Recovery, Renewal, Resilience

Strong collaboration between local government and their partners, communities and local businesses is required to anticipate challenges in the aftermath of COVID-19. Further, co-operation in the design of recovery strategies is critical to ensure communities are engaged and empowered in their recovery. Recovery strategies will need to be tailored to address the diversity of impacts and needs of different communities. Consider how to:

• Conduct an impact assessment to identify where COVID-19 has created effects, impacts and opportunities (see TMB 8) - and identify which of these impacts will bring longer-term challenges in recovery
• Refresh impact assessments with updated information as other effects, impacts and opportunities become known
• Identify other challenges that lie ahead as we progress to living with COVID
• Review what planning is required and what partnerships will support recovery:
  • Define recovery goals in partnership with the community and local organisations, and account for the need to measure progress and outcomes in the future
  • Plan for the need to adapt/pivot and establish new local resources, services and programmes to address pre-existing, new and emerging needs of communities, e.g. infrastructure planning to address housing supply challenges/employment programmes for young people
  • Maintain and enhance partnerships that have been developed through the pandemic, by bringing these partners together to co-produce plans and actions to address the new and emerging challenges
• Identify logistical and operational challenges that may occur as continuous management of the virus is required
• Review lessons from previous phases of track and trace/vaccination programmes, recognise the challenges, such as people not responding to track and trace or vaccine hesitancy, and prepare strategies to address these (see TMB 31)
• Manage the expectations of communities, to ensure that they understand that potential future outbreaks may mean restrictions may be re-introduced
• Review communication strategies for previous localised restrictions, consult with local partners on their effectiveness

The ALARP principle acknowledges that we might not be able to eliminate all risk, as risk is part of life, but we may be able to manage it. It is necessary to control risk, particularly when it comes to public health and safety. Throughout the pandemic we have continuously acknowledged the existence of COVID-19 risk and managed this risk to as low a level as practicable through various containment measures. When assessing COVID-19 risk ALARP, consider:

• What level of COVID-19 risk is as low as reasonably practicable and acceptable, e.g. for lockdown to end (this could be based on factors such as levels of hospital admissions due to COVID-19, or the number of people vaccinated)
• The likelihood of the hazard or the risk occurring and what degree of harm might result from the hazard or risk
• What actions are available to minimise the risk
• What cost is associated with available ways of minimising the risk - Is the cost proportionate to the risk
• Communicate with the public and educate them about risk being ALARP, to increase understanding that we will continue to live with COVID-19, and that recovery will consider risk in terms of ALARP
• Develop guidance for businesses (e.g. nightclubs) on operating according to the principles of risk ALARP in relation to COVID-19 containment

We present a high-level report of the 'light touch' Impact Assessment conducted by Essex Resilience Forum and Recovery Coordination Group following the first wave of COVID-19. Lessons include the need to revisit/update impact assessments to identify new impacts from subsequent waves.

To read this briefing in full, follow the source link below to TMB Issue 32 (p.2-5).

The 2021 UK Census offers a unique opportunity to increase our long-term understanding of the health, social and economic impacts of COVID-19 on different communities. In due course, local government can use the insight that the Census provides to plan and provide funding for services that will be critical in recovery and renewal, such as changes in housing, education and healthcare. Grassroots organisations, charities and businesses can also use this information to inform their future work and to secure funding. Consider:

• A targeted and localised communications campaign that highlights issues that are relevant for local people in their community:
  • Engage local community members/groups that may have influence and knowledge on the priorities of specific communities to inform communications and support the encouragement of people to take part
• Partner with organisations that work with different communities to promote the value and benefits that the information gained through the Census will bring
• Tailor communications and ensure that the value and benefits detailed are relevant to particular groups (e.g. people with disabilities, ethnic communities)
• Develop a variety of resources that support people to take part, for example:
  • Create a variety of resources (e.g. animation films) that explain how to complete the Census and where people can get support with filling out the Census form, signpost people to organisations that can help
• Ensure all resources are accessible in terms of language and consider access needs of people with disabilities

The Integrated Review of Security, Defence, Development and Foreign Policy provides a comprehensive view of the UK’s national security and international policy[1]. This case study will detail the key messages from this review relative to local and national resilience.

Building resilience in the UK and internationally (IV. Strategic Framework - Section 4)

The review recognises that national resilience goes hand in hand with global resilience. The unprecedented challenges brought about by the global COVID-19 crises highlights how international cooperation is critical yet fragile under such immense stress, unaided by the historic preference for efficient governance and processes rather than robust resilience capabilities. The review sets out the UK’s priorities for strengthening both national and global resilience (p.87):

• Build national resilience to mitigate the impacts of ‘acute shocks and longer-term challenges’ on the lives and livelihoods of people in the UK, through robust risk planning, ‘effective and trusted governance, government capabilities, social cohesion, and individual and business resilience’
• Build health resilience at national and global levels to improve global pandemic preparedness through a ‘One Health’ approach informed by learning from COVID-19
• The development of a ‘comprehensive national resilience strategy’ (p.88):
  • A ‘whole-of-society’ integrated approach to resilience that focuses on: ‘improving public communications on preparedness; strengthening the role and responsibilities of local resilience forums (LRFs) and assessing the resilience of critical national infrastructure (CNI)’
  • Review risk assessment approaches, ‘increase local and national capabilities (people, skills and equipment) and strengthen analytical, policy and operational tools’ (p.89)
• Funding and resources through the Spending Review (SR 2020) commitments include; the establishment of a ‘Situation Centre’ which will generate and produce live data, analysis and insights to decision-makers on real time events in the UK and across the world to increase the UK’s ability to quickly identify, assess and respond to national security threats and crises (p.104)

Climate change agenda

The review recognises the urgent need to tackle climate change and biodiversity loss to drive forward a ‘zero-carbon global economy, support adaption and resilience, and protect the most vulnerable’, and to build resilience to climate change impacts at local levels, e.g. against floods (p.89):

• ‘Accelerate the global and national transition to net zero by 2050’ through a variety of initiatives (e.g. increasing support for net zero innovation and new industries)
• Drive ‘sustainable and legal use of natural resources by supporting agriculture that regenerates ecosystems’ and increases the availability of and accessibility to sustainable food resources (p.90)

Connecting resilience, health and migration

Outbreaks of infectious disease are likely to become more frequent in the future and efforts to manage and mitigate their effects is essential. The review supports the view that the resilience and health sectors are inextricably intertwined and require strategic prioritization at local, national and global levels through (p.93):

• Equitable access to healthcare (e.g. COVID-19 vaccines) for global, national and local recovery from the current pandemic through ambitious domestic vaccination strategies and by providing support for developing countries to increase access to vaccines globally (e.g. via the Covid-19 Vaccines Global Access Facility initiative[2])
• Reviews of biosecurity strategies to recognise the interconnecting relationships between population ‘health, animals and the environment’ and the development of a robust approach to the resilience of healthcare supply chains (p.94)
• Increase of crisis response capabilities at local levels by providing funding (£5.4bn) to support local authority response capabilities (p.104)
• Investment and cooperation in the reformation of the global health system that recognises the potential value of data and identifies the strengths required between health and economic institutions for resilience (p.94)
• Global coordination and collaboration to increase and improve research and development for vaccination, therapeutics and diagnostics, to strengthen preparedness for pandemics on global scales (p.94)

Migration poses a multitude of complex challenges, such as risk to the lives of the most vulnerable and pressures on host country institutions and systems (e.g. health). To build resilience in this capacity, the UK is committed to providing support that addresses the root drivers of migration, e.g. to improve ‘stability and socio-economic conditions in fragile regions’ (p.95).

Implementation of the Integrated Review

To ensure the successful implementation and delivery of the goals set out in this review, the UK is prioritising (p.97):

• Flexibility, agility, accountability for delivery and strong ministerial oversight when dealing with complex strategic issues, to increase coherence, structure, the ability to react quickly to and deal with cross-cutting challenges and effective implementation;
• Building support for strategy implementation through strategic communications and community engagement
• This review reinforces the view of The National Risk Register[3] on how community engagement and participation in risk planning is essential. The pandemic has provided local and national governments with a unique opportunity to harness and develop volunteers and community response and recovery capabilities to strengthen community resilience and increase its positive impacts on preparedness for future challenges caused by COVID-19 and future crises in a broader sense
• The attainment of a culture that supports integration, adaption and innovation through inclusion and participation. To do this, the review acknowledges the need to further develop and harness the opportunities provided by the pandemic, those that will achieve a culture that manifests the collaborative, agile and inclusive behaviours that enable integration, for example (p.98):
  • The mitigation of cognitive biases that impact decision-making through a systematic process of challenging procedures, decisions and strategies
  • Increase awareness of, connectedness to and representation of all people in the community
• The importance of having the right people with the right knowledge, skills and abilities (KSA) to form ‘flexible, diverse and multidisciplinary teams’. To accelerate progress towards professionalisation, training and skills, the UK will review the viability of a dedication College for National Security, in preparation for the next SR (p.99)
• The establishment of a ‘Performance and Planning Framework’ and an ‘Evaluation Taskforce’ to provide continuous review and assessment of integration performance and impact measurement (p.99)

