DISASTER-CONSTRUCTION-AND-RECONSTRUCTION-el.v
ResearchGate has not been able to resolve any citations for this publication.
A live, virtual conference, “Driving Responsible Conduct of Research during a Pandemic,” was held in April 2021, 13 months after the COVID-19 pandemic fundamentally altered the conduct of clinical research across the USA. New York was an early epicenter of the US pandemic, highlighting preexisting problems in clinical research and allowing us to assess lessons learned and to identify best practices for the future. Risks and opportunities were categorized broadly into three areas, protecting the welfare and safety of human subjects, ensuring trust in science and medicine, and implementing efficient, ethical, and compliant clinical research. Analysis of conference proceedings, and recent publications, shows a need for preparedness that is more effective, robust partnerships, and organizational systems and standards to strengthen the ethical and responsible conduct of research.
Sažetak Analiza obavezujuće vakcinacije protiv COVID-19 iz ugla ljudskih prava pokazuje da takva praksa ugrožava realizaciju niza fundamentalnih prava, uključujući pravo na život, fizički integritet, bezbednost i zdravlje. Osnovna pretpostavka za sprovođenje imu-nizacije protiv bilo koje zarazne bolesti, pa tako i protiv COVID-19, jeste da je vakcina koja se primenjuje ispitana, efikasna i bezbedna. Vakcine protiv ove zarazne bolesti ne samo da nisu dovoljno ispitane, već su se u upotrebi našle i one koje se zasnivaju na genet-skom materijalu i koje nikada do sada nisu bile korišćene u svrhu imunizacije od bolesti. Prethodni informisani dobrovoljni pristanak lica je conditio sine qua non. Niko ne može biti izložen političkom, društvenom ili bilo kakvom drugom pritisku da se vakciniše uko-liko to sam ne želi da uradi, a pravo na delotvorni pravni lek i obeštećenje mora biti obez-beđeno svima. Proizvođači vakcina se ne mogu osloboditi od odgovornosti za potencijalne štetne posledice. U interesu je javnog zdravlja da države preduzmu mere radi zaštite od neprikladnog uticaja farmaceutske industrije. Cilj rada je da doprinese naučnoj raspravi u ovoj oblasti. Ključne reči: vakcine protiv COVID-19, pravo na slobodan pristanak, pravo na zdravlje, pravno na informisanost, Svetska zdravstvena organizacija, mRNA vakcina.
The COVID-19 infection fatality rate for children under the age of 17 is less than 0,003%. Children are at extremely low risk of severe illness from COVID-19, and children do not spread the illness in any significant way. Once a vaccine becomes widely available for schoolchildren, will lawmakers leave it up to parents and guardians to choose whether to vaccinate their children or will they mandate schoolchildren to get a COVID-19 vaccine to attend school? This article assesses both arguments for and against mandatory COVID-19 vaccination for school children. The article further analyzes applicable international bioethical and human rights norms and standards with regard to informed consent as contained in the various international treaties to hold states legally accountable for their actions under international law. To determine whether states may impose vaccine mandates for school children in terms of international human rights law, a proportionality test is applied. The critical focus of this article is explicating the rudiments of the bioethical and human rights standards relating to the mandatory COVID-19 vaccination of schoolchildren that must be confronted to ensure that children, that is, humanity's most valuable asset for the future, are afforded their fundamental human rights. Ultimately, it highlights the importance that these international bioethical norms are built into decision-making by public authorities when measures to prevent the spread of infectious disease with a case fatality rate of less than 0,003% in children are instituted.
