state (e.g., New York). The registration process allows the public health system in New York to trace the footsteps of the traveler in Canada and back to the USA. Hot spot mapping refers to identifying crowded places to ensure avoidance of these places. In Singapore, hot spot mapping was used at national parks and gardens and shopping malls. The maps are color-coded to indicate crowd levels. As such, the

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use of hot spot mapping apps can visually see where there are crowds to help them with social distancing (Lwin et al., 2022). Plasma donation (convalescent plasma therapy) is a method to treat infected people and alleviate symptoms. When a person is fully recovered from COVID-19, that person is able to help patients currently fighting the infection by donating his or her plasma. The plasma contains COVID-19 antibodies provided by the person’s immune system to fight the virus when the person was sick. As such, that person’s plasma can be used to help others fight off the disease. Plasma donation has been used effectively by several countries. For example, in Indonesia, a community of COVID-19 survivors banded together—called ExCov Community—who donated their convalescent plasma to hospitals and clinics applying this treatment. The community operates as a hub of assistance by processing inquiries from COVID19 patients to then disseminate the information to the community subgroups—the goal is to help patients gain access to and accelerate the process of getting convalescent plasma (Soesilo & Rahman, 2022). Hospital restructuring involves developing a new set of priorities in hospital admission to accommodate the large influx of COVID-19 patients. Hospitals in many countries had to be restructured to handle the surge of COVID-19 patients. For example, in Colombia hospitals sent home patients with low-risk medical conditions and implemented a telemedicine scheme to free up hospital capacity to treat COVID-19 patients (Barrios Fajardo et al., 2022). In Australia, hospitals and clinics geared up for increased Covid-19 patients by cutting back on elective surgery to ensure there was appropriate capacity (Polonsky & Weber, 2022).

30.2.2 Interventions by Government Governments in many countries issued mandates that had to be enforced to support and ensure the effective implementation of public health interventions. For example, in the USA, state governments issued specific mandates related to a number of people in social gatherings forcing businesses (e.g., bars and restaurants, gyms and fitness facilities, movie theaters) to shut down. Primary and secondary schools were forced to use distance learning. Many businesses (e.g., supermarkets) had to require their patrons to wear masks. People were required to work from home unless classified as “essential personnel.” Severe restrictions were placed on visiting patients in hospitals and nursing homes (Rahtz et al., 2022). In Australia, the government issued mandates of home lockdowns and curfews were established. Specifically, restrictions were put in place regarding activities such as leaving one’s home (e.g., 1 person is permitted to leave home, up to 1 h per day, for essential goods and no visitors), number of people permitted to weddings (5 people) and funerals (10 people) (Polonsky & Weber, 2022). In China, 4 days after the announcement was made about the corona virus, the entire City of Wuhan was locked down (Driskell et al., 2022). All public and personal transportation were barred. Schools and retail stores were closed. Residents were not allowed to leave the city. Most

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corporate offices had security guards monitoring body temperatures of people entering office-buildings. Residential compounds were closed to visitors. The lockdown of Wuhan lasted for 76 days. In Croatia, government invested in the procurement of critically important sanitary goods and services such as disinfectants, masks, and other protective gear (Miočević et al., 2022). In Finland, the government mandated cancelations of public events and cultural activities and restricted international travel (Repo et al., 2022). A particular feature of Ghana’s response to the pandemic has been the public disinfection campaign (Dadzie, 2022). Specifically, the Minister of Local Government and Regional Development, in response to the President’s order, was charged with disinfecting all open spaces, markets, and lorry stations in the country. The government also played a key role in managing the pandemic in Indonesia (Soesilo & Rahman, 2022). For example, the government organized a Fast Response Team, developed mandates to protect healthcare workers, purchased medical supplies and testing kits, designated hospitals to treat COVID-19 patients, converted apartment complexes housing athletes into emergency hospitals, among others. The government also imposed large-scale restrictions: limiting activities in public spaces or facilities and modes of transportation; closure of shopping malls, schools, and the workplace; and restrictions of religious and social-cultural activities. In South Africa, night-time curfews were implemented as part of the initial stages of the lockdown (Kruger, 2022). Vietnam’s response to the crisis was swift and effective (Nguyen & Mai, 2022), as the government took preventive measures when cases of infection were not confirmed. For confirmed cases, the infected people—and anyone exposed to them—were quickly traced and treated. The government closed the country’s borders and banned incoming travel from infected regions. Quarantine was mandated for incoming individuals from countries recognized as pandemic risks. Social distancing mandates were issued in areas where confirmed cases were identified. The government also mandated closure of non-essential businesses such as gyms, restaurants, and schools. The government also provided funding to upgrade the healthcare system. Guidelines for prevention and treatment of COVID-19 were regularly updated. Facilities and equipment for testing and treatment were upgraded. Governments were engaged in other programs, too. They accelerated vaccine production, supported hospitals and other healthcare organizations, created alliances and initiatives, funded testing sites, restricted domestic and international travel, and conducted communication campaigns. Let us discuss these endeavors in some detail. With respect to vaccine production, some countries that were at the forefront of producing their own vaccine (e.g., USA, UK, Russia) have developed accelerated programs for the production and distribution of vaccines in an effort to vaccinate the public in the fastest way possible. Although many pharmaceutical companies around the world (Pfizer, Moderna, CanSino Biologics, Inovio, AstraZeneca, Sinopharm, Novavax, Johnson & Johnson, etc.) have been at the forefront of the corona virus battleground, they needed resources from their government to expedite the innovation and commercialization of the new vaccines and treatment of the infected, and many governments obliged. For example, in the USA, government mandates were issued to expedite the clinical trials and testing of new vaccines (Moderna and Pfizer)

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(Rahtz et al., 2022). In Russia, several research centers started exploration and development of vaccine as early as January 2020. The first vaccine was Gam-COVID-Vac (Sputnik V) developed by Gamaleya National Center of Epidemiology and Microbiology. Three more vaccines are currently being developed by Russian research centers: EpiVacCorona—a vaccine by the State Research Center of Virology and Biotechnology Vector; “Koviak” by the Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of Russian Academy of Sciences; and a vaccine by the Saint-Petersburg Research Institute of Vaccines and Serums (Krasnikov et al., 2022). Governments provided significant support for hospitals and other healthcare organizations. Hospitals and other healthcare organizations have been overwhelmed by an influx of COVID-19 patients. As such, they needed additional resources from government. In many cases, these resources were provided. Consider Colombia as a case in point (Barrios Fajardo et al., 2022). Under the state of emergency, the Colombian government took steps to ensure the economic sustainability of the healthcare system—provided funds to hospital networks; reduced VAT on medical equipment, cleaning supplies, and medicine; and eliminated import duties on healthrelated equipment and supplies. Additionally, the government supported diagnostics. Given lack of adequate hospital facilities, the government converted facilities to make-shift hospitals. For example, in Bogotá, the Mayor’s Office created a temporary hospital center in the capital city’s biggest convention center, to reduce patient congestion in the Bogotá’s main hospitals. In Russia, St-Petersburg was the first city to convert existing large buildings, such as exhibition centers, into medical facilities to treat COVID-19 patients (Krasnikov et al., 2022). Furthermore, in South Africa, the Ministry of Health trained healthcare professionals on how to treat COVID-19 patients (Kruger, 2022). Governments effectively intervened by creating alliances and initiatives as well. In some countries, government collaborated with universities to train and certify university laboratories to handle diagnostics. In Colombia, for example, an initiative referred to as COVIDA at the Universidad de Los Andes administered more than a million free COVID-19 tests to vulnerable groups, including cab drivers, street vendors, and delivery personnel (Barrios Fajardo et al., 2022). Other universities implemented initiatives to produce cheap mechanical ventilators. In Rwanda, the government teamed up with many health-related institutions such as Rwanda Biomedical Centre, the Rwanda Centre for Disease Control, the World Health Organization, and the Rwanda Red Cross Society (Francis & Mugabo, 2022). They then created a taskforce to deal with the pandemic, namely the National Rapid Response Team. Through this strategic alliance, a plan was developed (National Preparedness Plan) and implemented rapidly and efficiently. The plan involved border screening, training of healthcare workers in disease detection, a communication campaign, a vaccination program, and a logistics program to ensure that health facilities are adequately equipped. The taskforce notably was led by the Prime Minister. In the USA, Operation Warp Speed smashed records for the development and production of three successful COVID-19 vaccines (Rahtz et al., 2022). This “operation”

