Recovery, Renewal, Resilience

One of the key learning points emerging from the pandemic concerns how it has forced a reappraisal of what recovery encompasses, who it is for, and how it can be effectively planned for and implemented. For example, considering recovery and business continuity planning it was clear from many of the early interviews with recovery experts that however well-prepared organizations felt they were, the scale, scope, uneven impacts, and prolonged duration of COVID-19 were not adequately anticipated. Enhancing preparedness and wider societal resiliency for the complex and "unruly" challenges ahead requires improved capabilities to assess the landscape of systemic risks, develop foresight, and scenario planning with communities.

Our work has further emphasized the multi-dimensional and long-term nature of recovery. Specifically, we recognize the importance of recovery frameworks and how they are the foundation for the kind of local inclusive development and transformative renewal initiatives that the pandemic has underlined the imperative for. Such frameworks act to inform impact assessments, prioritize actions, and guide the monitoring and evaluation of recovery activities. However, the past two years has shown the inadequate focus in the past on incorporating public health concerns, and more especially pandemics, within recovery thinking. For example, the social determinants of health - e.g., where people are live, learn, work etc. - have been so central to COVID-19 risk factors and health outcomes that tackling these inequities through renewal initiatives are critical to enhancing community wellbeing and reducing vulnerabilities to future disasters.

This lesson is part of a collection of team reflections from the Recovery, Renewal, Resilience team, shared in the final Manchester Briefing under their ESRC-funded project. The collection of 10 reflections can be found in Issue 51 of The Manchester Briefing, accessible via the link below:

For two-years we have been examining the way that Recovery and Renewal was managed by the resilience community – through a combination of experiences, including: participating and contributing strategic advice in local government recovery coordination groups (RCG); researching global lessons on COVID-19 which we shared through 51 issues of TMB; interviewing global resilience and risk professionals to uncover their changing impression of Recovery and Renewal (summer 2020, spring 2021, winter 2021; gaining feedback from >80 workshops and presentations we delivered on Recovery, Renewal, Resilience). Unique insights are currently being collected from interviews with RCG Chairs – the strategic leads who chaired RCGs and were typically local government Chief Executives.

These RCG chair interviews are providing rich insight which, when combined with our participant observations over the two years of RCGs, has taught us a great deal, including:

• challenges of coordinating Recovery and Renewal at the national, sub-national and local levels – such as different impacts, prioritisations, and potential solutions
• the local ambitions for recovery, including the transactional activities that were implemented to address the impacts and disruptions of COVID-19
• the local appetite for renewal, including the transformational initiatives to exploit the enthusiasm for changing societies in the aftermath of COVID-19
• learning about the politics of COVID-19 (e.g. governance, scrutiny, accountability), the maturity of resilience arrangements and partnership working at all levels, the value of analysing the impacts of the pandemic

We have learned of the impact of specific constraints from the prolonged crisis, including;

• the challenges of repetitive waves of infections, reintroduction of control measures, parallel response coordination, information and data supply, emerging and acute impacts and needs, work/crisis/empathy fatigue
• preparedness of resilience arrangements (e.g. guidance, knowledge, reality checks) to deal with pandemics beyond the initial responses
• the limitations of current partnerships for integrated emergency management, such as what is the role of local resilience partnerships in a health-led crisis
• what the R in LRF actually means – questioning whether it reflects ‘Resilience’ as a strategic priority in its widest sense, or better characterises ‘Response’ to an event
• the need for new forms of active learning, support and research – including the role of government, centres of excellence and academics in supporting resilience partnerships

This lesson is part of a collection of team reflections from the Recovery, Renewal, Resilience team, shared in the final Manchester Briefing under their ESRC-funded project. The collection of 10 reflections can be found in Issue 51 of The Manchester Briefing, accessible via the link below:

This case study, written by Eduardo Robles Chavez and the Manchester Briefing team, presents examples of effective vulnerability mapping during COVID-19 in New Zealand and Wales, contrasting these with Mexico and Chile where mapping focused only on infection rates. Read this case study by following the source link below (p.13-16)