U ovom radu analiziraju se karakteristike i funkcionisanje polupredsedničkog sistema u Republici Srbiji. Predmet analize rada predstavljaju različiti faktori koji presudno opredeljuju političku praksu unutar poluprezidencijalizma - konstitucionalna struktura, ustavna ovlašćenja izvršne vlasti, izborni sistem, partijski sistem, odnos između predsednika i parlamentarne većine. U radu se objašnjava razvoj samog koncepta i ključnih odlika polupredsedničkih sistema od početka njegovog proučavanja do savremenih definisanja ovog pojma od strane komparativista. Opšta saznanja o polupredsedničkim sistemima analizirana su na primeru Srbije. Poluprezidencijalizam u Republici Srbiji karakteriše oscilovanje između dve faze - predsedničke i parlamentarne. Kao presudni razlozi ovog fenomena ističu se partijski sistem i odnos između predsednika i parlamentarne većine. Mogućnost istovremenog obavljanja državne i stranačke funkcije jača faktičku moć ličnosti koja se na njima nalazi, što rezultira u čestoj homogenizaciji bicefalne izvršne vlasti.
Tekst se bavi tekućom reformom međunarodnog zdravstvenog režima, koja je planirana da se okonča 2024. godine usvajanjem novog ugovora o pandemiji ili revizijom postojećih međunarodnih zdravstvenih propisa. Taj proces u ovoj fazi razvoja nije daleko odmakao, ali svakako postoje planovi da se centralizuje globalna zdravstvena uprava u koju su uključeni razni javno-pravni interesi i akteri. Strukturalno-institucionalnim pristupom autorka procenjuje stepen razvoja transnacionalne centralizacije međunarodnog zdravstvenog režima, fokusira pažnju na njene bitne činioce, aktere i interese i ukazuje na propuste u pogledu odgovornosti i ljudskih prava ispoljene u ovom procesu.
Ključne reči: međunarodno zdravstveni režim, globalna uprava, Svetska zdravstvena organizacija, EU, SAD, pandemija, odgovornost.
In response to the ongoing discussion about creating a new pandemic treaty, we first identify that the security discourse has dominated global health governance. Yet, we argue that the solidarity discourse is necessary for promoting global health and compliance with relevant legal instruments in the post-COVID era. At the critical moment where transformation of the global pandemic response regime is about to happen, we consider that the sense of feeling prepared prior to a disease outbreak and the sense of urgency when it happens require an ethical reason – that is, global solidarity. Without it, the institutional redesign might not work. The belief in and realisation of global solidarity, shared between global citizens and the nation-states they constituted domestically, include both dimensions of self-interest and global public good. The former comes from the expectation for the boomerang effect of sharing, and the latter accumulates all the primary and side benefits from the process of sharing burden and effort. Thus, the discourse of global solidarity is not only ethically necessary, in order to ensure commitment to carry costs to assist others of equal membership, but also practically necessary, in order to promote the incentives of seeking international support and cooperation.
Polarization is increasing worldwide. When broken down by region, V-Dem data suggest
that every region except Oceania has seen polarization levels rise since 2005. Africa has had the smallest increase during this period, although it has long had high levels of polarization. Rising polarization in Europe is being driven by deepening political divisions in Eastern and Central Europe, Southern Europe, and the Balkans. In the Western Hemisphere, the largest democracies—Brazil, Mexico, and the United States—are all experiencing extreme levels of polarization. East Asia’s polarization levels have traditionally been low, though increasing political tensions in places like South Korea and Taiwan are driving up the region’s score. And in South Asia, India’s polarization has skyrocketed since 2014.
To better understand the various paths by which polarized societies might overcome or
reduce their political divisions, this working paper examines perniciously polarized countries that have successfully depolarized, at least for a time. Through a quantitative analysis of the V-Dem data set, this study identifies 105 episodes from 1900 to 2020 where countries were able to reduce polarization from pernicious levels for at least five years. These 105 episodes represent roughly half of the total episodes of pernicious polarization during the time period, thus indicating a fairly robust capacity of countries to depolarize. If considered in terms of country experiences rather than episodes (because many countries have experienced multiple episodes in a cycle of polarization and depolarization), then the data indicate that two-thirds of the 178 countries for which V-Dem provides polarization data have experienced one or more episodes of pernicious polarization, but only thirty-five countries (20 percent) have failed to experience any depolarization to below-pernicious levels.