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involved an alliance among government bodies, pharmaceutical companies, and distributors involved in the supply channel. Governments effectively intervened by funding testing sites. Many governments (e.g., Australia, Canada, USA) allocated resources for testing sites (e.g., drive-in sites to limit the spread of the virus) (Rahtz et al., 2022; Shapiro & Stanton, 2022; Polonsky & Weber, 2022). Resources were also provided to labs in hospitals and clinics to analyze the COVID-19 tests—people received results within 24 h. The expedited testing and results resulted in less pressure to quarantine people suspected of being infected. Governments were involved in restricting domestic and international travel. In some countries such as Australia that have states acting independently, domestic restrictions were also put in place. For example, in Australia, Western Australia (WA) restricted travel from all states for several months; travelers that were allowed to enter WA had to go into mandatory quarantine (Polonsky & Weber, 2022). In Indonesia, the federal government mandated restrictions on domestic travel. Domestic travel is usually at its peak during the “Mudik” (i.e., “homecoming”), when migrants in cities return to their hometowns to celebrate major holidays with their families. The pandemic forced the government to restrict Mudik-related travel to control the virus’s spread. This mandate was very difficult for most migrants; nevertheless, the vast majority of them exercised self-restraint and accepted the travel restriction (Soesilo & Rahman, 2022). In South Africa, all borders were closed and no movement of citizens between provinces was allowed (Kruger, 2022). Furthermore, many governments issued international travel mandates. For example, Australia took some of the most severe restrictions on international travel (Polonsky & Weber, 2022). The government limited international travelers entering the country; it also limited the number of Australians allowed to re-enter Australia from overseas. Additionally, it placed restrictions on Australians leaving Australia, to prevent Australians from catching the virus and returning with it to infect other residents. Government was also involved in conducting communication campaigns. In many countries governments took an active role in communicating with the public about protocols in relation to the pandemic. For example, as the U.K. government finalized its lockdown, it launched a marketing communication campaign to persuade the public to protect the National Health Service (NHS): “Stay Home, Protect the NHS, Save Lives.” Moreover, Queen Elizabeth addressed the nation on COVID19, counseling Britons about the need for “coming together to help others” and caring for one another, as reflected by the message that “we will be with our friends again; we will be with our families again; we will meet again.” The Queen also celebrated NHS workers’ efforts, complementing the government’s pro-NHS campaign (Shabbir et al., 2022).

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30.2.3 Interventions by Non-governmental Organizations Typically following the lead of governments, or intervening in the absence of effective governance, Non-Governmental Organizations (NGOs) and Businesses were instrumental to effective interventions, which required the production, promotion, delivery, and administration of countless life-saving goods and services. Below, we highlight some of them. Supporting the public health interventions are medical institutions, including hospitals, clinics, testing labs, medical associations, aid agencies and civic groups, pharmaceutical companies, pharmacies, and innumerable manufacturers, suppliers and personnel across sectors, along local and global value chains. These institutions had to be fully mobilized, often expanded and reoriented, and integrated/coordinated across time, space, and mission, to ensure the effective implementation of the public health interventions. Consider the following examples from the countries studied for this book. The Ghana Medical Association took on the charge to educate the public on COVID-19 prevention, testing, and treatment. This institution worked closely with Ghanaian telecommunication companies and the Ghana Health Service to provide the necessary data for effective contact tracing. The Ghana Health Service also created and maintained a real-time COVID-19 online monitoring system for those identified as infected. The Noguchi Memorial Institute of Medical Research in Accra and the Kumasi Centre for Collaborative Research were charged with testing and diagnostics (Dadzie, 2022). In Russia, Moscow was the first city to convert hospitals and other facilities into COVID-19 treatment centers (Krasnikov et al., 2022). Numerous examples of effective interventions by the medical establishment exist. Educational institutions had to be extraordinarily elastic, to address the needs of students and faculty across all age-cohorts and disciplines. Many countries closed school buildings in response to social distancing mandates. For example, in Croatia, school closure was introduced early in March 2020; all educational institutions were closed (Miočević et al., 2022). In-person schooling was replaced by distance learning. Initially, schools were provided the choice of instituting in-person learning, distance learning, or a mixed method. However, toward the end of 2020, the government mandated that all high schools use distance learning as the only schooling method. In Russia, all colleges and universities switched to online teaching starting in March 2020. Elementary and secondary schools did the same starting April 2020 (Krasnikov et al., 2022). Indeed, each country that had the technological capability to transition to online learning did so, in some form and when/where possible, while also implementing other measures to include mask wearing, social distancing, and hygiene. The business community was also vital to fighting the spread of the virus and to providing goods, services, and experiences to meet basic needs, to ensure health and safety, to enrich lives, and to enable communities to flourish, albeit differently, and to prevent unimaginable economic collapse. The pandemic has changed the

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landscape of the workplace. Organizations in many countries (e.g., USA, Australia, Canada, Argentina) have reconfigured work environments to allow and encourage their employees to work remotely, to allow social distancing and prevent the spread of the virus (Kharoubi Echenique & Pels, 2022; Polonsky & Weber, 2022; Rahtz et al., 2022; Shapiro & Stanton, 2022). In Russia, industry associations played a major role in mitigating the spread of the virus. Industry associations were involved in training safe employee–customer interactions (e.g., contactless delivery or cashless payments in e-commerce and retail), providing health protocols to ensure employee wellness (e.g., increasing frequency of health checks in fitness clubs and workplace disinfections), engaging customers to act responsibly (e.g., using personal protective equipment while exercising in fitness club) (Krasnikov et al., 2022). In South Africa, we see business firms such as Distell (a leading company in the manufacturing of alcoholic beverages) producing sanitizers. Vodacom (a smartphone provider) provided free online medical consultations related to COVID-19. Transnet provided facilities to help those who were infected selfquarantine. When the pandemic swept through Spain, the country did not have an industry that produces masks or respirators; the business community stepped in to redress this problem (Montero-Simó et al., 2022). Many companies readjusted their operations to manufacture these items and indeed many items. Financial institutions and their resources are needed in times of crisis such as pandemics. Access to such resources and their distribution requires coordination among catalytic institutions and citizen-consumers. Government cannot subsidize every program and effort; in some cases, government may simply refuse to offer financial support or fail to support adequately. Brazil provides an example of a country in which a major actor in the financial sector, Itaú Unibanco, intervened to provide financial assistance in the wake of government dysfunction, by donating billions of Brazilian Real to help suffering communities (Hemais et al., 2022). Ghana reveals a more grassroots response, in the form of fund-raising campaigns launched by religious establishments, political parties, and other NGOs (Dadzie, 2022). Importantly, these NGOs channeled donations directly to public health institutions such as hospitals, clinics, and medical research centers. Neighborhood associations and other civic groups play an important role in the pandemic fight. In Indonesia (Soesilo & Rahman, 2022), neighborhood associations were key in mitigating the spread of COVID-19. A typical neighborhood association comprised 10–50 households and each community had 3–10 associations. For example, leaders of these associations were charged with identifying and recording members of community who contracted the virus (who were reported to health officials for medical treatment). The leaders were also tasked with educating community members about COVID-19 handling procedures and safety measures. They also inspired and encouraged community members to help each other, especially those who had to be quarantined. International health bodies committed to global health and well-being, such as the World Health Organization (WHO) (2021) and the United Nations (2021). The WHO, from the beginning, has compiled and provided information related to the COVID-19 pandemic that counsels how to implement public health and social