COVID-19 differs from previous crises in terms of its scale, its complex and prolonged nature, and the fragilities that it has exposed. Yet, the disruptions and losses experienced are broadly similar to those brought about by other recent major emergencies. Consider the lessons learned from previous disaster recovery efforts that aim to “promote longer-term, integrated thinking and planning, to create pathways out of the pandemic that more effectively support recovery” and renewal:

• Analyse how the crisis has changed vulnerability (prolonged crises in particular). Use this knowledge to inform recovery strategies and renewal initiatives (e.g. Ecuador)
• Recognise the long-term needs of recovery and renewal. Acknowledge that the impacts of pandemic are not static and will not end on a particular date (e.g. India). A flexible and adaptable approach will support longer-term activities that can change where and when required
• Plan recovery and resilience programmes that integrate actions to deal with the risk of other hazards that can interact and exacerbate the impacts of the current crisis (e.g. Ethiopia & Mozambique)
• Implement an approach that targets the most vulnerable and marginalised sectors of the population, given the uneven impacts of the pandemic and response strategies (e.g. Montserrat)
• Depoliticise, as far as possible, the recovery agenda by establishing the needs of those more vulnerable above political interests (e.g. Chennai)
• Understand recovery and renewal as a holistic process that focuses on the impacts of COVID-19 on the economic, social, and mental wellbeing of communities (e.g. Dominica)
• Support community-building activities and engage the community in recovery and mitigation activities (e.g. Colombia)

A current research project, by the Overseas Development Institute, is examining social protection (SP) measures employed during the pandemic in LMICs. The project is producing a series of working papers. One paper examines the inclusion of refugees in government-led SP and the “alignment and integration of cash assistance to refugees and government social protection”. The paper evaluates the effectiveness of social protection responses across four countries in terms of: “Timeliness; coverage adequacy; and level adequacy (value of benefit)”. It also offers the emerging lessons from the study and initial policy recommendations. Consider:

Lessons on the drivers of effective government social protection response

• The maturity of SP systems and pre-existing local and state capacities directly impacted how effectively SP programmes met the needs of refugees during COVID
• Targeting criteria that evaluates eligibility based on risk of vulnerability could be more effective, timely and suitable during a crisis rather than traditional criteria such as length of residency or status
• Benefit levels of government systems are unlikely to be sufficient for refugees’ needs, as these are typically higher than those of nationals and require very careful consideration. The main challenge identified when setting benefit levels which include refugees during the pandemic is that governments are “faced with two competing objectives: (1) preventing social tension and unfairness between population groups” (by varying benefit levels between refugees and nationals); and (2) “ensuring that everyone can meet their basic needs”

Policy recommendations for protecting refugees during a crisis

• Conduct a national socio-economic survey, to include data on refugees’ needs, to develop an overview of the needs of the population across the country. This can enable more effective social protection programme design that effectively meets the needs of everyone
• A review of registration processes can highlight barriers to access for refugees (e.g. in terms of the documents required to register for programmes). Where this is not possible, governments can “draw on international/national/local humanitarian actors’ databases of refugee populations” to swiftly target them with support during crisis
• Hosting governments could consider “integrating refugees into social insurance” (e.g. those with work permits) which may reduce political or public opposition as those receiving benefits will be contributing to national insurance
• Careful consideration of benefit levels and trade-offs between “politically greater acceptability but possibly lower effectiveness” in terms of meeting refugees needs is essential

Low- and middle-income countries (LMICs)

This case study extracts some key points from the UK's National Audit Office report 'Initial learning from the government's response to the COVID-19 pandemic'. Read this case study in full (p.13-14) in TMB Issue 38 by following the source link below.