Adults aged 65 and over are disproportionately impacted by the coronavirus disease 2019 (COVID‐19) pandemic and represent by far the largest share of severe disease and death. This paper critically examines ethical arguments for using implicit and explicit age criteria as a standard for allocating scarce lifesaving resources during the pandemic. Section 1 introduces the topic. Section 2 distinguishes standard from pandemic triage. Section 3 assesses ethical arguments for criteria that are implicitly age‐based, including quality‐adjusted life years, disability adjusted‐life years, and total number of future life years. Section 4 examines ethical arguments for criteria that are more directly age‐based, including fair innings, equality between old and young, and priority to the worse off. The paper concludes that neither implicit nor explicit age‐based allocation withstands careful scrutiny.
In November 2021, the World Health Assembly (WHA) is hosting a special session to discuss the proposed plans for a pandemic treaty. Despite the fact that there are scant details concerning the treaty, the proposal has gained considerable support in both the academic community, and at the international level. While we agree that in the wake of the numerous governance failures during COVID-19, we need to develop appropriate global solutions to be able to prevent, detect, respond to, and recover from future global health crises—and that such mechanisms should be rooted in global equity—we disagree, however, that this pandemic treaty, currently, is the most appropriate way in which to achieve this. Indeed, notions of global community, solidarity, fairness are far removed from the reality that we have seen unfolding in the actions of states responding to the pandemic. This is the crux of the tension with the proposed treaty: the balance between the ideal cosmopolitan worldview held by those in power in global health, and the practice of national security decision-making witnessed in the last 18 months. Indeed, we do not believe that a pandemic treaty will deliver what is being extolled by its proponents, and it will not solve the multiple problems of global cooperation in global health that supporters believe it will.
Background
In the pandemic time, many low- and middle-income countries are experiencing restricted access to COVID-19 vaccines. Access to imported vaccines or ways to produce them locally became the principal source of hope for these countries. But developing a strategy for success in obtaining and allocating vaccines was not easy task. The governments in those countries have faced the difficult decision whether to accept or reject offers of vaccine diplomacy, weighing the price and availability of COVID-19 vaccines against the concerns over their efficacy and safety. We aimed to analyze public opinion regarding the governmental strategies to obtain COVID-19 vaccines in three Central Asian countries, focusing particularly on possible ethical issues.
Methods
We searched for opinions expressed either in Russian or in the respective national languages. We provided data on the debate within three countries, drawn from social media postings and other sources. The opinion data was not restricted by source and time. This allowed collecting a wide range of possible opinions that could be expressed regarding COVID-19 vaccine supply and human participation in the vaccine trial. We recognized ethical issues and possible questions concerning different ethical frameworks. We also considered scientific data and other information, in the process of reasoning.
Results
As a result, public views on their respective government policies on COVID-19 vaccine supply ranged from strongly negative to slightly positive. We extracted the most important issues from public debates, for our analysis. The first issue involved trade-offs between quantity, speed, price, freedom, efficacy, and safety in the vaccines. The second set of issues arose in connection with the request to site a randomized trial in one of the countries (Uzbekistan). After considering additional evidence, we weighed individual and public risks against the benefits to make specific judgements concerning every issue.
Conclusions
We believe that our analysis would be a helpful example of solving ethical issues that can arise concerning COVID-19 vaccine supply around the world. The public view can be highly critical, helping to spot such issues. An ignoring this view can lead to major problems, which in turn, can become a serious obstacle for the vaccine coverage and epidemics’ control in the countries and regions.