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measures, to understand and more effectively combat the virus (WHO, 2021). Their efforts to deter the global “Infodemic”—spreading harmful and potentially deadly disinformation and misinformation—have helped communities to administer appropriate mitigation responses (WHO, 2020). Another influential international body is the Vatican (Santos & Chai, 2022). This religious institution has organized a COVID-19 commission to mitigate the pandemic and prepare a post-pandemic future. The commission involved five working groups with different goals and objectives: (1) acting now for the future; (2) looking to the future with creativity; (3) communicating hope; (4) seeking common dialogue and reflection; and (5) supporting to care. The Commission played an important role in bringing together governments, businesses as well as non-governmental organizations to prepare for mitigation efforts of future pandemics. The traditional press and media played an important role. In almost every country we studied, responsible press and media organizations played an important role in the dissemination of news about the pandemic and instructions related to compliance of health mandates (social distancing, wearing mask, home lockdown, quarantining, testing, vaccinations, and sanitary practices). For example, in Ghana (Dadzie, 2022), the press and media, with leadership from the Ministry of Information, were effective. Furthermore, media organizations have provided free airtime and space for COVID-19 public education campaigns. In Indonesia, social media played a key role in disseminating information (Soesilo & Rahman, 2022). Social media carried messages of emergency pleas for plasma donor and hospital vacancy information. Social media influencers were among the first priority of vaccine recipients. These influencers then conveyed health information to their followers. Furthermore, social media digital platforms were highly instrumental in mitigating the spread of the virus in Indonesia. For example, Gojek and Tokopedia are social media digital platforms designed to help people meet their daily needs (e.g., hail riding service, assistance in food and grocery shopping, online shopping, financial services, hotel bookings, travel services, shipping and logistics, cleaning services, among others). These platforms include links to other medical online platforms providing online consultation with medical doctors, doctor’s appointment, COVID-19 tests, and purchase of medicine. In Lebanon (Aoun & Aoun Barakat, 2022), social media and television played a crucial role in raising consciousness amongst the Lebanese. The pandemic took priority over other political and economic concerns. Publicity through the local media contained highly emotional messages from COVID-19 patients, hospital staff, and influencers urging people to “Stay Home” and “name and shame” the people and institutions breaching health guidelines. In Rwanda (Francis & Mugabo, 2022), the government prepared a detailed COVID-19 standard operating procedure and a Risk Communication and Community Engagement team to coordinate COVID-19 information and decrease the likelihood of misinformation. An important element of the standard operating procedure is strategies on how to mitigate misinformation and “conspiracy theories.” In Singapore (Lwin et al., 2022) authorities have launched a communication campaign highlighting where to find valid and credible information about the pandemic, prevention, and treatment. In Vietnam, a popular song was re-recorded to include

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lyrics that educate about the dangers of COVID-19 and how to stop it. The song has since gone “viral”—positively, via social media and mainstream media—and has been translated into other languages (Nguyen & Mai, 2022). Moreover, alliances between and among societal institutions played a key role in the mitigation of the spread of COVID-19. The success of the aforementioned pop song was facilitated by the Vietnam National Institute of Occupational and Environmental Health. In Indonesia, a collaborative program was established between the Chamber of Commerce of Indonesia and the national government, the Mutual Cooperation Vaccine Program—dubbed as Vaksinasi Gotong Royong (Soesilo & Rahman, 2022). The program was designed to accelerate and expand the coverage of COVID-19 vaccination program across the country to help achieve faster herd immunity. The program focused on distributing vaccines for employees of private companies and their families, paid for by employers. In Indonesia, volunteers banded together to form Wargabantuwarga.com. This is a website carrying information on medical access and assistance related to COVID-19 in Indonesia. The website collects, records, and provides various health-related information from various sources scattered in digital space (e.g., information about health facilities contact and locations, availability of medical supplies, hospital bed availability, locations of oxygen tank vendors, plasma donor list, ambulance contact numbers, COVID-19 test and vaccine program schedule and locations, and available premises for self-isolation). Volunteers help collect and verify data before they are published on the website. In Mexico, 16 companies and foundations coalesced and financed a fully equipped, temporary, hospitalization facility (with 607 beds), located in Centro Citibanamex, a large convention center in Mexico City (Rodríguez-Reyes et al., 2022). The National University provided technical and medical advice, while the operation was run by Mexico City’s Ministry of Health. Ordinary people—who often prove to be extraordinary during crisis—played key roles in all countries. In Argentina disenfranchised and/or underappreciated women were key to an effective response to COVID-19 (Kharoubi Echenique & Pels, 2022). In Lebanon—a country with a government adrift and divisive political factions, suffering from economic collapse, overwhelmed by a refugee crisis, rocked by a devastating explosion and enduring endless corruption—“ordinary” citizens and their hospitals, businesses, and civic groups have mobilized to stem the viral tide and save lives (Aoun & Aoun Barakat, 2022). In Indonesia (Soesilo & Rahman, 2022), responding to a shortage of face masks, household volunteers across the country produced and distributed thousands of handwoven face masks to their fellow citizens—free of charge. In Russia, volunteers helped patients by visiting patients’ homes during quarantine (Krasnikov et al., 2022); they helped by staffing COVID hotlines and providing legal and psychological counseling. Consequently, the Russian government responded to the growing volunteerism and provided grantfunding for 2 billion RUR to almost 900 non-profits that employ volunteers.

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Moderating Factors Related to Public Health Interventions

The sample of interventions we highlighted in the preceding sections all were significant, impactful, and enhanced well-being. However, they varied considerably as a function of moderating factors. In this section we will address these moderators, which we categorize into two major groups: (1) demographic, geographic, and socio-cultural moderators; (2) institutional and other macro factors. A synopsis is found in Table 30.2. In the discussion below we see these moderators transcend simple categorization and offer illuminations to the Shultz et al. (2017) model and the updated framework introduced in the Prologue (Shultz et al., 2022) and revisited in an Epilogue toward the end of this chapter. The Epilogue draws explicit attention to health/wellness and to constructive engagement by/among catalytic institutions and their stakeholders, if we hope to optimize well-being outcomes for those stakeholders during a crisis the size, scope and impact of COVID-19 and potentially other crises.

30.3.1 Demographic, Geographic, and Socio-cultural Moderators This group of moderators comprises health literacy, age, population density, geographic location, refugees and migrants, nationalism, cultural values, and religion. We discuss below these moderators in some depth. Our study of the various countries revealed that an important moderator appears to involve health literacy and the rise of misinformation about COVID-19. Health literacy refers to the level of personal knowledge, skills, and confidence in healthrelated matters. Countries with population high in health literacy are likely to react more positively and effectively to public health interventions. Obviously, one can easily assert misinformation—the Infodemic—regarding COVID-19 was prolific, including false statements about the rate of infection and mortality rates, the source of the virus and treatment, and how governments and other societal institutions have responded to the spread of the disease. The use of social media in exacerbating misinformation was also evident in many countries; it was more pronounced and problematic in some countries than others. In Singapore, for example, the government has recognized the importance of health literacy in combating the virus (Lwin et al., 2022). As such, the government has conducted a communication campaign to educate the public about COVID-19 and other health-related concerns. Specifically, the government adopted a multi-pronged approach to educate the public about the virus (e.g., media, government websites, social media, and Gov.sg channel on WhatsApp and Telegram) and to provide clarifications on fake news. In South Africa (Kruger, 2022), communication campaigns (e.g., out-of-home advertising, television advertising, social media, online services, text messaging, leaflets,

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Table 30.2 Moderating factors related to public health interventions Moderators Demographics

Geography Cultural dimensions

Public health robustness and literacy

Political polarization

National Political Leadership

Experience with National Health Emergencies

Aspects and assessments • Age: Countries with younger populations tend to generally more resilient • Population density: Lower density, higher geographic isolation tend to be at less risk • Refugees, migrants, and other vulnerable groups tend to be at higher risk of infection and spread • Geographic location: Geographically isolated countries/communities more able to effectively block/control intrusive infections • Greetings: Cultures with non-physical-contact greetings tend to minimize person-to-person spread • Religion: Diversity and importance of religion in everyday life tend to be counter to secular mitigation requests or mandates • Collectivistic cultures tend to be more socially compliant with public health measures than individualistic cultures • Presence/absence of a universal health system: Countries with universal health coverage tend to respond more quickly and effectively • Strong enforcement of public health mandates: Public adherence to mandates and enforcement tend to create lower rates of infection and death • People underserved and/or with comorbidities tend to be at higher risk • Nationalism/xenophobia tend to trigger social conflicts when appealing to “the good of the many” • Government censorship and misinformation: Effectiveness of public health interventions can be undermined by misinformation/ disinformation to counter accurate, scientific information • Public trust/distrust in government: Driven by political polarization to resist public health directives and mitigation mandates • Effective National Leadership: Leadership tends to play and important role to ensure implementation and effectiveness of public health interventions • Speed of response: Success tends to be tied to the government’s rapid, and science-based, response in dealing with the pandemic • Innovation and coordination at the national level: New government regulating bodies may be needed to coordinate strategies with business and government to mitigate the spread of the disease • Countries experienced with pandemics tend to have national plans and protocols in place for immediate deployment and response

and banners) were launched by the Ministry of Health to educate South Africans about the impact of COVID-19 on health-related matters. In the USA (Rahtz et al., 2022), the problem of misinformation created a distrustful and vaccine-hesitant/ resistant citizenry—a segment of the population which, in turn, fueled a deadly national surge of the virus. However, we believe that misinformation in the USA was perhaps more an artifact of political polarization than health literacy.