The Independent Panel for Pandemic Preparedness and Response recently issued a report calling on the international community to employ a package of reforms to transform the global pandemic preparedness and response system to prevent a future pandemic. The report finds that the current system is unfit to prevent another novel and highly infectious disease from developing into a pandemic. The report recommends a transformational reform of the existing pandemic prevention, preparedness and response system, including:

• Form a “Global Health Threats Council” to ensure political commitment to pandemic preparedness, prevention and response. In the Council:
  • Assign responsibility to key actors through “peer recognition and scrutiny”
  • Establish a ‘Pandemic Framework Convention’ in all countries within the next six months
• Introduce an international surveillance system to:
  • Enable the WHO to share information about outbreaks of concern, and
  • Rapidly deploy experts to investigate such outbreaks
• Immediate investment in national preparedness by:
  • Reviewing current preparedness plans
  • Allocating the required financing and resources to ensure readiness for another health event
• Make The Access to COVID-19 Tools Accelerator (ACT-A) a global platform to transform the current market model to one targeted at delivering global public goods (vaccines, diagnostics, supplies)
• Establish a funding model for the WHO to increase its agency and financing
• Develop an “International Pandemic Financing Facility” to:
  • Fund ongoing preparedness
  • Enable immediate finance support for response if a pandemic is declared
• Adopt a political declaration which commits to transformative reform of global pandemic preparedness and response

Involving citizens in the recovery planning and development process can lead to more effective policy outcomes and build trust and a two way dialogue between citizens and government. COVID-19 has had diverse impacts on the lives of individuals and communities, and their involvement in deciding the routes to long-term recovery following the pandemic is crucial. Consider the good practice principles for deliberative processes offered by the OECD, which will support the achievement of "high-quality processes that result in useful recommendations and meaningful opportunities for citizens to shape public decisions":

• Clearly define the issue as a question that is aligned with the concerns and challenges faced by different communities
• Invite people to make recommendations for addressing the issues that affect them, respond to recommendations in a timely manner, and monitor and feedback regularly to people on the progress of their implementation (e.g. Scotland's Citizens' Assembly)
• Ensure the process is inclusive and representative of all people in the community, e.g. stratified random sampling to select a participant group which fully represents a community's demographic profile
• Make information easily accessible through public communications. Include the purpose, design, methodology, recruitment details, experts, recommendations, the response, and implementation follow-up
• Establish a mechanism through which people can request additional information, ask questions and keep up to date on progress of activities
• Appoint a liaison person who can feed information in from and out to the community
• Take time to reflect on and evaluate deliberative processes, to ensure learning, help improve future practice and understand impact

Last month, Japan’s Nuclear Energy Agency (NEA) marked ten years since the Great East Japan Earthquake (GEJE), and the subsequent tsunami that devastated the region and caused a nuclear accident at the Fukushima Daiichi Nuclear Power Plant[1]. Post-accident analysis verified that radiation from the accident at the power plant has not had any direct impacts on human health. However, the evacuation of hundreds of thousands of people living in surrounding areas resulted in premature deaths, due to issues such as lack of access to healthcare or medicines, and stress-related problems[2]. COVID-19 is like Fukushima, in that it presents both policy makers and the general public with a range of multi-dimensional challenges that need to be addressed through recovery and renewal processes. We explore three lessons from Fukushima recovery that can support and prompt thinking for recovery from COVID-19:

Preparedness and disaster management plans

Like COVID-19, the GEJE exposed fragilities in the planning for complex and extraordinary disasters, which were addressed by reformulating disaster management plans at national and local levels in Japan. Consider the following lessons and activities to recover and renew disaster management planning in the light of COVID-19:

• Review and revise disaster management plans at both national and local level to ensure plans are kept up to date:
  • Integrate lessons learned during the pandemic to inform new disaster management planning, legislation and policies - add a new section to disaster management plans that covers the management of pandemics
  • Focus on the following issues: coordination of administrative and operational functionalities; preventative measures, such as education, safety drills, and issuing and transmitting of information and warnings; evacuation and rescue activities, and primary goods supply and distribution in emergency situations; and overall coordination of reconstruction and restoring livelihoods during the recovery phase[3]

Engaging local stakeholders

‘Resilience is strengthened when it is shared’[4]. Establishing strong communication and collaboration - between communities and local medical staff, between central government and municipalities, and with experts - was found to build awareness amongst local residents about exposure risks to radiation, and how to reduce those risks in the future[5]. Stakeholder engagement is critical in the management of future outbreaks, recovery of preparedness for future crises, and recovery from the impacts of COVID-19. Consider:

• Authentic stakeholder engagement means meaningful, creative and impactful interactions with people and communities, and the co-production of recovery and renewal strategies[6]:
  • Recognise community voice, influence, and measurable local impact as part of recovery activities
  • Actively involve community members in recovery conversations and meetings, to bring together a range of knowledge, skills, abilities and perspectives
  • Build on collaborative relationships and integration initiatives that have been developed through the pandemic in local areas. Conduct a review to identify areas where these established relationships and initiatives offer opportunity for creative and impactful engagement in recovery[7]
• Effective participation requires leaders to utilise a range of models of engagement that[8]:
  • Encourage community participation (e.g. joint planning groups)
  • Develop interactive and partnership working, by providing the community with access to expertise, advice and training (e.g. disaster risk planning)
  • Facilitate community mobilisation and empowerment, by establishing partnerships with voluntary organisations and community groups, and initiating community development programmes[9]

Recognising the impacts on mental health

Fear of exposure to radiation, plus the evacuation itself, created significant psychological distress for those who experienced the events of Fukushima. These have some similarities to the psychological effects of COVID-19: risk to health due to exposure to the virus, isolation from family, friends and critical social support networks, and the uncertain economic conditions caused by the pandemic[10]. COVID-19 has shown how significantly social and economic determinants influence mental health. Our mental health is heavily reliant on a variety of factors such as the quality of our relationships, employment, education, and access to food, income and housing[11]. COVID-19 presents key challenges, but also an opportunity to rethink our approach to mental health and implement structural changes in mental health support so as to address the aftermath. Multifaceted-support and societal recovery progress has been found to help address the impacts of the Fukushima disaster on people’s mental health[12]. Mental Health Europe offer guidance to recovery and renewal of mental health support[13]:

• Establish comprehensive long-term strategies that aim to mitigate the consequences of the crisis, co-producing these strategies with service users and the organisations that represent them
• The promotion of ‘basic social rights’, together with targeted investment in economic protection, such as ‘universal basic income, income protection schemes, loan guarantees, rent protection’ and booster packages (e.g. recovery/renewal loans, business support and advice, targeted employment programmes)
• Invest in mental health literacy about the social determinants of mental health, and how ‘experiencing distress is a normal reaction’ in the exceptional circumstances of the pandemic. This will help tackle stigma and discrimination, and further strengthen the ‘sense of community and solidarity’ that has emerged throughout the pandemic
• ‘Promote cross-sectoral collaboration and more integrated social and health care, including investments in peer support’
• Facilitate and support community-based services that ‘respect the will and preferences of users, in line with the UN Convention on the Rights of Persons with Disabilities. Involve people with lived experience in the design, implementation and monitoring of these services’

References:

[1] https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03109-1

[2] https://www.mhe-sme.org/position-paper-mental-health-in-the-aftermath-of-covid-19/

[3] file:///C:/Users/r66633rj/Downloads/ijerph-15-02381.pdf

[4] https://www.mhe-sme.org/position-paper-mental-health-in-the-aftermath-of-covid-19/

[5] https://www.worldbank.org/en/news/feature/2021/03/11/learning-from-megadisasters-a-decade-of-lessons-from-the-great-east-japan-earthquake-drmhubtokyo

[6] Hayano, R. S. (2015) ‘Engaging with local stakeholders: some lessons from Fukushima for recovery’, Annals of the ICRP, 44(1_suppl), pp. 144–152. doi: 10.1177/0146645315572291.

