Recovery, Renewal, Resilience

There is not yet sufficient global supply of COVID-19 vaccines - echoing the challenges faced at the beginning of the pandemic when there was insufficient PPE. Variation across regions/countries in the availability of vaccine brings the risk of accentuating long-term health inequalities and could entrench wealth inequalities, as some regions/countries are yet to begin their vaccination programme. This could lead to challenging questions for officials and elected leaders on the prioritisation of who receives the vaccine. For example, "Is it right to vaccinate a low-risk person in Country A (that has vaccine) rather than a high risk, front line health worker in Country B (that does not have sufficient vaccine)?" Consider how vaccine distribution plans and priority groups may polarise public opinion on the value of life and risk, including:

• The UN note that a 'me first' approach could prolong the pandemic as well as cause further economic and human suffering
• Changes to vaccination supply plans or redirecting vaccine stock to other regions/countries to manage targets may heighten public discomfort and disturbance
• Creating tier systems for access to vaccines can lead to fracture lines emerging in society, prompting civil disturbances or protests which may also increase transmission and lead to local outbreaks
• Individuals not agreeing with their classification may reject authority and breach guidelines
• Negative publicity for officials in managing change and social order may impact coming elections

Formal learning from COVID-19 is beginning to take place at national and international levels, to capture rapid dissemination of information and lessons. Similar approaches at local government levels are identifying emerging trends in response and identifying gaps and opportunities for the future e.g. The Ney report on Local COVID-19 outbreaks: Lessons learnt and good practice from Leicestershire’s experiences of responding to a local surge in COVID-19 cases. Consider:

• Learning can capture information in cities or regions
• Learning can be undertaken by individual local governments or a consortium through mechanisms such as peer review (see ISO 22392)
• Lessons may be disseminated within a single locale or more widely. The may be between cities or regions or internationally with organisations such as the Global Resilient Cities Network

We provide a few examples of formalised international learning and the key issues addressed to provide consideration for similar pieces of work at local level.

• The UN has developed The Compendium of Digital Government Initiatives in response to the COVID-19 to capture emerging trends in digital responses of UN Member States against the COVID-19 pandemic, and provide a preliminary analysis of their main features
• The Health System Response Monitor (HSRM) collects and organises up-to-date information on the responses of health systems and also captures wider public health initiatives
• New Zealand’s Independent Review of COVID 19 Clusters in Aged Residential Care Facilities which provides lessons on care facilities for the elderly and recommendations for improvements
• Korea’s COVID-19: Testing Time for Resilience which includes information on holding elections during COVID-19
• Consideration of how to learn lessons through debrief, assessing performance and peer review