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Age may have played a moderating effect on the relative effectiveness of the public health interventions. Countries that have younger people are likely to weather the pandemic storm better than countries with a large elderly population; people over the age of 65 were/are especially susceptible to infection and more likely to die from COVID-19. Spain, a country with 42% of its population over the age of 65, has been ravaged by COVID-19 (Montero-Simó et al., 2022). Lebanon, which has a relatively young population, has experienced lower recorded mortality rates (Aoun & Aoun Barakat, 2022). Population density and geographic location may have played an important role in moderating the effectiveness of public health interventions designed to mitigate the spread of the virus. For example, Australia has a relatively small population, of 24 million people, with a low population density of three people per square kilometer. Low population density may account for Australia’s successful public health policies and programs (Polonsky & Weber, 2022). In contrast, India has suffered greatly, perhaps due to its high population density (Santos & Ray, 2022). In Mexico, the mortality rates differed between two states, and this may have been due to population density (Rodríguez-Reyes et al., 2022). A higher fatality rate is recorded in Mexico City than in Jalisco. The population density in Mexico City is much higher than that in Jalisco. New Zealand also performed well in managing the spread of the corona virus. This may be in partly due to low population; another explanation for New Zealand: It is a geographically remote, island nation (Wooliscroft et al., 2022). Refugees, migrants, and other vulnerable groups may have moderating effects in a country. Countries besieged by illegal refugees and migrants have unique, sometimes daunting public health challenges, as many of these people may be unaccounted for by government. Communicating with illegal refugees and migrants therefore can be difficult; locating, testing, and vaccinating them is difficult. Colombia is a case in point (Barrios Fajardo et al., 2022), as it struggles to respond to the flood of refugees and migrants fleeing an imploding Venezuela, which continues its downward political and economic spiral. The migration from Venezuela has been characterized as the largest exodus in Latin American in recent history. Many of the migrants/refugees entered Colombia illegally. Furthermore, public health interventions against the virus tend to be ineffective, and certainly are difficult to manage, in countries with large populations of refugees and illegal immigrants, especially when they live in densely populated camps or communities. Such is the case in Lebanon, host to refugees and migrants from Palestine, Syria, and Iraq, which collectively may account for as much as 30% of the population inside (Aoun & Aoun Barakat, 2022). These camps and communities are overcrowded and do not have sufficient access to basic water, sanitation, and hygiene services, which in turn increase residents’ risk of exposure to the virus. Furthermore, refugees and illegal immigrants are less likely to report COVID-19 cases due to lack of awareness, fear of stigma, isolation, and possibly the risk of deportation. Nationalism and the more troubling xenophobia often emerge in times of crisis. Although pandemics, similarly to other disasters, can prompt cooperation among distant parties, they can also trigger social conflicts over resources. If resources are

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inadequate or unavailable, people become tribal or “nationalistic.” We witnessed this situation in the USA during the production and distribution of vaccines, when the Biden Administration was pressured to share the vaccine with developing countries (Rahtz et al., 2022). However, many—though not all—Americans have voiced tribal concerns; in a situation of limited supply, they object to sharing the vaccine and advocate booster shots for Americans as the higher priority. Hence, the rise of nationalism can decrease the distribution of vaccine to the most vulnerable, thus moderating the effectiveness of the distribution intervention and potentially the global spread of COVID-19. Culture appears to be a moderator. Generally, countries with individualistic cultures (e.g., USA, UK) were much more resistant to COVID-related public health measures than were collectivistic countries. For example, some of the success to limit the spread of SARS-CoV-2 in the City of Wuhan can be attributed to Chinese sense of collectivism (Driskell et al., 2022). In contrast, a collectivist culture may mean greater sociability—interpersonal relationships, especially among family members and other people in the community, characterize their way of life. As such, public health measures that conflict with the need for social contact are likely to fail. This may have happened in countries such as Lebanon (Aoun & Aoun Barakat, 2022). Another cultural moderator may be the way people greet each other. In other words, cultural norms and customs related to greetings differ significantly among countries. In many countries in Europe greeting are expressed by kissing on the cheeks at least twice. Such greetings violate the social distancing guidelines. In Thailand, on the other hand, people greet one another through noncontact. Noncontact greeting may be a significant factor in mitigating the spread of the corona virus in Thailand (Virakul et al., 2022). Similarly, religion may play a role as moderator variable. Lebanon is a case in point. Lebanon has at least 18 different religious sects, and religion plays an important role in most aspects of daily life. Many of the religiously devout defied public health mandates. Thus, preventive measures such as lockdowns and social distancing cannot, or did not, change predetermined outcomes.

30.3.2 Institutional and Other Macro Moderators Our multi-country study has revealed a set of possible institutional and macro-level moderators. Indeed, institutional/macro-level moderators were explicitly mentioned in all 28 country-specific studies. We organize these moderators in three categories: (1) institutional factors related to the public health system (e.g., presence/absence of a universal health system, public trust in the public health system, degree of enforcements of the public health mandates, institutions supporting research and development in healthcare, experience with past pandemics), (2) institutional factors related to the government (e.g., leadership at the national level, the quality of the relationship between/among the leadership of the national government and state governments, coordination at the national-level political economy, public trust in the

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government, government censorship of pandemic information, political conflict, the speed of government response, and emergency decrees), and (3) institutional factors related to the economy (e.g., the strength of the economy, the extent of the informal economy in the country, and cooperation of the business community with government mandates). Institutional Factors Related to the Public Health System: One important moderator we were able to identify from our multi-country study is the presence/absence of a universal health system. In other words, the effectiveness of public health interventions in combating the corona virus seems to have been moderated by the extent of healthcare coverage. Specifically, public health interventions are likely to be more effective in countries with a universal health system. It is a factor contributing to the country’s resilience in fighting pandemics. Consider Colombia, which has universal health coverage involving both public and private healthcare institutions, centrally managed by the Ministry of Health and Social Protection; that is, a universal health system that guarantees coverage, accessibility, quality, and regulation of healthcare (Barrios Fajardo et al., 2022). The country’s universal health system was acknowledged as a source of resilience in combatting COVID-19— perhaps because every Colombian has access to medical treatment. Colombia’s health system monitors and manages hospitals’ admissions of COVID-19 patients and patient treatment in ICUs, and the trend in the rate of COVID-19 infections and mortality. The universal healthcare coverage in Thailand (established 17 years ago by the former Prime Minister Thaksin Shinawatra’s government) may have been a factor in Thailand’s successful responses, too (Virakul et al., 2022). Public trust in the public health system may be another moderator. Mandates such as social distancing, wearing masks, and getting tested cannot be effectively implemented with a minimal degree of public trust in public health institutions. For example, the effectiveness of many of the interventions implemented was easily implemented because of the high degree of trust in the Australian government and its public health system (Polonsky & Weber, 2022). This has been a significant factor facilitating high compliance with mask and home lockdown measures. Rwanda’s public health intervention against COVID-19 looks to be an enduring success story. Public trust in government is attributed as an important factor in the campaign against the corona virus. The government has built public trust through previous public health campaigns against malaria and HIV/AIDS. This trust played a significant role in strengthening the effectiveness of the campaign against COVID-19 (Francis & Mugabo, 2022). The same assertion can be made for Thailand, with its early success in stemming the spread of the virus (Virakul et al., 2022). The degree of enforcements of public health mandates most likely is a moderator. Tighter enforcements of public health mandates appear to be positively correlated to lower rates of infection and death from COVID-19. In Mexico, for example, the mortality rates differed between two states: mask wearing was mandatory and enforced in Jalisco, but it was only suggested in Mexico City and a higher fatality rate is recorded in Mexico City (Rodríguez-Reyes et al., 2022). In Sweden, the “Swedish lockdown” was not much of a lockdown, compared to other European countries (Haavisto et al., 2022). Daycare centers, and elementary and secondary