[7] Boyle, D and Harris, M. (2009). The Challenge of Co-Production: How equal partnerships between professionals and the public are crucial to improving public services. https://neweconomics.org/uploads/files/312ac8ce93a00d5973_3im6i6t0e.pdf

[8] http://www.scdn.scot/wp-content/uploads/2016/10/Models-of-Community-Engagement.pdf

[9] https://www.good-governance.org.uk/wp-content/uploads/2020/04/COVID-19-blog-07-04-20.pdf

[10] file:///C:/Users/r66633rj/Downloads/Empowerment-in-action-case-studies-of-local-authority-community-development.pdf

[11] https://openknowledge.worldbank.org/handle/10986/18864

[12] https://www.preventionweb.net/news/view/76401

[13] NEA, OECD (2021) Fukushima Daiichi nuclear power plant accident, ten years on. https://www.preventionweb.net/publications/view/76402?&a=email&utm_source=pw_email

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 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

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

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

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 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).

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).

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).

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).

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

Mongolia's government took early, decisive preventative measures to fight COVID-19. Reports suggest that its 3.2m population have contained the virus to (at the time of writing) 287 confirmed cases and 0 deaths. Mongolia's weak health system and links to epicentres of COVID-19 (China with which it shares a land border, and South Korea with a large population of Mongolian migrant workers), suggests it could be hard-hit by COVID-19. Following WHO's advice on 22nd January 2020, containment action included:

• Immediate activation of the State Emergency Commission to support the Ministry of Health
• On 25th January, closed all schools and kindergartens, transferring classes to TV and internet-based lessons
• In mid-February, implemented preventative measures e.g. cancelled a national holiday, stopped travel between the capital (Ulaanbaatar) and provinces
• Closed borders with China and Russia to all land and air travel
• 21-day quarantine and testing for citizens who returned from overseas
• Enforced wearing of masks with additional handwashing and sanitisation

These actions also helped reduce flu infections and gastro-intestinal infections.

Government organisations in India have been directing substantial effort to tackling the crisis. Part of this effort has involved producing a series of case study articles on how cities have tackled COVID-19. The actions those cities have implemented contain lessons which are transferable on: managing the spread of the virus, the use of technology, communication approaches, approaches to governance, and the participation of the community. Sharing case studies is a great contribution to the local, national and international effort to tackle the virus. Consider preparing case studies similar to:

• In Pune, how it took a people-based approach to responding to hotspot areas: https://www.cdri.world/casestudy/response_to_covid19_by_pune.pdf
• In Karnataka, how it worked with the IT sector to develop its technological approach to responding to the effects of COVID-19: http://cdri.world/casestudy/response-to-covid19-by-Karnataka.pdf
• In Goa, how it repurposed manufacturing capacity to produce hand sanitizer, and recovering production capacity of its pharmaceutical industry: http://cdri.world/casestudy/response_to_covid19_by_goa.pdf
• In Odisha, how women lead the fight against COVID-19 and child-focused interventions: http://cdri.world/casestudy/response-to-covid19-by-odisha.pdf

In all, there are eight case studies on the site, all detailing different approaches to responding to COVID-19.

Other case studies to consider:

Lahaul and Spiti:

http://cdri.world/casestudy/response_to_covid19_by_lahaul-and-spiti.pdf

Jharkhand:

http://cdri.world/casestudy/response_to_covid19_by_Jharkhand.pdf

Madhya Prades:

http://cdri.world/casestudy/response_to_covid19_by_madhya_pradesh.pdf

This includes integrating qualitative and holistic decision-making strategies and techniques. Key areas to consider:

• Be vision-oriented. Construct an agreed picture of the new system after recovery and align response and recovery decisions to achieve this vision. Consider the consequences of short-term decisions on achieving the vision
• Identify the theme/criteria that can help to achieve the vision and create manageable work packages and sub-packages
• Engage communities in the decision-making process. Utilise communities are sources of information and knowledge
• Consider intuition as a source of information and innovation. Harness expert and local knowledge to generate diverse action scenarios
• Agree on relevant ethical values. Identify and include the ethical values in the decision evaluation process to ensure coherence and feasibility
• Mitigate bias. Engage a wide range of stakeholders in the decision-making process and encourage in-depth discussion

TMB Issue 10 brings together the reflections of our learning from the first 10 weeks of gathering lessons on recovery and renewal from COVID-19. Follow the source link below to read all of the reflections from our team (p.9-15).