[1] https://www.gov.uk/government/publications/global-britain-in-a-competitive-age-the-integrated-review-of-security-defence-development-and-foreign-policy

[2] https://www.who.int/initiatives/act-accelerator/covax

[3]https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/952959/6.6920_CO_CCS_s_National_Risk_Register_2020_11-1-21-FINAL.pdf

Views from the Frontline (VFL) found that many communities feel that they would benefit significantly if they were to be included in the planning, preparing and monitoring of disaster risk interventions. Communities, and the people within them, are acutely aware of their vulnerabilities and will have diverse needs and priorities. By including the community in the development of plans and actions, local governments can recognise these diversities and directly respond through policies and interventions. Further, inclusion and co-operation can increase a community's awareness of the valuable resources that are available to them before, during and after disasters. Consider:

• Facilitate regular interaction of local government with communities and grassroots organisations in decision-making processes and disaster risk reduction programmes:
  • Establish community consultations/workshops
• Engage and involve local stakeholders in the preparation of local policies, plans and actions aimed at disaster risk management:
  • Ensure the adoption of an inclusive approach when doing so, e.g. including volunteers, marginalised people (women, children, people with disabilities, migrants, older people, LGBTQI+)
• Collate knowledge and ideas, and generate collective action between local government and communities on what is required to address different types of disaster risk:
  • Collaborative knowledge sharing and action can mitigate threats, address vulnerabilities and improve the community's sense of security and safety
• Involve local knowledge of communities to improve risk mapping, generate local ownership and empowerment, and increase awareness and preparedness:
  • In Tanzania, local residents carry out remote detection to identify sanitation issues in rural areas by sending SMS messages to local engineers and media outlets
  • This raises the awareness of local people quickly to potential risks and enables local authorities to monitor water supplies remotely and at a lower cost

Many people, particularly those shielding, may be anxious about having annual servicing and repairs done to their homes, property or possessions e.g. cars, bicycles. Thus, they may delay routine maintenance and servicing of gas and electric appliances, vehicles, etc. or be encouraged to personally attempt maintenance or repair that they are not skilled to safely complete. This may put them, and others, at risk. Consider:

• Communicating the importance of annual servicing, repairs and maintenance in keeping people safe, including:
  • Encourage residents to check the expiry of, and keep up to date with, servicing, maintenance and repairs to avoid the risks of faulty boilers, for example
  • Signpost residents to safe working conditions that customers may expect of local organisations when they work in people’s homes
  • Encourage local organisations to detail the COVID-safe work practices that they have in place
• When restrictions ease, there may be a rush for maintenance and repair services, (e.g. roadworthiness/vehicle testing and servicing), which may cause a backlog or delay in service delivery:
  • Remind residents and encourage them to check when they are required to renew their MOT – the UK introduced a 6 month extension for vehicle roadworthiness (MOT) certificates in the first lockdown as garages were forced to close, so this will have disrupted normal scheduling
• Those who may be struggling financially due to the pandemic may be concerned about the affordability of maintenance and servicing:
  • Remind residents that keeping up to date with annual services can prevent future maintenance that may cost more to repair/replace
  • Signpost residents to financial advisory services (see TMB 30)

A number of countries have been praised for their management and containment of COVID-19, and are delaying vaccination delivery as they to continue examine data on different vaccines (e.g. Australia/New Zealand) and build public trust (e.g. Japan)[1]. Other countries continue to grapple with the virus and are yet to begin a full roll out of vaccination programmes, primarily due to supply issues[2]. In the UK, various factors have enabled more covid-19 vaccine first doses per 100 people than any other nation of comparable population size[3]. These factors are addressed in the four key areas of a national vaccination plan[4];

• Early investment in supply and coordinating activities, e.g. the establishment of a UK Government Vaccine Taskforce with the remit of ensuring the UK population would have access to a safe and effective vaccine
• A clear initial aim for the vaccination programme (see TMB 28): “the prevention of COVID-19 mortality and the protection of health and social care staff and systems”[4]
• A focus on Place: creating a network of vaccination sites to ensure safe and easy access for the whole of the population, e.g. active hospital hub sites and local vaccination centres
• A focus on People: the identification of priority groups and rapid recruitment and training of vaccinators (including a range of non-clinical support staff to increase capacity)

Local government have played a critical role in leading communities through the pandemic. They have harnessed strong community links and established partnerships with emergency services and the voluntary, community and faith sectors which have proven invaluable. For example, local governments have supported the planning of local health protection and emergency response, including supporting vaccine delivery[5],[6]. Below, we offer lessons from UK case studies that demonstrate the actions of local government in supporting vaccine delivery.

Manage logistics[7]:

• Take responsibility for logistical challenges to relieve the pressure on healthcare staff so that they can focus on administering vaccines
• Provide logistical support services to vaccination clinics and centres by mobilizing volunteers and council staff as stewards to all vaccination sites
• Set up marquees at new clinic sites, install heating, resolve parking problems, and organise additional bin collection services to deal with waste

Address vaccine hesitancy:

• Train community champions[8] or create an army of vaccine advocates[9] to address vaccine concerns and build trust, working with volunteers, and community and faith leaders. Create videos with key COVID-19 safety and vaccine messages in different languages to dispel myths
• Hold online discussions with councillors, healthcare planners and local general practitioners, to create a two way conversation with the local community; to hear, listen and respond to their important concerns and questions[10]
• Establish a programme to follow-up with those who have refused the vaccine. For example, The Health Sandwell team[10] are addressing vaccine take-up in their area by using their trained negotiation skills which they normally use to support people to stop smoking
• ‘Making every contact count approach’[11], where workers in non-healthcare settings are trained to provide guidance and interventions to the community on various health matters such as healthy weight and nutrition to promoting good mental health. For example, Gateshead council works with more than 40 organisations from across the public, private and voluntary sectors to address vaccine hesitancy in the community

Support accessibility:

• Recruit local vaccinators, e.g. retired health workers[12]
• Recruit or mobilise local community volunteers to provide transport for people who have mobility issues[13]
• Set up vaccination clinics in local community venues used by different groups, e.g. mosques

The key learning gained from the vaccine roll out in the UK reflects:

• The community leadership role of local government
• The importance of strategic partnerships within the community
• Harnessing these partnerships to enable the co-production of systems and actions between official bodies, community voluntary organisations, businesses and individuals, that have direct benefit for the community as a whole

References:

[1]https://www.theguardian.com/world/2021/jan/08/why-the-delay-the-nations-waiting-to-see-how-covid-vaccinations-unfold

[2] https://www.irishexaminer.com/news/arid-40212677.html

[3] https://ourworldindata.org/grapher/uk-covid-vaccination-doses-per-capita?tab=chart&stackMode=absolute&time=2025-08-03&region=World

[4]https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/951928/uk-covid-19-vaccines-delivery-plan-final.pdf

[5] https://www.local.gov.uk/our-support/covid-19-vaccination-case-studies

[6] https://www.opml.co.uk/blog/five-lessons-for-local-governments-during-covid-19

[7] https://www.local.gov.uk/sheffield-city-council-dealing-logistics-so-nhs-can-focus-jabs

[8]https://www.local.gov.uk/birmingham-city-council-training-community-champions-address-vaccine-concerns

[9] https://www.local.gov.uk/sandwell-council-creating-army-vaccine-advocates

[10] https://www.local.gov.uk/sandwell-council-creating-army-vaccine-advocates

[11] https://www.local.gov.uk/gateshead-council-using-making-every-contact-count-approach

[12] https://www.local.gov.uk/cambridgeshire-and-peterborough-working-whole-community

[13] https://www.local.gov.uk/kirklees-council-weve-set-free-transport-service-get-frail-residents-vaccination-clinics

View this case study in its original format (including references) by following the source link below.