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schools remained open; so did restaurants and cafés (although at reduced capacity), and gyms and swimming pools. No mandates—not even recommendations—were issued to wear a mask in public places. Applying the Oxford Stringency Index (a metric capturing the rigor of COVID-19 interventions), Sweden was far below the average index compared to other European countries in the spring and early summer of 2020. Institutions supporting research and development (R & D) in healthcare are an important moderator. Countries with institutions supporting R & D have advantages in the fight against COVID-19. The Rwanda Biomedical Centre (RBC) played a major role in stemming the virus tide in the country (Francis & Mugabo, 2022). The RBC is the most prestigious medical institution in the country; it is responsible for conducting research, providing diagnostic services, and implementing healthcare interventions to protect the Rwandan people against diseases. Note, too, that all the vaccines were developed in countries with substantial R & D budgets for basic science and healthcare. Yet another moderator may be the degree of experience with past pandemics. Countries experienced battling pandemics had established plans and protocols to deal with COVID-19 and future pandemics. Singapore learned from its experience with Severe Acute Respiratory Syndrome (SARS) in 2003 (Lwin et al., 2022), which helped the country to develop new protocols to improve preparedness communication among health authorities, the government, scientists, and the community. These protocols were useful in the battle against COVID-19. Similarly, the success of the interventions put into place in Thailand and Vietnam can be partly attributed to previous experience with major infectious disease outbreaks (SARS, Avian Influenza, and Influenza H1N1). Institutional Factors Related to Government, which occur within and across jurisdictions. We first consider leadership at the national level. National Leadership does play an important role to ensure the implementation and thus the effectiveness of public health interventions. For example, in Wuhan the lockdown was initially chaotic. People had less faith in the local government and more in the national government (Driskell et al., 2022). The lockdown became effective only after the involvement of the central government. The converse can be argued in relation to the USA and Brazil, where the effectiveness of public health interventions was undermined due to lack of leadership at the national level (Hemais et al., 2022; Rahtz et al., 2022). In Finland, the Ministry of Social Affairs and Health provided leadership for municipalities, hospital districts, the Finnish Institute for Health and Welfare, regional state administrative agencies, and other ministries (Repo et al., 2022). Finland’s Prime Minister moreover took a significant lead with operations, and in mid-March a state of emergency was declared for a period of 3 months. Government leadership at the national level was instrumental to effective, sequential mandates. The first mandate restricted public gatherings, followed by declarations regarding state of emergency, work by remote means, distance learning, temporary changes in the labor market (lay-offs made easier, annual leaves made more flexible, unemployment benefits extended, etc.), introduction of a major economic package, closing of leisure travel, and closing of restaurants, in that order. In Thailand, the

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Prime Minister established the Center for COVID-19 Situation Administration to lead and coordinate the national response to the pandemic (Virakul et al., 2022). Furthermore, the Ministry of Public Health created Team Thailand to help develop interventions such as the “Stay Home—Stop Virus—Help Nation” campaign, the “Social Distancing, Wearing Face Masks, and Handwashing” campaign; other campaigns aimed to restrict social gatherings, inter-provincial travel, monitored “fake news” or misleading information on social media, and helped hospitals and clinics to deal with the influx of COVID-19 patients. The quality of the relationship between the leadership of the national government and state governments plays an important moderating effect on the effectiveness of public health interventions. Effective implementation of public health programs requires coordination among governmental agencies, especially between those at the national and state and local levels. Australia, for example, benefited from a good relationship between the Federal government and seven states and territories, especially during the pandemic. This is essential, given that interventions were administered at the state level (Polonsky & Weber, 2022). Innovation and coordination at the national level: Many countries have created new government regulating bodies to coordinate strategies to mitigate the spread of the disease. We look again to Australia, which created a taskforce at the cabinet level of the national government that included the Prime Minister and governors of each state. The taskforce met weekly to ensure coordination and sharing of experiences, ideas, and best practices. Conversely, lack of leadership and coordination at the national level is a lesson learned, too. Failure of the national government to coordinate and lead has been devastating to Brazil (Hemais et al., 2022) and the USA (Rahtz et al., 2022). In Brazil, the federal government (“led” by Jair Bolsonaro) has reacted dismally to the COVID-19 crisis; Brazilians’ well-being has deteriorated significantly. The response by the Trump Administration and the Republican Party more generally has also been devastating, with the exception of vaccine development; some federal government institutions/agencies (e.g., CDC, NIH, FDA) however have performed admirably and effectively. In Indonesia, the national government promoted a nation-wide vaccination program while allowing provincial and local governments to execute the vaccination program in a manner that fits well with the demography and local customs of the region (Soesilo & Rahman, 2022). In Mexico, the relative ineffectiveness of those public health interventions that were implemented may have been due to lack of coordination between/among national and local governments (Rodríguez-Reyes et al., 2022). Similarly, in the USA, the President’s failure to lead or even to develop a coordinated response to the pandemic left communities in all corners of the country to suffer one of the highest infection rates in the world (Rahtz et al., 2022). In Vietnam, the government’s response was well-coordinated—from central government to local governments (i.e., provinces, districts, communes, and villages). Consistency of policy implementation was monitored and enforced (Nguyen & Mai, 2022). Public trust in government has a strong moderating effect. The USA is a case in point (Rahtz et al., 2022). Public heath interventions were not particularly effective in the USA due to a politically polarized population, a significant portion of which

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had lost trust in government and institutions. Citizens and residents of New Zealand and Singapore comparatively seem to have high trust, and, relatedly, good compliance with mandates. Government censorship of pandemic information is another potential moderator. The effectiveness of public health interventions can be undermined by government censorship of accurate, scientific information related to the spread of disease. The typical justification for such action is to ensure that the public would not panic and ostensibly to protect people. In many cases, however, censorship is applied to save face (e.g., to cover up negligent government action) or simply for cynical political gain. Consider what happened in Wuhan (Driskell et al., 2022). In December 2019, eight physicians warned peer doctors and others (through social media) that seven people had contracted a virus similar to SARS. Immediately, the Wuhan municipal government reacted by announcing that this information is based on rumor, not fact. However, the local government failed to mute public concerns; the central government then intervened. Officials from Beijing reprimanded local officials for failing to regulate the media. In the USA, a preponderance of evidence suggests the Trump Administration abdicated responsibility and deflected blame to others, for purely political and/or vane reasons (Rahtz et al., 2022). Did political conflict play a role in moderating the effectiveness of public health interventions? The answer is perhaps. Consider Lebanon, besieged by conflict in a sectarian political system composed by leaders of the country’s largest sects—a system far from being characterized as “good governance” (Aoun & Aoun Barakat, 2022). The government was highly conflicted in mandating a lockdown. Specifically, political conflict arose concerning travel restrictions to and from Iran. Given that the government was strongly influenced by the Hezbollah faction, travel restrictions to and from Iran were not strictly enforced. Speed of government response; did it make a difference? Yes, rapid government response made a difference. New Zealand seems to be a success story (Wooliscroft et al., 2022). A factor that may account for this success is the government’s rapid, and science-based, response in dealing with the pandemic. New Zealand was among the first countries to go to a full (level four) lockdown in early 2020, when only 52 COVID-19 cases were detected. Subsequent lockdowns occurred with only a handful of identified cases. Furthermore, the lockdowns have been swift. The same can be said in the case of Rwanda—the first African nation to implement full lockdown, a week after its first case was reported in March 2020 (Francis & Mugabo, 2022). South Africa provides another example, as the South African Government reacted quickly after the first case of COVID-19 was detected, declaring a national state of disaster and soon after imposing lockdowns (Kruger, 2022). Vietnam was also effective in its rapid, coordinated response to COVID-19 (Nguyen & Mai, 2022). Unfortunately, the U.K. government delayed implementing the COVID-19 lockdown and interventions recommended by the WHO during the pandemic’s initial and perhaps most critical stage (Shabbirsss et al., 2022). The consequences were dire in terms of the number of infected people and mortality. Among the most salient moderators, we finally have emergency decrees. Such authoritative, legal, systemic proclamations surely moderated and advanced

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well-being, too. The declaration of emergency decrees by some governments, such as Thailand’s, created a policy-foundation to enforce many mandates associated with public health interventions, including social distancing, wearing face mask, limiting travel, curfew, and 14-day quarantine (Virakul et al., 2022). How about institutional factors related to the economy? Economic factors also played a role in moderating the effectiveness of public health interventions. Consider the role of the strength of the economy. Lebanon, in deep economic crisis, may be a case in point (Aoun & Aoun Barakat, 2022). The country’s economy has relied heavily on the services sector and remittances from expatriates scattered across the globe. The country struggled with a national debt of $93 billion—the highest debtto-GDP ratio in the world. This situation hindered and often prevented imports of critical medical supplies. Furthermore, the government was unable to assemble a financial package to help equip both public and private hospitals with much needed resources, such as ventilators, protective equipment, and additional beds. To complicate matters, disregard for some public health measures (e.g., social distancing and lockdown) served yet another blow to the economy, which in turn constrained the government from launching an effective public health campaign to combat the virus. The extent of the informal economy in the country may also be an important moderator. Countries that have sizable informal economies have difficulty implementing public health interventions, as the majority of people involved in the informal economy are “unaccounted for”—they are not in the government databases (e.g., taxation, social services, labor, unemployment), they therefore are difficult to communicate with, to locate, to test, and to vaccinate. That situation is not unique to Lebanon; it reminds of a lesson learned from Colombia (Barrios Fajardo et al., 2022), where a high percentage of workers operate in “subsistence marketplaces,” including micro-level informal enterprises with deeply rooted resourceinsufficiencies and weak regulation. As such, Colombians in the informal economy are unaccounted—their work is not monitored, regulated, or registered by the government, and, by extension, they have limited or no access to public support, especially in relation to public health programs. We have seen a similar situation in Lebanon, where many refugees are employed in the informal economy (Aoun & Aoun Barakat, 2022). As such, they constitute vulnerable populations, which exist in many countries. Lastly, we recognize business cooperation with government mandates, as an important moderator. Public policy mandates (e.g., social distancing and wearing masks) cannot be effectively implemented without the cooperation of the business community, which becomes clear for businesses in all the countries studied and the marketing systems in which they function and strive to flourish.