Water withdrawal for public/private suppliers and public services (defined as public water use) and for irrigation (defined as irrigation water use) are essential components of agricultural water management as well as of the planning and management of domestic, commercial, and municipal water supplies. A significant fraction of the public and irrigation water use is consumptive (defined as the part of water withdrawn that is consumed) in nature, and it is primarily freshwater. Global climate change and variability have substantially impacted the large-scale drivers of freshwater resources across the globe, which include, for example, precipitation, temperature, evapotranspiration, soil moisture, and hydrologic extremes. Global environmental change has also influenced several local-scale freshwater availability drivers, such as water quality, municipal policies, and water taxation. Overall, the changes in freshwater resources have potentially stressed irrigation and public water use. Population growth has altered the supply–demand fronts of water balance, resulting in increased water supply stresses. Researchers have considered several soft- and hard-path solutions to augment the deficit in the supply–demand fronts; however, each solution has its own pros and cons. The ongoing COVID-19 pandemic has exacerbated the already existing critical issues related to sustainable future water use. New challenges have emerged, requiring both short- and long-term solutions. Hence, it is essential to understand the current public and irrigation water use changes resulting from the pandemic. An appropriate estimate of the future changes in water use would help develop/upgrade new/current water resource systems that can mitigate risks and show increased resiliency against global climate and environmental changes and unprecedented events like the COVID-19 pandemic. In this opinion chapter, we discuss some examples of the regional/local changes in water use during the ongoing pandemic and our increased preparedness or the lack of it. Additionally, the chapter focuses on the future risks and resilience of water resource systems to meet the future demands of water use as well as to face unprecedented events such as the COVID-19 pandemic.KeywordsWater useCOVID-19Climate changeResiliencyFreshwater
From a human security perspective, the concept and practices of security should be oriented around the everyday needs of individuals and communities, whatever the source or nature of threat they may face. Human security has lost some momentum as an intellectual project as a result of its imprecise definition and scope. In addition, in policy terms, human security has been eclipsed by a resurgence of geopolitical visions of security, reinforced by a rise in nationalism and great power rivalry. Yet Covid-19 demonstrates how human security brings added value as an analytical and normative framework. The pandemic exposed the limitations of the traditional security paradigm and it demonstrated that traditional measures of national security are no assurance of societal resilience or individual protection. Moreover, from a human security perspective, Covid-19 exposes the structural inequalities and contradictions which underpin norms of security in many societies, given that experiences of security and insecurity are shaped by gender, socio-economic inequalities, and ethnicity.
After almost two years of battling an unprecedented health emergency, the world continues to be confronted with new waves of the COVID-19 pandemic and the global South finds itself in the grip of a new form of systemic inequality enshrined in the patently flawed vaccine distribution strategy. At an upcoming Special Session of the World Health Assembly, the World Health Organization and its member states are undertaking an effort to agree on negotiating a new international legal instrument for pandemic preparedness and response.
But does the world need a new “pandemic treaty”? Is it the right thing, at the right time? The Geneva Global Health Hub (G2H2) has unpacked these pertinent questions through research undertaken involving a broad range of experts including those who have concretely tackled the COVID-19 response in their countries. G2H2 has mapped the complexity of this treaty proposal and its potential implications for the future scenario of global health governance.
The resulting report launched by G2H2 on 24 November addresses the need for new approaches to the challenge of a pandemic future. In the wake of the harsh but real lessons that COVID-19 continues to administer, it focuses on some of the pathogenetic political and economic structures that must be recognized if the international community is serious about restoring democratic multilateralism and giving the world and the people a proper chance to better deal with future health emergencies and crises.
Background
A special session of the World Health Assembly (WHA) will be convened in late 2021 to consider developing a WHO convention, agreement or other international instrument on pandemic preparedness and response – a so-called ‘Pandemic Treaty’. Consideration is given to this treaty as well as to reform of the International Health Regulations (IHR) as our principal governing instrument to prevent and mitigate future pandemics.
Main body
Reasons exist to continue to work with the IHR as our principal governing instrument to prevent and mitigate future pandemics. All WHO member states are party to it. It gives the WHO the authority to oversee the collection of surveillance data and to issue recommendations on trade and travel advisories to control the spread of infectious diseases, among other things. However, the limitations of the IHR in addressing the deep prevention of future pandemics also must be recognized. These include a lack of a regulatory framework to prevent zoonotic spillovers. More advanced multi-sectoral measures are also needed. At the same time, a pandemic treaty would have potential benefits and drawbacks as well. It would be a means of addressing the gross inequity in global vaccine distribution and other gaps in the IHR, but it would also need more involvement at the negotiation table of countries in the Global South, significant funding, and likely many years to adopt.