While restrictions are gradually eased, religious festivals will also take place, e.g. Easter, Ramadan, and Ridvan. These occasions are often celebrated through community gatherings and special religious services/activities that enhance connectivity for people. As traditional celebratory activities have been unable to go ahead over the last year, and the message of lockdown easing takes hold, consider the need to:

• Review local plans that were in place during religious festivals in 2020:
  • Consult with community members when revising previous plans, to understand what has gone well and what could be improved this year
  • Support communities in the planning of COVID-safe celebrations for 2021, e.g. by allowing worship to be held in community spaces such as parks or public gardens
• Recognise and acknowledge the influence of faith and faith leaders in building trust and influencing behaviour:
  • By directly engaging in conversations with communities about religious celebration planning, other conversations can emerge, e.g. vaccination safety, concerns and attitudes towards uptake

While the vaccine programme may be in its early stage in many countries, thought is required on how to access people who are not on any social services list or registered in any location. This includes homeless people, illegal immigrants, stateless people and refugees who are not in the 'system'. Excluding such people from the programme risks the virus continuing to affect them, and then spreading into other parts of society. Consider:

• Take a national perspective on how to involve people who are marginalised from mainstream public services in the vaccine programme
• Establish who is responsible for vaccinating unregistered people
• Decide whether all vaccination centres are open to vaccinating unregistered people
• How partners that have strong community links can disseminate the vaccine message to unregistered people
• Assess the consequences of unregistered people not being vaccinated
• When the first vaccination of an unregistered person should take place and a target time frame in which to vaccinate all unregistered people
• Identify challenges for the vaccination programme in vaccinating unregistered people
• Recognise that un-registered people may be fearful or hesitant to come forward to receive the vaccine:
  • Consider a moratorium/amnesty on those who regard themselves to be illegally resident in the country to receive the vaccine
  • Work with partners and external organisations who have links to un-registered people to communicate that they can register to receive the vaccine without fear of immigration enforcement activities

Due to lockdown measures and temporary breaks to in-person public service provision, communicating specific information to migrants and refugees on their rights and obligations has been challenging. This includes communications on re-settlement programmes to support their integration into communities (see TMB Issue 29 for guidance on national resettlement programmes). Some countries have introduced temporary policy changes and targeted communication of such changes is crucial so that migrants are aware of the essential services that are available to them during the pandemic, e.g. Spain suspended the obligation to have valid documents in order to access essential public services such as healthcare and vaccination. National information strategies can be complemented locally by reaching out directly to migrants living in communities. Consider:

• Identify and establish contact with the leaders of refugee and migrant groups to communicate important messages
• Collaborate with migration support services, NGOs and local volunteers to develop a targeted online communications platform for migrants and refugees, e.g. “Migration Information Hub”, Leeds City Council, UK
  • Use the platform to inform migrants about COVID-19 related issues and guidelines; access to health care, food, housing, work rights, visa status, signpost immigration services and detail any changes to policy measures
  • Ensure alternative communication strategies are explored, such as information leaflets through migrations support services reach those who do not have access to the internet
  • Provide information on how victims of discrimination can get help and support
• Collect further data and information on reaching specific groups through consultation with the relevant communities, to improve future preparedness for crisis communication with migrants and their families
• Ensure easy access to information by translating key material into the languages of migrant communities:
  • Recruit translation volunteers to support the translation of information and development of multilingual media for the platform, e.g. YouTube videos
• Organise free workshops for migrants and refugees via Zoom, e.g. ‘How to access health services’, to inform on free services, including mental health facilities
• Develop and deliver targeted communication strategies to influence communities’ perceptions of migrants, working with local community leaders and groups, and organisations that support and advocate for migrants:
  • Tackle and counter misinformation online to prevent prejudice against migrants and mitigate the negative impact of the health crisis on immigrant integration
  • Set up a social media campaign that directly addresses the prevention of discrimination and spread of misinformation, e.g. “Somos Panas", Columbia
• Invite the public to help counter the spread of misinformation by sharing fact-based information with their own communities

As COVID-19 vaccine delivery programmes gain pace, attention has turned to vaccine hesitancy and the associated challenges to achieving optimal vaccination goals[1]. Public hesitancy has developed as people are anxious and uncertain about the safety and regulation of the vaccine[2]. Vaccination hesitancy has been found to relate to the public perception of risk, connected to two factors:

• The risk of morbidity or mortality
• Elements of an event that cause fear, worry, mistrust or upset to the public[3]

Recent studies have identified three predominant groups that are at higher risk of COVID-19 vaccine refusal, requiring targeted strategies and communications to address their concerns and hesitancy:

• Women aged 30-39[4]
• Low-income groups[5]
• Socioeconomically disadvantaged groups and BAME communities[6]

Potential causes of COVID-19 vaccine hesitancy:

• The speed at which the available COVID-19 vaccines were produced and approved may lead to scepticism or mistrust relating to their benefit, effectiveness and long-term side effects[7]
• Pregnant women were not included in the majority of COVID-19 clinical trials, so there was little data available to evaluate vaccine safety relating to fertility, pregnancy and young children[8]
• Misinformation through social media and the challenges caused by the anti-vaccination movement in developing and communicating scientific expertise and building public trust in the effectiveness of COVID-19 vaccines[9]

Strategies to address vaccine hesitancy

Although the WHO advise that there is no specific reason for risks that would outweigh the benefits for pregnant women in some vaccines[10], the inclusion of pregnant women in COVID-19 therapeutic trials is crucial to ensure the identification of efficacious and safe treatment[11]. The Behavioural Science and Public Health Network[12] and the European Centre for Disease Prevention and Control[13] offer the following recommendations to address COVID-19 vaccine hesitancy:

• Increase trust and confidence in the safety and effectiveness of the COVID-19 vaccine by:
• Clearly communicating its rigorous development and testing process
• Provide details of the COVID-19 development and testing process, highlighting the way in which the same rigour has been applied for previous vaccines
• Train health care workers to respond to hesitant patients, e.g. their common concerns, addressing those concerns
• Design community-level interventions to target high risk vaccine refusal groups by supporting the development of community networks:
• Leverage and support existing channels that have influence on decision making, such as; community and faith leaders of ethnic minority and low-income communities; teachers and youth/sport club leaders who interact with the parents of young children; online communities and networks[14], e.g. Mumsnet
• Establish community educational and promotional activities to inform on the safety and benefits of vaccination (via talks, videos, presentations and discussions)
• Launch advocacy campaigns supported by community members to promote vaccine safety and counter anti-vaccination messages, to mitigate the prevalence of misinformation in BAME communities[15]
• Establish an on-line decision aid for parents
• Use information from trusted health agencies to produce online information and vaccine information pamphlets for pregnant women and new mothers:
• Detail different vaccines in full, relative to their available safety data, to ensure women can make a factually informed decision
• Raise awareness of online information and disseminate pamphlets

References:

[1] https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(20)30016-8/fulltext

[2] https://www.ecdc.europa.eu/sites/portal/files/documents/Catalogue-interventions-vaccine-hesitancy.pdf

[3] https://oxfordmedicine.com/page/measles%20and%20the%20hesitancy%20to%20vaccinate/measles-and-the-hesitancy-to-vaccinate

[4] https://www.smh.com.au/politics/federal/covid-19-vaccine-advertising-campaign-to-target-specific-fears-20210109-p56svi.html

[5] https://www.sciencedirect.com/science/article/pii/S2666776220300120?via%3Dihub

[6] file:///C:/Users/r66633rj/Downloads/COVIDvaccinePaper4.pdf

[7] https://www.ox.ac.uk/news/science-blog/covid-19-vaccine-hesitancy-uk#

[8] https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30484-8/fulltext

[9] https://www.bma.org.uk/news-and-opinion/pushing-back-tackling-the-anti-vax-movement

[10] https://www.who.int/news-room/feature-stories/detail/the-moderna-covid-19-mrna-1273-vaccine-what-you-need-to-know

[11] https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30484-8/fulltext

[12] https://www.bsphn.org.uk/_data/site/54/pg/675/COVID-19-Vaccination-Reducing-Vaccine-Hesitancy.pdf

[13] https://www.ecdc.europa.eu/sites/portal/files/documents/Catalogue-interventions-vaccine-hesitancy.pdf

[14] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32642-8/fulltext

[15] https://socialcare.blog.gov.uk/2021/01/27/overcoming-vaccine-hesitancy-in-our-diverse-communities/

Vaccination certification for COVID-19, sometimes referred to as immunity/vaccine passports, are being considered by some countries as a strategy to relax the strict measures that have been imposed on society over the last year. The document is designed to certify people as immune to COVID-19 based on vaccination. Consider the ethical issues associated with varying restrictions on individual liberties based on possession of a vaccine certificate. Consider:

• If a vaccination certification programme could cause unequal treatment of individuals by segregating members of society into different tiers of infection risk and contagiousness, for example:
  • Members of groups who live with systemic discrimination and marginalization may face more barriers to accessing particular areas of society or activities if they are not certified as vaccinated
  • Differences in exposure, access to health care and vaccination certification may lead to some groups having higher or lower proportions of vaccine-certified people
• If the application of vaccination certification should only be used with existing precautions and should not prevent non-vaccine certified people from accessing areas or activities, e.g. people who have not received a vaccination certificate should not be prevented from travelling but may be required to take a test/quarantine on arrival as per the existing precautionary measure
• Whether vaccinations certifications should:
  • Impact a person's ability to exercise fundamental rights such as voting, accessing and social care or education
  • Cause an increase in cost or burden for vaccine-certified individuals, e.g. frontline healthcare workers who are vaccination certified should not be expected to manage more work
• If the perceived benefits of vaccine certifications could increase the risk of people increasing their exposure to intentionally become infected and receive a certificate, which poses risks to an increase in community spread and could potentially cause harm to others
• The perceived value of vaccine certificates and counterfeit market activity/certificates
• How to mitigate implementation risks, e.g. certification being managed by certified bodies, results being processed and confirmed by licensed laboratories, and certificates being issued by health authorities
• To protect personal data and minimize breaches of confidentiality, legal and regulatory measures should be put in place to limit the access to data by governmental authorities