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30.4

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Interventions Deemed Effective in Mitigating the Adverse Economic and Social Effects

We discuss interventions assessed as effective in mitigating the adverse economic and social effects associated with COVID-19. The discussion is broken down by interventions administered by government and non-government institutions, as summarized in Table 30.3.

30.4.1 Interventions by Government Institutions Government plays a significant role in mitigating the adverse effects of the pandemic on consumption. Again, examples are many and varied; we highlight a few of them, Table 30.3 Interventions to mitigate adverse economic and social effects Type of catalytic institutionsa Governmental

Non-governmental (NGO)

a

Mitigation strategies • Legislation to provide direct COVID relief financial payments to at risk populations • Tax regulations and obligations adjusted to support needed relief to families and workers • Support for home-based small business/microenterprise startups • Directives to utility companies to provide free power and water to those in greatest need due to the loss of livelihoods • Guarantees of minimum living wage for vulnerable families • Directives to bank and financial institutions to offer loan deferrals • Utilities to offer payment deferrals • Directing private landlords to reduce rents and stop home evictions • Educational and childcare stipends to allow workers to work remotely without additional expenses • Expansion of resources for COVID testing sites and labs to expedite results and minimize lost revenue for those required to quarantine • Socialized governance: Government officials coordinate with and mobilize communities to meet urgent and essential needs • Organizational philanthropy: Business community programs, outreach and support • Trade associations and unions: Financial and emotional support programs for members and non-members • Religious organizations and faith-based groups: Outreach to communities via churches, mosques, and temples • Neighborhood coalitions and individuals: Civic duties in neighborhoods across all countries to assist with financial, mental, and emotional well-being

See Shultz et al. (2017, 2022)

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below. In Australia, policies were developed directing banks to offer loan deferrals, utilities to offer payment deferrals, private landlords to reduce individual rentals, and policies on home eviction moratorium (Polonsky & Weber, 2022). Governments in Canada (Shapiro & Stanton, 2022) and the USA (Rahtz et al., 2022) allocated COVID-relief funds and issued checks to alleviate financial, physical, and mental hardships caused by the pandemic. The spending program to assist consumers is expected to be offset through new taxes on vacant properties and luxury products in Canada. In China, the central government implemented a series of policies to stimulate the economy, including a consumption stimulus involving deferred tax payments and reduction of rent (Driskell et al., 2022). The Colombian government provided a small monthly stipend for the poor, basic utilities despite nonpayment, and landlords were prohibited from evicting tenants (Barrios Fajardo et al., 2022). In Finland, the government mandated deferrals of mortgage and debt repayments; interest rates for consumer credit were regulated (Repo et al., 2022). In Ghana, government issued directives to utility companies to offer free water and a significant payment waiver on electricity use (Dadzie, 2022). Indonesia’s government spent considerable resources on basic necessities for the poor and low-income households, including upgrades to social welfare benefits; it provided free electricity to the poorest households, reduced income tax by 30% for certain sectors, extended measures for loan relaxation and credit restructuring, and reduced interest on loans for small-to-medium enterprises (Soesilo & Rahman, 2022). The economic stimulus program provided by the government of New Zealand was massive in relation to GDP: New Zealand’s GDP in 2020 was $322 billion; during the first year of the pandemic alone, the government committed $62 billion to the COVID-19 Response and Recovery Fund (Wooliscroft et al., 2022). In Rwanda, the government developed and implemented a social protective program to deliver free food to at least 20,000 households in the capital, Kigali (Francis & Mugabo, 2022). Spain’s government approved a law guaranteeing a minimum living wage of 462–1015 € to vulnerable families, which helped 850,000 households and more than 2.3 million people (Montero-Simó et al., 2022). Vietnam has had many successful policy interventions, as the government actively mitigated the adverse economic impact of the pandemic; specifically, extending the tax payment deadlines and rental fees for businesses. It also reduced taxes, provided incentives to banks and credit organizations to support businesses and people, and provided financial support to about 20 million laborers whose jobs were cut or reduced due to COVID-19 (Nguyen & Mai, 2022). As with consumption, governments also played a significant role in mitigating the adverse effects of the pandemic on production. Again, we see many examples. The Australian government required businesses to implement at-home arrangements such as telecommuting and flexible working schedules (Polonsky & Weber, 2022). However, work from home is considered inefficient by some observers, given the possibility for distractions, including children. Accordingly, the Australian government provided subsidies to families working from home to assist with expenses related to childcare. The Australian government has also allowed employees who work remotely to deduct related expenses, thus reducing tax obligations. Loans were

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offered to small business with the condition that the money should go directly to their workers, to mitigate unemployment. In China, the government developed a stimulus package to support the digitalization of small and medium-sized enterprises (SMEs). The package included deferred tax payments, R & D subsidies, and lowered lending rates. Social insurance payments were reduced to incentivize firms to retain employees (Driskell et al., 2022). Colombia’s government provided payroll assistance to business firms that suffered a decline of over 20% in revenues for a period of 3 months (Barrios Fajardo et al., 2022). In Croatia, the government instituted an exemption on payment of income tax and contributions small businesses whose revenue declined by more than 50% within a specified period; it allowed a deferral on VAT payments. The Croatian Small Business Agency administered loans to support liquidity of small businesses. Finland’s government mandated subsidies for businesses (Repo et al., 2022). In Ghana, the government issued directives to healthcare establishments to increase salary and wages to frontline healthcare workers and offered life insurance to those not covered. Unemployment caused by the pandemic was offset by the government-created Labor-Intensive Public Works (LIPW) program, including maintenance and rehabilitation of rural roads, small earth dams and dugouts, soil conservation, and tree planting; at least three-fifths of LIPW beneficiaries have been women (Dadzie, 2022). Other government programs were instrumental to alleviating the economic and social pain and suffering associated with the pandemic. In many countries, the government took an active role in communicating with the public to engage in economic behaviors that can support their local economies. For example, the U.K. government’s “Eat Out to Help Out” campaign represented shopping and dining out as a duty to support the local economy and community (Shabbir et al., 2022). Many governments (e.g., Australia, Canada, USA) allocated resources for testing sites and labs to expedite the results, sometimes within 24 h; these efforts resulted in less pressure on quarantining those who were suspected to be infected, thus reducing both stress and the costs associated with taking leave from work (Polonsky & Weber, 2022; Rahtz et al., 2022; Shapiro & Stanton, 2022). Socialized governance—the extent to which government officials mobilize the community to meet urgent and essential needs—was also identified as an effective intervention to mitigate the adverse economic and social effects of the pandemic. Consider how socialized governance played out in the City of Wuhan (Driskell et al., 2022). Given that the city residents were on lockdown, government officials, property management companies, and volunteers delivered food and supplies to households. Similarly, in Colombia socialized governance was important to meeting the subsistence needs of the poor, such as when the government cooperated with NGOs and the business community (particularly retail stores, e.g., grocery stores and restaurants) to deliver food baskets to poor households (Barrios Fajardo et al., 2022). In Indonesia, the provincial government of Greater Jakarta developed a fund-raising initiative dubbed the Social Collaboration Program, which was designed to provide a mechanism for citizens to participate in helping others via donations. The program allowed donors to choose the beneficiaries through a publicly open database. Donors contribute to food provision (staple needs, allowances, etc.), small businesses

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(to facilitate educational training for small businesses, funding, etc.), education (smartphones, tablets, computers, or laptops in remote areas, etc.), and human settlement (help build physical infrastructure in poor, underserved communities, etc.) (Soesilo & Rahman, 2022). A municipality in Turkey (Kadıköy-Istanbul) is also a timely case: The municipality managed a marketing system that designed, developed, and distributed an assortment of products and services to vulnerable residents. This local government provided needed social services by coalescing with NGOs and local and national businesses (Ekici, 2022).