Conclusions
Reform of the IHR should be undertaken while engaging with WHO member states (and notably those from the Global South) in discussions on the possible benefits, drawbacks and scope of a new pandemic treaty. Both options are not mutually exclusive.
Vaccines are so far proven to be safe, although related adverse events cannot be excluded. The urgency for COVID-19 vaccines determined a dilution of the general expectations of safety and efficacy of vaccination (from safe and effective to safe and effective enough). In many countries, a no-fault program was established to compensate individuals who experienced serious vaccine-related injuries. The impressive number of administrations worldwide and the legal indemnity afforded to manufacturers of approved vaccines that cannot be pursued for compensation fed the debate about the availability of a compensation model for COVID-19 vaccine-related injuries. Several European countries have long introduced a system, Vaccine Injury Compensation Programs, to compensate people who suffer physical harm because of vaccination. In Europe, COVID-19 vaccination is strongly recommended for the general population and in many states is declared mandatory for healthcare workers. In 1992, Italy edited Law no. 210 providing legal protection for individuals who reported injuries after mandatory and recommended vaccinations as a no-fault alternative to the traditional tort system. Despite its recommended nature, COVID-19 vaccination is excluded from the no-fault model in several European states, and the Italian government is called to provide clear and firm instructions for the management of the many requests for compensation. The authors provide an overview of the existing compensation models in Europe and analyse available legislative proposals.
Since the onset of the SARS-CoV-2 pandemic, an array of off-label interventions has been used to treat patients, either provided as compassionate care or tested in clinical trials. There is a challenge in determining the justification for conducting randomised controlled trials over providing compassionate use in an emergency setting. A rapid and more accurate evaluation tool is needed to assess the effect of these treatments. Given the similarity to the Ebola Virus Disease (EVD) pandemic in Africa in 2014, we suggest using a tool designed by the WHO committee in the aftermath of the EVD pandemic: Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI). Considering the uncertainty around SARS-CoV-2, we propose using an improved MEURI including the Plan–Do–Study–Act tool. This combined tool may facilitate dynamic monitoring, analysing, re-evaluating and re-authorising emergency use of unproven treatments and repeat it in cycles. It will enable adjustment and application of outcomes to clinical practice according to changing circumstances and increase the production of valuable data to promote the best standard of care and high-quality research—even during a pandemic.
This paper frames the approach to determining policies in response to the COVID-19 pandemic, which either prioritise human health security protection or economic vulnerability. In this paper, the human security concept will be used to explain COVID-19 as a health security problem due to the existence of an existential threat. However, the same approach is not applicable in looking at COVID-19 as an economic security problem. Because the existential threat is less visible in human economic security aspects, it tends to be more appropriate to look at COVID-19 as the stressor that strengthens human vulnerabilities. This paper uses a qualitative descriptive approach by using the conceptual framework to analyse news, reports, books, and academic journals as the sources of data. The writers analyse and group the data by types of security, as well as based upon the root causes that contribute to human vulnerability, then compare both sectors. This paper argues that in the pandemic situation, human health is threatened, whereas the economy is at a vulnerable position due to COVID-19. This paper also argues that COVID-19 has not yet threatened human economic security in the early stage, but soon, it will. As a result, stakeholders need to prioritise policies based on the human health security approach.
Recognizing marked limitations of global health law in the COVID-19 pandemic, a rising
number of states in the World Health Assembly have proposed the development of a new pandemic treaty. This prospective treaty has the potential to clarify state obligations for pandemic preparedness and response and strengthen World Health Organization authorities to promote global health security. Examining the essential scope and content
of a pandemic treaty, this column analyzes the policymaking processes and substantive
authorities necessary to meet this historic moment.