The success of the vaccine programme will, in part, depend on how many people accept the vaccine. The prevailing narrative in a country may influence those who are anxious about the vaccine or uncertain about whether they should have it. Often there are vocal groups in support of, and in opposition to, vaccines and those groups are already very active around COVID-19. Governments will be a main facilitator of vaccine programmes so (in collaboration with partners) should consider addressing voices that oppose vaccine programmes. WHO provides guidelines for responding to vaccine deniers, including broad principles for health authority spokespersons on how to behave when confronted. The principles are based on psychological research on persuasion, public health, communication studies, and on WHO risk communication guidelines. The WHO guidelines cover:

• Tactics by vocal vaccine deniers e.g. skew science, shift hypothesis, censor, and attack opposition
• Who is the target for advocating vaccines i.e. the public are your audience, not the vaccine deniers
• The speaker should represent the well-grounded scientific consensus
• Verbal and nonverbal skills, and listening skills
• Do's and don'ts of verbal and nonverbal communication
• Constructing the argument to support vaccination

There have been well-documented breaches of the COVID-19 rules in, for example, workplaces, shops, public spaces. This has caused frustration and resentment, and made front-line staff question their perceived value and sacrifice. Current enforcement of the rules is led by the authorities, but there is potential for the public to report breaches via whistleblowing apps, which may help to target official enforcement activities. Consider:

• The potential to establish a whistleblowing app to collect information from the public on COVID-19 breaches
• Who should initiate and own an app to allow the public to report COVID-19 breaches, including the potential hesitation the public may have to report via Police websites
• Whether reports will be made anonymously by the public
• How to address and mitigate the potential for malicious or bogus reports
• What thresholds need to be met before action is taken
• How to analyse app data to identify patterns and trends of where, when and what breaches occur
• How to report back on subsequent enforcement actions and outcomes to individual whistle-blowers and to the wider public
• The need to increase capacity to engage, explain and encourage compliance by, for example, staff, trained volunteers, neighbourhood watch, local organisations (see COVID Marshals TMB Issue 28 (hyper) January 22nd)
• How to raise public awareness of whistleblowing apps to ensure that a lack of public awareness does not hinder their effectiveness

Graham Bell of AJC Bell Consulting outlines some over-arching principles of organisational resilience which can help organisations to reflect on the pandemic and learn from it to recovery and renew. This briefing offers guidance on beginning the journey to post-pandemic recovery and renewal.

Read this briefing in full by following the source link below to TMB Issue 29 (p.2-7).

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

Vaccines must be a global public good, which contribute to the equitable protection and promotion of human well-being among all people. At national level, a clear aim for vaccine programmes is essential, e.g. reduce immediate risk to life, in order to inform the identification of priority groups. As sufficient vaccine supply for whole populations will not be immediately available, WHO have provided a Prioritization Roadmap and a Values Framework, to assist with the prioritization of target groups. The WHO guidelines and framework advise to:

• Identify groups that will achieve the vaccine programme aim where there is an immediate risk to life, e.g. Stage 1 Priority Group - Care home residents, staff and volunteers working in care homes; Stage 2 Priority - Frontline health workers and those of 80 years of age and over. Priority groups should be listed and detailed to cover the whole population that is to be vaccinated
• Clearly define groups within priority phases, e.g. workers who are at very high risk of becoming infected and transmitting COVID-19 because they work in, for example, frontline health care, COVID-19 treatment centres, COVID-19 testing laboratories, or have direct contact with COVID-19 infected patients
• Avoid classifying groups as 'essential workers' as a qualifier
• Make priority groups explicit, straightforward, concise and publicly available
• Assess the prioritisation of those who are in high population density settings, e.g. refugees/detention camps, prisons; or who are not recorded in existing systems, e.g. un-registered persons
• Recognise vaccination as a global issue to begin conversations that identify how we will achieve the aim of reducing immediate risk to life globally, through international collaboration

Conventional campaigning tactics, such as door-to-door visits and town hall meetings to connect and talk to constituents, are not currently possible in many countries due to COVID-19 guidelines and concerns over risk of virus transmission. Clear guidelines that have the agreement of major parties are needed to ensure appropriate electioneering keeps election candidates and voters safe. Consider the need to:

• Develop an agreement between major political parties on the rules they commit to follow to ensure the safety of their election campaigns
• Identify alternative campaigning methods that are appropriate, such as:
  • Increased use of telephone and postal campaigning
  • Online platforms to support webinars and online town hall meetings with candidates to interact with voters
  • Increased involvement of volunteer helpers in constituencies
• Identify campaigning methods that are not appropriate, for example:
  • Driving voters to voting booths
  • In-person public appearances in places where crowds may then gather
• Appoint an arbitrator to advise on the adherence to agreed rules and the appropriateness of campaigning methods
• Consider how positive and negative campaigning may affect public mood at an already stressful time
• Communicate rules to campaign offices well in advance to allow preparation
• Communicate the campaign rules to the public

As the roll out of the COVID-19 vaccine gains pace, there has been reporting of a rise in criminal activity targeting people who await information about their vaccine. Examples of how fraudsters are exploiting the vaccine launch includes: scam text messages that request personal information such as bank details; fraudsters turning up at peoples' houses posing as National Health Service employees and offering vaccination for immediate payment. Fraud undermines public confidence in official programmes and contribute to a negative narrative around the vaccine programme. Consider public messaging to:

• Use a range of communication channels to build public awareness of fraudsters' tactics to encourage vigilance regarding vaccination communications
• Ensure communications about fraud awareness are available in different languages and different media e.g. to support migrants or support people with disabilities such as via informational videos: https://signhealth.org.uk/resources/coronavirus/
• Publish a list official government and health websites/social media channels that are authorised to provide official information on the vaccine
• Include in fraud communications information on the ways in which people will be invited for an official vaccine, and ways that they will not be invited
• Identify partnering organisations that can distribute messages about vaccine fraud e.g. organisations that run befriending schemes, check-in and chat services, vaccination partners
• Disseminate consistent information to these partnering organisations to advise them of how to provide information about fraud without concerning people about the safety of the vaccine itself

Developing a succinct plan that details the organisation's overall strategy for recovery and renewal can help ensure the organisation is working towards the same goal and with the same vision. The plan can be developed with partners and disseminated to relevant parties through local networks. An example of this is the Core Cities UK 10 Point Plan to Leave Lockdown - 10 policy initiatives developed for government to work with cities in exiting lockdown. In brief, the plan considers:

• Clear and transparent criteria for entering and exiting lockdown
• Rapid, localised Test and Trace and vaccination
• Adequate business support packages
• Extended furlough and self-employment support
• Sustainable financing of local government
• Winter support packages for vulnerable people
• Safe and secure places to live e.g. ban on landlord evictions and return of the 'Everyone In' campaign to end rough sleeping
• Commitment to dialogue with key stakeholders across locally agreed geographies
• Focused support for education and learning institutions e.g. rapid Test and Trace for all students and staff, reviewing exam timetables
• Increased local enforcement powers to tackle non-compliance

The pace at which some organisations and individuals have been moving during the COVID-19 pandemic has been relentless with many in prolonged ‘crisis mode’[1]. The pace, combined with mounting tensions and ever-present uncertainties have taken their toll on individuals and systems, leading to systems being overwhelmed, burnout and fatigue. For some systems, organisation and individuals, the recent holiday period has led to a pause in the relentless pace of COVID-19. This case study raises questions about whether continuing to work in a crisis response mode throughout 2021 is the best option, whether it is feasible, and which operations can be paused to create capacity in overwhelmed systems in order to create a potentially more sustainable pace and nurture resilience in people.

Gradually, people have begun to familiarise themselves with the notion of a ‘new normal’ in which our behaviours and expectations of the world we live in are adapted and changed[2]. This new normal came quickly and unexpectedly, and had to cement itself into organisations and individuals during an emergency and, as a result, the pace was rapid. But, as time moves on the new normal has to transition into a new business as usual. This is not a return to normalcy pre-pandemic, but rather a strategy of consistency that adopts COVID-19 learning to substantively address identified shortcomings with a view to facilitating systems, organisations and people to function in a sustainable way, despite the ongoing difficulties and disturbances. This requires:

• The identification of processes to pause or reduce
• The reorganisation of priorities and tasks
• The redeployment of resources[3]

Developing a sustainable pace that will take systems, organisations and individuals through the whole of 2021 might be achieved through analysing lessons learnt and undertaking impact assessments – TMB 17 and TMB 18.

These assessments can help systems, organisations and people to:

• Take stock of their current environment, operations and behaviours to consider whether their pace and activities are fit for purpose and sustainable for 2021
• Take the time to draw on expertise from a whole range of other systems, organisations and people to evaluate their situation
• Take the time to make necessary systematic and sustainable changes to the pace of operations to ensure inclusivity and resilience
• Build relationships and resources beyond an organisation or individual to develop partnerships which may help to reduce pressures and develop a more sustainable pace of operating

In turn, this helps to build approaches for 2021 and the future that can protect systems, organisations, and people, built their resilience and align components of the system (that may unnecessarily be running at a different pace) to increase overall efficiency and resilience.