30.4.2 Interventions by Non-government Institutions Non-government institutions played an important role in mitigating the economic and social pain associated with the pandemic. In this context, we discuss institutions that literally were not the government. An incalculable number of them are instrumental to respond to and recover from pandemic. Many of them were articulated in other chapters. Below, we share some transcendent themes for businesses and NGOS, requisite for effective interventions to mitigate ill-being effects of COVID-19. We emphasize the business community, specifically an orientation toward organizational philanthropy among businesses vested in a broader community. In the world economic order in which most countries and people find themselves, business groups and NGOs play significant roles to mitigate the adverse economic effects of various stressors; the systemic distress of a pandemic necessitates proactive responses from businesses, business groups, networks and value chains, and NGOs to reduce the distress via the delivery of goods, services, and experiences. Among many countries and examples, we first draw attention to Brazil. As intimated earlier, several businesses (e.g., Itaú Unibanco) donated resources to help desperate communities, which were largely failed by government. NGOs and other political organizations (e.g., MST—Movimento dos Trabalhadores Rurais Sem Terra translated as Landless Rural Workers’ Movement) helped thousands of people in need, all over the country, with donations of raw and cooked food, support to local farmers and access to physicians (Hemais et al., 2022). In India, NGOs played a major role in helping feed migrant workers. Consider the Working Peoples’ Charter (WPC), a network of more than 150 local organizations of informal workers in 13 states of India, which provided food to over 80,000 migrant workers; Goonj, the NGO based in Delhi, teaming up with 92 partner NGOs to deliver rations to about 17,700 families. NGOs in India remarkably outperformed the state governments in providing humanitarian relief (Santos & Ray, 2022). South African companies such as Pick n Pay (food retail company) conducted a large-scale “feed the Nation” fund-raising campaign and Nedbank (a financial institution) provided hunger relief to vulnerable communities during the pandemic (Kruger, 2022). It should also be noted that the business community adapted to the pandemic. The lockdown has caused many organizations to find alternative ways of maintaining their business and serving

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customers. That is, in many organizations in many countries (e.g., Argentina, USA, Canada, Australia) policies were established to allow and encourage employees to conduct their work remotely (Kharoubi Echenique & Pels, 2022; Polonsky & Weber, 2022; Rahtz et al., 2022; Shapiro & Stanton, 2022). Adaptations include remote business communication, online commerce and home delivery, workplace remediation to ensure social distancing and mask wearing, and of course vaccine development and distribution. Many of these endeavors evince clear and subtle philanthropic, altruistic, and frequent volunteerism processes, to cooperate and thus to execute the plethora of business and socioeconomic transactions and relationships in local, regional, and global marketing systems. Again, NGOs played an important role in lessening the economic and social pain and suffering from the pandemic, where governments simply could not or would not. Government and the business community cannot effectively address—or have chosen not to effectively address—the consumption needs of vulnerable populations such as illegal migrants and refugees. NGOs can be most effective in and among these communities. We mentioned earlier Colombia’s efforts to assist refugees and migrants. NGOs were/are indispensable to this cause, as demonstrated by Permiso Especial de Permanencia (an NGO), which provided food, shelter, access to health treatment, education, legal services, and childcare (Barrios Fajardo et al., 2022). In Russia, many NGOs, faith-based organizations (e.g., the Russian Orthodox Church), and trade associations played an important role in helping to deliver food, medications, and other essentials; providing psychological counseling, information, and legal advice (Krasnikov et al., 2022). Indonesia’s neighborhood associations played a key role in mitigating the economic distress caused by COVID-19, including a “Love-Thy-Neighbour” campaign designed to provide food assistance, vitamins, and moral support (Soesilo & Rahman, 2022). These themes raise, or raise again, our consciousness regarding the systemic nature of a global pandemic. They also alert us to the interventions and solutions required in response to it and to prevent or better mitigate future pandemics.

30.5

Epilogue

The scale, scope, and impact of the COVID-19 Pandemic are enormous, affecting seemingly every person and institution, across boundaries and time. A systemic, global assessment and reckoning is paramount. Thoughtful consideration and accounting may help all of us to prepare for, and possibly to prevent, future pandemics and other global disasters, thus preserving health, enhancing wellbeing, and reducing costs for billions of people. Toward that desirable outcome, the myriad contributions from the scholarly explorations of 28 countries are informative and useful. In addition to the preceding synthesis and tables, some transcendent themes emerged while assembling, editing, and in some cases writing the manuscripts submitted and reviewed for this book. Those themes were introduced

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in the Prologue found in Chap. 1 (Shultz et al., 2022). We conclude by revisiting them, below. Recall the simplicity of the organism that is SARS-CoV-2: a single strand of RNA surrounded by a protein and lipid sheath (e.g., Fischetti et al., 2020; Shultz et al., 2022); recall as well that its global spread and the havoc it has caused is almost entirely explained by human behavior, which enables the organism to infect, to reproduce, to mutate, and to kill its human hosts. That death toll at the time of this writing is more than 4.7 million people and counting, the second most deadly pandemic in human history. A crisis of such lethal consequence clearly draws attention to the degree of health and wellness among people and the communities in which they reside. We have generally regarded health and wellness to be implicit in any systemic initiative to enhance quality of life and community well-being, especially in a system confronted with pandemic, hence our decision not to include those factors in the model authors used to organize their chapters. We now however add them to the framework, an explicit reminder that some baseline measures for both constructs are important to assess trends and outcomes of institutional responses to a pandemic and other widescale crises that affect human health. This change was partly driven by some cynical responses to COVID-19; for example, denial, obfuscation, and even attempts to use the pandemic as a political cudgel. To this day that disingenuousness and treachery contributes to and exacerbates the pandemic’s devastation. Furthermore, that which constitutes best-practice policies and behaviors is more likely to be discovered or determined in comparison to baseline measures and ongoing measurement for health and wellness, to assess trends and outcomes of institutional interventions. This deduction applies to the COVID-19 pandemic and potentially other crises that affect health, QOL, and wellbeing, locally, nationally, regionally, and globally. Second, all authors directly or indirectly speak to the importance of Catalytic Institutions—specific and coordinated initiatives by various levels of government, NGOs, businesses, and civic groups (as well as good citizens) to mitigate, control, or end the COVID-19 pandemic. Successful interventions however are not random or haphazard. They materialize from well-conceived and typically well-planned—and sometimes desperately urgent—Constructive Engagement, necessitated by leaders and other key actors in those institutions who are motivated to collaborate. Specifically, they are motivated to cooperate with each other and all stakeholders to produce/deliver goods, services, and best practices to facilitate QOL and wellbeing during the crisis, and hopefully beyond it in flourishing communities. Such engagement requires a spark of sorts, even when various actors/stakeholders may not see immediate incentives or personal/institutional gain from engagement; perhaps especially when they do not see immediate incentives or gain to cooperate and to coordinate policy and behavior to mitigate and redress the crisis. Accordingly, we added these two factors to a revised framework introduced in the Prologue and revisited in Fig. 30.1. We again emphasize the spark or sparks (e.g., people, events, laws—both legal and scientific—rules, norms, and other entities, institutions and initiatives) requisite to ignite or motivate collaboration.

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“Best” Practices

Macro Factors Geo/Environment Population Political/Legal Economic Social/Cultural Education Administration Infrastructure Technology

661

Community Well-Being/QOL Macro-Micro Links

Goods/Services Assortment Amount Quality Choice

Consumption/Demand

Catalytic Institutions

Marketing Systems

Government

NGO

Business

Distressed

Flourishing

Citizen-Consumers: Served/Under Served Potential Determinants Health/Wellness Location/Access Income/Wealth/Capital Social/Cultural Capital Situational Commonalities Transparency/Accountability Motivation Market Literacy/Access

Constructive Engagement

Fig. 30.1 Systemic framework for constructive engagement to facilitate quality of life in distressed and flourishing communities [see also Shultz and Peterson (2019), Shultz et al. (2017), and Shultz et al. (2012)]

We reiterate, truly Constructive Engagement in the context of the COVID-19 pandemic. evinces resilience and tends to manifest as deliberate and proactive cooperation among catalytic institutions, in coordination with citizen-consumers within the community/country and other stakeholders around the world; awareness of and consideration for macro and micro factors [as well as nuanced, moderating factors introduced in this chapter] that can help or hinder effective responses; consensual science- and fact-based initiatives—truly “best” practices and related goods and services—to mitigate, control or end the pandemic; transparency, accountability and effective communication; valid and reliable measures to assess individual QOL and community well-being, and the extent to which communities and countries are flourishing, over time (Shultz et al., 2022, p. TBD).