References:

[1] https://www.health.mil/News/Articles/2020/03/26/In-a-COVID-19-world-pace-yourself-to-stay-resilient-and-avoid-burnout

[2] https://theconversation.com/coronavirus-has-led-to-an-explosion-of-new-words-and-phrases-and-that-helps-us-cope-136909

[3] https://www.alliancembs.manchester.ac.uk/media/ambs/content-assets/documents/news/the-manchester-briefing-on-covid-19-b16-wb-20th-july-2020.pdf

In Greater Manchester UK, the Greater Manchester Combined Authority (GMCA) Ageing Hub, Greater Manchester Health and Social Care Partnership, and partners launched the ‘Keeping Well this Winter campaign’ to support older residents in the region. The resources are designed to:

• Encourage conversations about keeping well during winter using a short film produced by older people, a talking tips guide and booklet to provide clear, practical resources containing key messages for staff and volunteers who have any contact with older residents, their friends or families

Resources are also being distributed directly to older residents through printed copies to avoid digital exclusion.

In addition, to support the promotion and dissemination of this information, a communications toolkit has also been designed for partners and includes:

• Leadership messages
• Briefings and networks/forums
• Internal and external electronic/printed newsletters
• Websites and social media accounts

The tips in these resources may be adapted to apply throughout the year and with other vulnerable people.

Research suggests that the effectiveness of the COVID-19 vaccine will be heavily affected public attitudes about vaccination. For a highly infectious disease, even a vaccine with adequate efficacy, pace, and coverage may be insufficient to tackle population dynamics (e.g. age and population size) that produce high disease prevalence. Consider public messaging to:

• Foster widespread public understanding and enthusiasm for vaccination, while addressing sources of hesitancy for vaccines (generally and for COVID-19)
• Promote vaccine acceptance through culturally-sensitive, evidence-based and local communication
• Promote the continued need for other prevention practices even after a vaccine becomes available as reducing transmission requires a sustained commitment to public health practices
• Ensure that vaccines are understood by all communities, particularly underserved groups for which longstanding disparities in vaccination coverage have been evident

In Palestine, officials invited young people to share ideas that they felt could help address the impacts of COVID-19. This has been supported by successful initiatives such as the establishment of a Youth Committee on the Palestinian Water Authority as a means of helping to develop the sector. Members of the Youth Committee were also involved in the 2020 Palestinian National Development Agenda. The Palestinian government and Youth Committee have built on their learning and expertise in these sectors to provide innovative ways of addressing COVID-19. Consider:

• Placing Youth Committees at the heart of public awareness campaigns about areas they have been involved in e.g. in Palestine, water consumption and management during COVID-19
• Utilise young people in the creation of innovative smart apps, and online information e.g. in Palestine, the "PalWater App", which provides a platform for customers and service providers to communicate. The application also acted as an alarm reporting system where young people could upload live images and their locations to help citizens notify local authorities of real-time issues
• How involving young people in COVID-19 recovery and resilience can help to build integrated and sustainable long-term solutions e.g. in Palestine, the water sector initiative is being replicated with the Palestinian Ministry of Social Development to establish more youth committees at the local level

We describe the background, perspective, research design and approach, our work and deliverables and our team. To read this briefing in full, follow the source link below to TMB Issue 27 (p.2-5).

Interface management considers how to streamline communication, monitor progress and mitigate risks when working with multiple contractors, subcontractors, and clients. This is particularly important during COVID-19 where the government may set out its requirements in contracts, but the actual delivery of a service is done through third parties. One example where effective interface management failed was in the outsourcing of a security firm to supervise quarantined travellers in a hotel in Victoria, Australia. The firm were asked to undertake their 'normal' tasks monitoring movement, alongside biohazard containment which required extensive specialised training they did not have - ultimately leading to widespread transmission of COVID-19. Given the number of outsourced services (e.g. in transportation, security, and health), consideration should be given to the new ways in which service delivery and health merge:

• Evaluate what can reasonably be expected from a contractor given their expertise and resources and provide additional training or resources to ensure COVID-safe services are delivered
• Ensure agreements, resources and expectations for COVID-safe provision are discussed and understood by all parties involved in delivering a service e.g. from government to outsourced supply chains
• Evaluate the impacts of performance-based metrics for services against short and long-term risks to delivery and to health
• Consider who is responsible for 'regular risks' (e.g. costs, lateness and cancellations of services etc.) during COVID-19 and who should manage the public health risks -ensure regular updates are communicated amongst all parties to provide an informed approach of regular and COVID risk and where they converge

Time is a main barrier to learning lessons and implementing actions from those lessons. However, learning lessons while an event is still unfolding provides contemporaneous thinking to help guide actions. Organisations or all sorts can identify and learn their own lessons, feeding into industry/association calls for learning. Consider:

• Appointing someone to identify lessons during events
• Maintaining an up-to-date log of lessons to capture learning and support institutional memory
• Using the log of lessons dynamically and reflectively to asses performance and guide debriefs
• Coordinating the lessons learned across an area or industry to pool learning for greater effect, to bring the system together to share context specific learning through:
  • Holding workshops and industry seminars
  • Liaising with academic institutions, networks/associations, and business centres
  • Promoting information widely through various medias e.g. online and in print
• Guidance on collating lessons to assess performance and processes for debriefing can be found in TMBs 18 and 22

Building on TMB 24 (People) and 25 (Place), this briefing focuses on Renewal through Processes, concerning changes to ways of working, rules, procedures and access to services. To explore this we discuss some of the overarching conditions that influence why renewal through Process may be needed, we consider how Reshaping and Reorganising can assist in assessing performance of Processes for renewal and we present our thinking on a structure way to operationalise Reshaping and Reorganising Processes in the context of COVID-19.

Follow the source link below to read this briefing in full (p.2-5).

Social distancing and restricted movements are important measures to control transmission of COVID-19. But the efficacy of this may be improved by increased focus on targeted information that focuses on behavioral change. Persistent spikes in COVID-19 cases has promoted debate about the effectiveness of restricted movement as a preventative measure in and of itself. Lessons from Malaysia suggest that increased attention should be paid to communication strategies that focus on:

• Instilling new norms into people's daily lives through consistent and clear messaging from health officials
• Specific risk behaviours, preventive behaviours, illness behaviours, and compliant behaviours associated with cultural values, perceptions, belief, and attitudes
• Feedback from the public to improve and refine the communication process
• Reinforcing desired behavioural changes through continued behavioural change interventions, namely, capacity building, policy implementation and enforcement, resource mobilization and participation of various players including government, nongovernmental organizations, civil society groups and the target population
• Enhanced localized community messaging that is place specific
• Provision of regular, transparent data to the public in easy to understand formats. Do not decrease the level of open, detailed government information
• Targeted communications for specific hotspots such as some places of work (e.g. construction sites in Malaysia where infection spread quickly because of working conditions), and through providing guidance to associations, clubs and schools
• WHO 'Guidelines for Developing Behavioural Change Interventions in the Context of Avian Influenza' has some useful information on developing Behavioural Change Interventions here.

In October 2020, we were awarded funding from UK Research and Innovation (UKRI) to continue our work on The Manchester Briefing through a new project titled “Recovery, Renewal, Resilience: Informing, supporting and developing guidance for local resilience”. The project starts on 1st January 2021 so we will only briefly introduce it here – and the next issue of TMB (on 8th January 2021) will describe the project in more detail.

Research Objective: This project works closely with resilience partners to develop a generalizable, theoretically underpinned framework for how short-term recovery and long-term renewal to COVID-19 can enhance resilience. The framework will:

• Take a whole system approach to recovery and renewal (from community to national)
• Explore how to manage the changes in people, places and processes that is needed
• Address short-term, transactional recovery as well as longer-term, transformational renewal
• Complement existing guidance and resilience standards and lead to an international standard on recovery and renewal

Approach: The framework will be informed by (and inform) the committees that coordinate recovery in a local area by working closely with the resilience partners and engaging with local and national organisations on how they plan recovery and renewal on a system-wide basis. Our local government partners have different structures and geographies so we can create a framework that is widely applicable to local variations. At present we are pleased to have the collaboration with four local resilience partnerships and intend complementing this by partnering with three overseas cities.

Activities

• Collect and analyse national/international lessons on recovery and renewal
• Interview experts across the world on emergency planning, risk, and resilience
• Contribute to three local committees that coordinate their city’s recovery and renewal projects
• Facilitate webinars and training on recovery and renewal for resilience
• Develop and test a framework for recovery and renewal, refine it in different contexts (national and international), learn about its application, and use feedback to improve it
• Develop and test a methodology to assess the impact of the framework

Main deliverables

• Expert briefings on how to implement recovery and renewal for local resilience
• A searchable database of lessons for recovery and renewal for local resilience
• A theoretically underpinned, practice-tested framework to support thinking about recovery and renewal for local resilience
• A self-evaluation methodology to reflect on recovery practices
• The Manchester Briefing, case studies, and training products
• International and national standards having a global impact

We know that, across the world, organisations are at different stages of thinking about recovery so we aim to provide results that are helpful to those that may not yet have formally begun (nor have the structures to begin) their recovery process, as well as involve those that are more advanced in their thinking and activity.