In summary, the chapters included in this tome collectively reveal the importance of proactive and prosocial responses and effective interventions, regardless of the exact spark or sparks that ignite Constructive Engagement. Numerous best practices are described; some of them first emanated and were adapted from previous health crises; others emerged during the darkest periods of the COVID-19 pandemic, reminding that “nothing has more strength than dire necessity (Euripides, 412 BCE).” Some chapters also reveal the destructive effects that can occur when catalytic institutions fail to engage constructively, while other chapters reveal responses and interventions that have such utility they will last well beyond the pandemic. We will learn from the good and the bad; these lessons will continue to prove useful, as the tragic failure to comply with policies to stop the spread—the failure to behave responsibly and altruistically—has led many epidemiologists to

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conclude the pandemic will eventually move to the category of endemic. That is, a situation in which SARS-CoV-2 and its mutations will always be with us, at various levels of virulence, depending on our evolving technological innovations, policies, practices, and politics (e.g., Grad, 2021). Nevertheless, the many successes and lessons shared in this volume, including quick, responsive, fact-based leadership and governance; adaptive, prosocial business practices; scientific discoveries and new technologies in the forms of vaccines and therapeutics; civic engagement and cooperation; responsible personal conduct; and ways to influence all of them give us hope for better prepared, flourishing communities, and thus a better response to crisis, “next time.” Conflict of Interest The authors have no conflict of interest to disclose

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Repo, P., Polsa, P., & Timonen, P. (2022). The Finnish response to first wave of Covid-19: Accentuated persuasion. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Rodríguez-Reyes, L. R., Pasillas, M., & Camberos, K. (2022). Loss of Well-being during the COVID-19 pandemic in Mexico: A public policy analysis using a systemic approach. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Santos, N. J. C., & Chai, D. H. (2022). The Vatican’s response to the coronavirus pandemic: The COVID-19 commission and preparing the future. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Santos, N. J. C., & Ray, S. (2022). Community and market development in India during coronavirus: A focus on the migrant worker (MW) population. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Shabbir, H. A., Hyman, M. R., & Kostyk, A. (2022). A solidarity-care ethics and human flourishing approach to the Covid-19 pandemic: A U.K. perspective. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Shapiro, S. J., & Stanton, J. (2022). Canada after Covid-19: A flourishing community for everyone? In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Shultz, C. & Peterson, M. (2019). A macromarketing view of sustainable development in Vietnam. Environmental Management, 63(4), 507-519 Shultz, C., Deshpandé, R., Cornwell, B., Ekici, A., Kothandaraman, P., Peterson, M., Shapiro, S., Talukdar, D., & Veeck, A. (2012). Marketing and public policy: transformative research in developing markets. Journal of Public Policy & Marketing, 31(2), 178-184. Shultz, C. J., II, Sirgy, M. J., & Rahtz, D. R. (2022). Community, economy and COVID-19: A primer for lessons from multi-country analyses of a global pandemic. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Shultz, C. J., Rahtz, D., & Sirgy, M. J. (2017). Distinguishing flourishing from distressed communities: Vulnerability, resilience and a systemic framework to facilitate Well-being. In R. Phillips & C. Wong (Eds.), The handbook of community Well-being (pp. 403–422). Springer. Soesilo, P. K. M., & Rahman, F. (2022). The pillars of survival in the COVID-19 pandemics: The case of Indonesia. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. United Nations. (2021). Covid-19 response. United Nations. Retrieved June 30, 2021, from https:// www.un.org/en/coronavirus/information-un-system Virakul, B., Chiangmai, C. N., & Senasu, K. (2022). Thailand and COVID-19 pandemic: Lessons learned, challenges, and the silver linings. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. Wooliscroft, B., Ganglmair-Wooliscroft, A., & Hasan, S. (2022). COVID and New Zealand: An outlier case. In C. J. Shultz II, D. R. Rahtz, & M. J. Sirgy (Eds.), Community, economy, and COVID-19: Lessons from multi-country analyses of a global pandemic. Springer Nature. World Health Organization. (2020). Managing the COVID-19 Infodemic: Promoting healthy behaviours and mitigating the harm from misinformation and disinformation: Joint Statement by WHO, UN, UNICEF, UNDP, UNESCO, UNAIDS, ITU, UN Global Pulse, and IFRC. Retrieved September 23, 2020, from https://www.who.int/news/item/23-09-2020-managingthe-covid-19-infodemic-promoting-healthy-behaviours-and-mitigating-the-harm-frommisinformation-and-disinformation

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M. Joseph Sirgy (Ph.D., U/Massachusetts) is a management psychologist and the Virginia Tech Real Estate Professor Emeritus of Marketing at Virginia Polytechnic Institute and State University (USA) and Extraordinary Professor at the WorkWell Research Unit at North West University— Potchefstroom Campus (South Africa). He has published extensively in the area of marketing, business ethics, and quality of life (QOL). His awards include: International Society for Quality-ofLife Studies’ (ISQOLS’) Distinguished Fellow Award, ISQOLS’ Distinguished QOL Researcher, Academy of Marketing Science’s (AMS’) Distinguished Fellow Award, AMS’ Harold Berkman Service Award, Virginia Tech’s Pamplin Teaching Excellence Award/Holtzman Outstanding Educator Award and University Certificate of Teaching Excellence, the EuroMed Management Research Award, and the Macromarketing Society’s Robert W. Nason Award. Best paper awards include articles published in the Journal of Happiness Studies, the Journal of Travel Research, and Applied Research in Quality of Life. His editorial responsibilities include co-founding editor of Applied Research in Quality of Life, editor of the QOL section in the Journal of Macromarketing, editor-in-chief of the Journal of Macromarketing, editor of ISQOLS’/Springer’s book series on International Handbooks in QOL, Community QOL Indicators—Best Cases, Applied Research in QOL—Best Practices, and co-editor of Springer book series on Human Well-Being and Policy Making. Clifford J. Shultz II (Ph.D., Columbia University) is Professor and Charles H. Kellstadt Chair of Marketing at Loyola University Chicago. His scholarly focus is responsible marketing, policy, development and community well-being in distressed and transforming economies, particularly countries and communities recovering from war and other systemic traumas in Southeast Asia, the Balkans, Latin America and the Middle East. Research projects include peace-marketing initiatives in Afghanistan, Bosnia, Cambodia, Vietnam, Lebanon, Syria, Colombia, Myanmar, Nicaragua, and Iraq; social traps; the global refugee crisis; pandemics and other public health crises; sustainable agribusiness and tourism; food, water and energy in the Mekong River Basin; plastics pollution; externalities of the FIFA World Cup; intellectual property rights; and constructive engagement for win-win socioeconomic development, social justice and sustainable peace. Dr. Shultz has over 250 scholarly publications, including books, articles, chapters and conference proceedings. He served two terms as Editor-in-Chief for the Journal of Macromarketing, as President of the International Society of Marketing and Development, and President of the Macromarketing Society; he currently serves as Associate Editor for the Journal of Public Policy & Marketing and the Journal of Macromarketing, and he serves on several editorial and policy boards. His professional distinctions include two endowed professorships, numerous research grants and fellowships, Fulbright appointments in Vietnam and Croatia, distinguished visiting professorships, best article awards, several commendations for outstanding research, teaching and service, and recognition for extraordinary and sustained contributions to the field of Macromarketing. Dr. Shultz has been invited to lecture, to make research presentations at universities and research institutes, and to counsel governments, NGOs, and businesses on six continents. Don R. Rahtz (Ph.D., Virginia Tech) is a marketing / marketing communications researcher and is the J.S. Mack Professor of Marketing at William and Mary (USA). His expertise is in integrated marketing communication programs, international competitive intelligence, cultural intelligence, marketing research, survey methodology, analysis, situational awareness, and market assessment. He has had a particular interest in Quality of Life (QOL), environmental issues, economic sustainable development, transitional economies, business/community interface evaluation, and health systems. Presently he serves on the Editorial Review Boards of the Journal of Macromarketing and Applied Research in Quality of Life. He is a regular reviewer for many of

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the international conferences and journals in the marketing (e.g., Academy of Marketing Science) and quality of life areas (e.g. Social Indicators Research). He has traveled and worked extensively in the developing and transitional world. He has worked on projects in South Asia, North Africa, and Southeast Asia, with a particular focus on Bangladesh, Cambodia, Indonesia, Thailand, and Vietnam. Professor Rahtz has conducted a variety of workshops and seminars, and acted as a consultant to businesses in both the public and private sectors concerning the above topics, both in the United States and abroad. In addition, he has produced a number of publications regarding these topics that have appeared in books, academic journals, and the popular press. He is a founding member of the International Society for Quality-of-Life Studies (ISQOLS) where he has served on the Executive Board in a number of positions. He has served continuously as a Board Member of the Macromarketing Society for two decades. He has a long relationship with the International Society of Marketing and Development (ISMD) and currently serves on their board.