We are grateful to the following organisations for their interest in the project: Essex LRF, Thames Valley LRF, Merseyside FRS, Global Resilient Cities Network, Civil Contingencies Secretariat (Recovery and Human Aspects Team), Emergency Planning Society, Local Government Association, SOLACE, International Standards Organization, British Standards Institute.

The project is co-funded by Economic and Social Research Council (under grant reference number: ES/V015346/1), and The University of Manchester, UK.

The novelty of the COVID-19 pandemic has meant that information about the disease has continually been changing. During the pandemic explicit or implied certainty has led to inaccurate predictions e.g. in death and infection rates. While so little is known about COVID-19 (meaning uncertainty is unavoidable), communicating preliminary or emergent data as certain facts had impacts on behaviours and lives. Consider how acknowledging uncertainty about COVID-19 may:

• Improve the atmosphere around scientific debate and build public trust through conveying that evidence and practice could/should change with more information and research
• Improve people's trust in government authority as the information they provide is transparent, and in respecting uncertainty are able to acknowledge credible yet conflicting evidence

Increase regular evaluation of pandemic management plans - emergency planner's understanding of influenza viruses has increased dramatically in recent decades, yet, there is very little certainty about the determinants of, and possibilities for, pandemic emergence ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862331/). This is illustrated by contradiction that: COVID-19 was largely unexpected, but that there are a large number of influenza pandemic management plans in circulation.

COVID-19 has fundamentally changed the way organisations operate, and has COVID-19 has become more integrated into organisations, new forms of 'business as usual' have emerged:

1. Business as usual pre-COVID-19: processes in place before the pandemic that were considered the usual way of operating during minor disturbances e.g. annual infrastructure maintenance
2. Business as usual during response to COVID-19: processes that had to adapt swiftly under extreme uncertainty and completely changed normal pre-COVID operations e.g. building of additional hospitals to increase health service's capacity
3. Business as usual during recovery from COVID-19: processes that have ramped down but consider COVID-19 requirements e.g. standing down of Strategic Co-ordination Groups, and a return to organisations relying more on internal capacity/information, rather than multi-organisational approaches

An organisation's approach to 'business as usual' can impact response and recovery. Interconnectivity and connected governance is required to ensure that people's health and wellbeing are considered; that organisations have capacity; and that response and recovery are integrated. Consider:

• Pre-COVID operations (such as maintenance) may need to continue, but should not be undertaken without consultation with other partners who may be affected by such actions e.g. building/service closures due to maintenance. Undertaking pre-COVID operation's should therefore consider knock-on effects on the functionality of operations/organisations
• Risk assessing actions and disseminating this information to relevant stakeholders
• Key partners and related sectors should be included in decisions about 'business as usual' operations, to ensure they are appropriate, scalable and maintain interconnectivity

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

Renewal through Place requires consideration of transformation of where we live, available infrastructure, health and care systems, businesses, and neighbourhoods. We bring together some of the core issues related to Renewal through Place, concerning Relocation and Regeneration and the relationships this has with navigating, experiencing and utilising Place post COVID-19.

Follow the source link below to read this case study in full (p.18-20).

TMB 24 outlined our thinking on what the renewal of People might entail and this briefing argues that Places play an integral role in Renewal. Renewal may focus on healthier communities and equitable access to critical goods, services and amenities. This requires place-based economic planning to revitalise commercial development and employment opportunities.

Read this briefing in full by following the source link below to TMB 25 (p.2-8).

COVID-19 has shed new light on the way in which countries respond to, and recover from emergencies. This includes COVID-19 specific advice and broader lessons about emergency preparedness and management. For example, previous guidance on volunteer management has traditionally assumed a point of convergence at a disaster site, while this still holds true for many emergencies e.g. floods, lessons from COVID-19 demonstrate that volunteer management may also be dispersed, large-scale and without face-to-face contact. Consider how lessons from COVID-19 may help to revise emergency plans:

• Conduct a 'stock take' of current emergency guidance, and consider what may be missing or no longer fit for purpose
• Implement debriefs, peer reviews and impact assessments, drawing on expertise from local government and emergency practitioners, to evaluate how well current guidance worked and where it needs revising
• Consider that emergency planning must remain relevant to specific types of emergencies, but that broader lessons from COVID-19 can help strengthen guidance e.g. issues of inclusion such as gender, ethnicity, sexuality; health and socio-economic disparities and vulnerabilities; volunteering capacity; supply chain stability; green agenda; and partnerships arrangements
• Draw on resources beyond government guidance from global networks e.g. Resilient Cities Network's revised toolkit which builds recovery from COVID-19 into a wider resilience agenda for a safe and equitable world, and resources from International Organization for Standardization (ISO) which is developing new recovery standards in light of COVID-19 lessons (ISO 22393)

We bring together some of the core issues for the renewal of people, topics which can be considered in terms of Reconciliation, Reparation and/or Repair depending on the degree of harm caused.

Follow the source link below to TMB Issue 24 to read this case study in full (p.23-25).

We argue that Reparation is only one step in the process of helping people recover and move forward from COVID-19. An approach which considers Reparation and Reconciliation is required to build trust, and encourage healing in, and between individuals, communities, organisations and levels of government.

Follow the source link below to TMB Issue 24 to read this briefing in full (p.2-12).

The scale of COVID-19 requires information to the shared across countries and regions effectively. Consider how your organization can contribute to open data sets such as The Living Repository and the 'OECD - GOVLAB- Call for Evidence: Use of Open Government Data in COVID-19 Outbreak'. Consider contributing or using open data to identify:

• COVID-19 cases, individuals at risk, and forecasting future scenarios, including disease spread/contraction, and possible treatments for those infected
• Availability and demand for supplies, locating and connecting actors with medical supplies
• Whether communities adhere to guidelines and recommendations outlined by health authorities
• Public perceptions and how restrictions are affecting well-being, including crime e.g. the rise in domestic violence and child abuse
• Whether efforts are efficient, transparent, meet needs, and do not violate democracy, privacy, ethics or fundamental human rights
• Misinformation including accuracy, speed and scale of fact-checking
• How, where, and when lockdowns are lifted
• How the pandemic affects those who live and travel outside their country of national origin
• The most effective forms of aid to those most vulnerable to the pandemic's economic shocks
• The risks and challenges workers face to their health and safety and the protections available
• The impact on the ability of students and workers to meet learning and training outcomes
• Institutions most likely to close as a result of the pandemic and providing support
• The pandemic's effect on climate-related activities, global emissions, energy usage, and wildlife
• Disruptions caused by confinement measures on the economy e.g. analysing data on supply chains, trade, impacts on inclusive growth

Vulnerable people and people with disabilities are most at risk during disasters. The impacts of COVID-19 have exacerbated the risk to vulnerable people and people with disabilities, and has exacerbated the risks for marginalised groups of people. Consider assessing:

• How well evacuation plans incorporate vulnerable people and people with disabilities. This should include consideration of compounding impacts on at risk groups from COVID-19, and new vulnerable groups such as those with new underlying health conditions from contracting the virus
• The inclusiveness of disaster preparedness activities e.g. the accessibility of hygiene facilities, and accessibility of early warning messaging for those with disabilities, in poverty or with limited access to information
• The availability of alternative evacuation accommodation (rather than mass shelters) for particularly vulnerable people, where specialised care can be provided

While humour is not readily identifiable with disaster risk management, it has been shown as a useful tool to:

• Engage the audience, breaking through boredom
• Enable new ideas to emerge
• Invite people to change their frames of reference
• Creates a safe space to be candid and innovative
• Envision how things can go wrong/could change

One means of sensitively using humour is through cartoons. From week 13 of the speaker series, "Cities on the Frontline", the World Bank and the Global Resilient Cities Network commissioned cartoonists to create cartoons that represented the weekly theme to create cartoons that engage webinar participants differently. Consider how to sensitively use humour through outputs like cartoons to:

• Augment frank discussions about risk, meaningful engagement, and provide a safe space for respectful disagreement
• Explain information to individuals who may not have the technical experience in disasters e.g. there is often an expectation that communities who at risk are making decisions the same way that technical specialists do, yet, most individuals who are at risk in a floodplain, for instance, derive some benefit from living there. Thus, there are different decision-making factors to consider. Cartoons can help change the frame of reference for both risk specialists and communities
• Highlight potential problems. Cartoons can serve as metaphors, helping participants to see their role or project in a new light
• Provide non aggressive commentary on particular situations, especially those which are sensitive
• Encourage participatory discussions by depicting ideas at their extreme logical conclusions, or challenging positions or proposals to inspire dialogue about risk

The COVID-19 pandemic has produced a huge amount of information from a variety of sources, not least on the rules for local lockdown. In the UK, COVID-19 rules vary depending on whether you live in England, Wales, Scotland or Northern Ireland. In addition, millions of people are also affected by local restrictions. In Greater Manchester, for example, these restrictions have differed between metropolitan boroughs. The BBC have created a webpage 'Local lockdown rules: Check Covid restrictions in your area' that provides an example of how to support the public in finding information about COVID-19 restrictions in their areas, or areas of interest, through postcode searches. This helps to provide information about restrictions in individuals' locations and that of their friends, family or workplaces.

Compound disaster pose a serious risk during the pandemic, which requires a dual focus on the constant threat of COVID-19 to people’s health and to economies, and on natural disasters. The compound nature of natural disasters and COVID-19 intensifies the scale and broadens the scope of human, social, economic and environmental impacts[1]. Disasters have continued to rise year on year. In 2019, EM-DAT recorded 396 natural disasters globally, that led to 11,755 deaths, affected 95 million people, and resulted in 103 billion US$ in economic losses across the world. Floods were the deadliest type of disaster accounting for 43.5% of deaths, followed by extreme temperatures at 25% (mainly due to heat waves in Europe) and storms at 21.5%. Storms affected the highest number of people, accounting for 35% of the total people affected[2].

This trend has continued, 2020 is on course to be the hottest year on record[3] - impacts of this have been witnessed in parts of Africa and the Middle East where crops have been devastated by locust swarms that begun breeding several months earlier than normal due to weather conditions[4]. Of the 132 unique extreme weather events that have occurred in 2020 (as of late September), 92 have overlapped with the COVID-19 pandemic[5].

Learning from two cases: Vanuatu and Bangladesh

A recent example of a large scale disaster during COVID-19 is the category 5 Tropical Cyclone (TC) Harold that struck Vanuatu on 5 April 2020, affecting over 130,000 people (approx. 43% of the population) and resulting in three deaths. TC Harold caused significant damage to schools, medical facilities, homes, agricultural crops, telecommunications and the local boat fleet[6]. More vulnerable groups such as women were reportedly dealing with multiple concurrent crises, namely drought, scarcity of portable water, volcanic ash, acid rain and sulphur gas as there are also several active volcanoes[7].

While Australia did provide humanitarian aid, strict protocols were implemented when delivering supplies to minimise any chance of transmission to Vanuatu[8], and to date there are no, nor have been any cases of COVID-19 in Vanuatu[9]. However, much of the humanitarian support was offered remotely which demonstrates a shift in how aid is provides e.g. aerial surveillance to assess the scale of impact, logistics support to release relief items that were locally pre-positioned.

The cyclone that hit Bangladesh in May 2020 presents the opposite scenario. The impacts of cyclone Amphan were lessened by decades of disaster risk reduction strategies and a weakening of the storm as it made landfall, which meant the death toll was in the dozens rather than thousands[10]. However, the large number of COVID-19 cases in Bangladesh had serious ramifications for ‘normal’ disaster response. Coastal communities in the path of the cyclone had to make choices between braving the cyclone’s impacts as it hit land, and risking COVID-19 infection as 2.2 million people in Bangladesh were evacuated to shelters[11].

The combination of these cases – heavy impact on people and resources from a natural disaster, combined with high COVID-19 infection rates – demonstrate the worst case for which emergency planners and the humanitarian community need to plan. Going forward, disaster affected countries will be impacted by limitations faced globally, as countries contend with COVID-19 and the impacts this has on their own health systems and economies, and the impacts of this on offers of humanitarian aid. Additionally, logistical support, made more complex by travel restrictions and pressures on global supply chains for resources also needs to be considered, for example:[12]

• Impacts of restricting travel on providing and receiving support, including legislation to override COVID-19 restrictions for assistance
• Implications for efficient response if 14 day isolation periods are required e.g. if dispatching urgent search and rescue teams; how do you choose between saving people from a collapsed building or (re)infecting a community with COVID-19?
• Availability of reliable partnerships for international support including financing, mutual aid and personnel when many countries’ own health systems and economies are under huge strain
• Availability of appropriate protective equipment for all personnel deployed to support a humanitarian effort, including those working in-country
• Pressures on internal mobilization of resources, including the health system which is required for first response to both COVID and disasters
• Risk of infection during evacuations while travelling to and from evacuation centres and residing there

Despite these challenges there are measures which can help countries better prepare for compound COVID-19 disasters. Consider how to:

• Reconceptualise all disaster response as simultaneous COVID-19 response and mitigation of virus transmission
• Develop strategies that incorporate both climate change adaptation and reducing global health threats, by building COVID-19 into disaster risk reduction strategies. Use pre-existing resources such as the Disaster Resilience Scorecard for Cities, and it’s related Public Health Addendum[13], or the UN’s Build Back Better approach[14]
• Partner with disaster risk reduction and emergency planning organisations to integrate health management and disaster management
• Integrate data on COVID-19 and disasters to inform early warning systems, and invest resources into upgrading and expanding systems to manage complex situations
• Deliver preparedness messaging about disasters and other diseases, alongside COVID-19 advice, to keep issues at the forefront of people’s minds and to ensure communities have up-to-date information about mitigating risks posed to them, and the support services available[15]
• Build an understanding based on expertise and skills guided by science, while also building capacity in communities to better understand the hazards of a double disaster and plan collective action[16]
• Keep messaging simple. COVID-19 messaging is already fraught with confusion and misinformation, detailing the risks from other hazards may doubly confuse people if not done in a simple way

The influences of climate change has resulted in disasters which have become seasonal, reoccurring and protracted. This, combined with COVID-19 results in compound disasters that are continually unravelling, which blurs the lines between response, recovery, preparedness, and prevention[17]. It is therefore important to consider humanitarian assistance for a world that is facing two chronic challenges; COVID-19 and climate change.

References:

[1] https://www.sheltercluster.org/sites/default/files/docs/tc_harold_and_covid-19_vanuatu_recovery_strategy_v3_130820.pdf

[2] https://www.cred.be/publications

[3] https://www.theguardian.com/environment/2020/apr/27/meteorologists-say-2020-on-course-to-be-hottest-year-since-records-began

[4] http://www.fao.org/ag/locusts/en/info/info/index.html

[5] https://media.ifrc.org/ifrc/press-release/least-51-6-million-people-doubly-hit-climate-related-disasters-covid-19-new-analysis-ifrc-reveals/

[6] https://www.dfat.gov.au/geo/vanuatu/development-assistance/Pages/supporting-cyclone-recovery-reconstruction-vanuatu

[7] https://actionaid.org.au/wp-content/uploads/2018/08/STPC-AdvocacyReport2020-FINAL-pages.pdf

[8] https://www.dfat.gov.au/crisis-hub/Pages/tropical-cyclone-harold

[9] https://covid19.gov.vu/

[10] https://www.wri.org/blog/2020/05/south-asia-confronts-double-disaster-cyclone-and-covid-19?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+WRI_News_and_Views+%28WRI+Insights+Blog%2C+News%2C+and+Publications+%7C+World+Resources+Institute%29

[11] https://www.wri.org/blog/2020/05/south-asia-confronts-double-disaster-cyclone-and-covid-19?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+WRI_News_and_Views+%28WRI+Insights+Blog%2C+News%2C+and+Publications+%7C+World+Resources+Institute%29

[12] http://nautil.us/blog/a-warning-from-history-about-simultaneous-disasters

[13]https://www.unisdr.org/campaign/resilientcities/assets/toolkit/documents/Disaster%20Resilience%20Scorecard_Public%20Health%20Addendum%20Ver1%20Final_July%202018.pdf

[14] https://www.unisdr.org/files/53213_bbb.pdf

[15] https://www.bnhcrc.com.au/hazardnotes/79

[16] https://www.wri.org/blog/2020/05/south-asia-confronts-double-disaster-cyclone-and-covid-19?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+WRI_News_and_Views+%28WRI+Insights+Blog%2C+News%2C+and+Publications+%7C+World+Resources+Institute%29

[17]https://www.sheltercluster.org/sites/default/files/docs/tc_harold_and_covid19_vanuatu_recovery_strategy_v3_130820.pdf

Guest briefing by Dr. Su Anson and Dr. Katrina Petersen, Trilateral Research and Inspector Sue Swift, Lancashire Constabulary, prompts thinking on risk communication approaches in the context of COVID-19 and how the public can be active agents in their own response. The authors focus on: Identifying goals and outcomes; developing the message; channels for two-way engagement; and evaluating communications effectiveness.

Follow the source link below to TMB Issue 22 to read this briefing in full (p.2-7)

Research by University College London (UCL) suggests that confidence in understanding coronavirus lockdown restrictions varies greatly across the UK and has dropped significantly since early national measures were put in place in March. As part of their ongoing research UCL determine that people generally consider themselves compliant with restrictions, but UCL caution that this should be interpreted in light of previous reports that show understanding of guidelines are low; therefore possibly reflecting belief in compliance opposed to actual compliance levels. Consider how to ensure residents in lock areas understand the rules that apply to them:

• Make direct contact with resident via social or traditional media, messaging apps, or leafleting through doors to ensure people understand their local restrictions. This may be especially important in combined authority areas as restrictions differ across metropolitan boroughs, the boundaries of which may not be clear to residents
• Encourage the display of digital tools showing local information about which restrictions apply in certain areas. This may be a simple video, or an interactive tool which people could access through localised digital marketing on their smartphones
• Consider where local, clear information could be publicly displayed e.g. digital advertising boards at local bus stops, or localised social media and television adverts
• Consider the demographics, resources and capacities of each community to establish the most appropriate methods of dissemination and key actors who could support this. In Mexico, this included: Video and audio messages shared via WhatsApp; audio messages transmitted via loudspeakers; and banners in strategic locations

COVID-19 has created a set of scenarios for which no organisation was fully prepared. Learning lessons from the ways in which people and organisations responded to this crisis is vital for improving future responses and for gathering detailed and timely information to inform recovery and renewal activities. Gathering such information can be achieved through conducting activities to learn lessons.

Approaches to learning lessons

Taking a systems approach to learning lessons can ensure all parts of an organisation, operation, or even individual can be considered. One method particularly relevant to crisis management (and previously applied to this context by government) is the Viable Systems Model (VSM)[1]. To learn lessons across the whole system, VSM advises that 5 systems should be considered:

1. Delivery of operations
2. Coordination and communication of operations
3. Management of processes, systems and planning, including audit
4. Intelligence
5. Strategy, vision and leadership

These 5 systems are: broad-based; interconnected; provide a balanced framework of strategic, tactical and operational matters; aim for balance across these systems; and ensure nothing is missed or unduly prioritised at the expense of others[2]. As a result, the systems can support the process of learning lessons by structuring the questions to ask. The questions may go beyond the approach of “what went well/not well, and what do differently next time” and, instead, focus on the capabilities of the system.

Drawing on VSM’s 5 systems, we suggest a single question for ‘improvement’ which can be applied to each system to explore the experience and performance of the response, recovery or renewal[3]:

1. How could we improve our ‘delivery of operations’?
2. How could we improve our ‘coordination and communication of operations’?
3. How could we improve our ‘management of processes, systems and planning, including audit’?
4. How could we improve our provision and use of ‘intelligence’?
5. How could we improve our ‘strategy, vision and leadership’?

Learning lessons can gather information that can be applied while the event is still unfolding[4]. There are number of reasons why gathering lessons need to be done as soon as possible, even as an organisation continues to adapt to COVID-19 conditions. For learning lessons on response to COVID-19 consider[5]:

• The pandemic is still ongoing and waiting until it is over may result in lost institutional memory and learning. While there may be logs of actions and outcomes, the context of these become less meaningful as time goes on and people return to their non-COVI roles
• COVID-19 impacts were swift so there was limited time for organisations to make decisions. Evaluating the actions taken in response will help prepare the next phases and reduce uncertainty whether this is recovery, or a return to a response mode during any second wave
• Understanding how prepared your organisation was for the pandemic is critical, including preparations made once the virus was declared. This will help with future response for health crises and can provide insights into the preparedness and flexibility of the organisation for other types of emergencies

Common issues to be aware of when learning lessons include[6]:

• Scattered or incomplete documentation and contemporaneous evidence. This may have been compiled during the crisis, but not centrally managed meaning it is scattered throughout the organization
• Failure to include external stakeholders in post-event analysis e.g. beneficiaries, partners, customers, investors
• Failure to delegate follow-up actions, including timescales to specific teams or departments with clear deliverables and accountability for actions

Gathering lessons

Lessons can be gathered and learnt in a number of ways, for example, internally within organisations, with external support from other organisations, and from international contexts:

Learning lessons internally

Mechanisms to assess performance and understand lessons learnt internally include impact assessments and debriefs.

• Impact assessments to learn about the strategic effects of COVID-19 but also learn about specific or emerging system-wide needs, inequalities, and opportunities to improve. This is particularly useful in reflectively considering the outcomes of specific actions and how negative consequences can be prevented or minimised. Guidance on conducting impact assessments can be found in The Manchester Briefing on COVID-19 (B15)[7] which relates to UK National Recovery Guidance[8] that describes the process of conducting an Impact Assessment.
• Debriefing to learn lessons is the process by which a project or mission is reported on in a reflective way, typically, after an event. It is a structured process that reviews the actions taken, and lessons learnt from implementing a project, and its subsequent outcomes. However, instead of only being a post-event activity, learning lessons is important for all stages of managing COVID-19 including preparing, responding and recovering. This will track reflections and learning to ensure information and lessons are not lost and to effectively act on this information to improve future activities.

Learning lessons with external support

Mechanisms to learn lessons from external sources can include:

• Peer reviews which may be most useful to provide an opportunity for a host country, region, city or community to engage in a constructive process to reflect on their activities with a team of independent, expert professionals. Peer reviews can encourage conversation, promote the exchange of best practice, and examine the performance of the entity being reviewed to enhance mutual learning. A peer review can be a catalyst for change and provide benefits for both the host and the reviewers by discussing the current situation, generating ideas, and exploring new opportunities to further strengthen activities in their own context. Guidance on conducting peer reviews is available from the International Organization for Standardization (ISO): ISO 22392: Guidelines for conducting peer reviews[9].
• Learning international lessons is also possible from other analogous contexts. The Manchester Briefing collects such lessons and reviewing what other organisations and countries are doing can help to share insights on practices that are worthy of consideration.

Lessons from internal and external sources can help to reflect on practice and continually improve. But identifying lessons bring a responsibility to prepare to do something better next time using those lessons. This is a particular challenge during intense periods when finding the time to stand back to think about learning is just as pressurised as finding the time to plan to do things differently.

References:

[1] Applying systems thinking at times of crisis https://systemsthinking.blog.gov.uk/author/dr-gary-preece/

[2] The Manchester Briefing on COVID-19 (B16): Week beginning 20th July 2020

[3] The Manchester Briefing on COVID-19 (B17): Week beginning 27th July 2020

[4] https://www.willistowerswatson.com/en-US/Insights/2020/05/a-debrief-for-business-continuity-debriefing

[5] https://www.b-c-training.com/bulletin/covid-19-why-you-should-be-conducting-a-debrief-now

[6] https://www.willistowerswatson.com/en-US/Insights/2020/05/a-debrief-for-business-continuity-debriefing

[7]The Manchester Briefing on COVID-19 (B15) www.ambs.ac.uk/covidrecovery

[8] https://www.gov.uk/guidance/national-recovery-guidance

[9] https://www.iso.org/standard/50289.html

During COVID-19 decision makers have grappled with containing outbreaks and how to reopen or reclose business and services based on infection numbers and other measures. Research in Canada has shown that accounting for geography, epidemiology, and travel patterns, localized county approaches to lockdown result in fewer days of service and business closure, and impacts fewer people compared to entire province closures. The research suggests, when implementing a local lockdown, to consider:

• The trigger conditions that require a local lockdown to be enforced and ensure they are agreed with central government but can be enacted upon by local government
• Coordinating with neighbouring counties or metropolitan areas, including the criteria for when and how local lockdowns should be implemented and when a neighbouring region should also lockdown
• Gathering local lockdown lessons that can provide useful insights into compliance of measures, and implementing learning to help avoid ineffective strategies
• Decentralizing control over when a local lockdown should be enforced to ensure local decision makers can enact closures promptly

The compound impacts of COVID-19 and climate change are important examples of disruptive risks that require the renewal of existing risk-management systems and practices. Disruptive risks are defined as unexpected, widespread, protracted, transboundary and novel. To address these requires 'disruptive resilience' whereby the status quo in risk management is disrupted to encourage new and innovative way to enable towns and cities to respond and recover effectively from these risks. Consider how to use new kinds of data, modes of collaboration, financial mechanisms, innovation models and decision-making approaches meet challenges of 'disruptive resilience'. Consider:

• The development community should promote the notion of 'disruptive resilience' to respond to the rise in outlier and extreme events; the shift in established hazard patterns; the increase in multiple, simultaneous crises within single
• Policymakers and authorities need to revise urban risk-management practices, and embrace new kinds of data, collaboration, finance, innovation models and decision making
• Researchers must explore the financial, political, social and behavioural factors that inhibit or enhance disruptive resilience

In the UK, first-person accounts of living through the 2020 COVID-19 pandemic have been collected to better understand how people respond to pandemics and how to help people cope better in the future. This is particularly important if viral epidemics become more common. This type of research can form an important digital archive for future researchers. Consider working with local and academic organisations to develop an online survey to collate people's experiences on:

• How COVID-19 and the measures to control it are affecting and shaping interactions between individuals in society
• The effect of the pandemic on community wellbeing, quality of life and resilience
• The impact of digital technology on community responses to the spread of coronavirus
• The impact of the pandemic on how and where support can be accessed

How people with physical and mental health problems, and disability, and those who are facing inequality or discrimination have been impacted