The European Convention on Human Rights (ECHR) judgement no. 116(2021) of 8 April 2021 establishes the principle of mandatory vaccination, indicating the criteria that national legislation must comply with, following the principle of non-interference in the private life of the individual. Vaccination for the prevention of SARS-CoV-2 infection appears to be an essential requirement for providing healthcare assistance. The European experience with compulsory vaccinations, offers a composite panorama, as the strategy of some European countries is to make vaccinations compulsory, including financial penalties for non-compliance. As in other countries, there is a clear need for Italy to impose compulsory vaccination for healthcare workers, in response to a pressing social need to protect individual and public health, and above all as a defense for vulnerable subjects or patients, for whom health workers have a specific position of guarantee and trust. The Italian Republic provided for mandatory vaccinations for health professionals by Decree-Law of 1 April 2021 no. 44, to guarantee public health and adequate safety conditions. As stated by ECHR, the Italian State, despite having initially opted for recommendation as regards to SARS-CoV-2 vaccination, had to adopt the mandatory system to achieve the highest possible degree of vaccination coverage among health professionals to guarantee the safety of treatments and protection of patients’ health. We present the Italian situation on vaccine hesitation in healthcare workers, with updated epidemiological data as well as the doctrinaire, social, and political debate that is raging in Italy and Europe.
COVID-19 vaccine acceptance exists on a continuum from a minority who strongly oppose vaccination, to the “moveable middle” heterogeneous group with varying uncertainty levels about acceptance or hesitancy, to the majority who state willingness to be vaccinated. Intention for vaccine acceptance varies over time. COVID-19 vaccination decisions are influenced by many factors including knowledge, attitudes, and beliefs; social networks; communication environment; COVID-19 community rate; cultural and religious influences; ease of access; and the organization of health and community services and policies.
Reflecting vaccine acceptance complexity, the Royal Society of Canada Working Group on COVID-19 Vaccine Acceptance developed a framework with four major factor domains that influence vaccine acceptance (people, communities, health care workers; immunization knowledge; health care and public health systems including federal/provincial/territorial/indigenous factors)—each influencing the others and all influenced by education, infection control, extent of collaborations, and communications about COVID-19 immunization. The Working Group then developed 37 interrelated recommendations to support COVID vaccine acceptance nested under four categories of responsibility: 1. People and Communities, 2. Health Care Workers, 3. Health Care System and Local Public Health Units, and 4. Federal/Provincial/Territorial/Indigenous. To optimize outcomes, all must be engaged to ensure co-development and broad ownership.
The current paper focuses on the circumstances that have led to the high COVID-19 infection rates amongst the ultra-Orthodox population in Israel. The current study utilizes a qualitative design and is based on in-depth interviews, email correspondence and online records of 25 ultra-Orthodox individuals who either tested positive for COVID-19 or had contact with a verified COVID-19 patient. The data were analyzed through identification of main themes and an interpretation of their meanings. The findings showed that a wide range of causes led to the high infection rate, including aspects that derive from a structural element, a religious element and a social-ideological element—all of which are directly or indirectly connected to religion. These findings demonstrate the central role of religion in health outcomes among the ultra-Orthodox community in general and during pandemics in particular, and they shed light on the central role of religion in health outcomes among closed-religious communities. The findings further reveal the importance of cooperation between the state authorities and the religious ones, and of providing culturally adapted health service solutions in the fight against COVID-19 and promoting health more generally. Study limitations are discussed and recommendations for future research are provided.
While drawing upon the existing literature and policy documents on health security and its practice at the national and global levels, this article shows that the idea of health security has mostly remained rhetoric or at the most conceptualised and operationalised within the narrow Westphalian tradition of protecting nation states from external threats. By undertaking a critical examination of the national security strategies of some powerful G-20 countries, we show that non-traditional threats such as infectious diseases and pandemics are either absent from the list of potential threats or are accorded a weak priority and addressed within the state and military-centric notion of security. This approach has shortcomings that are laid bare by the ongoing pandemic. In this article, we show how national and global health security agendas can be advanced much more productively by mobilising a wider securitisation discourse that is driven by the human security paradigm as advanced by the United Nations in 1994, that considers people rather than states as the primary referent of security and that emphasises collective action rather than competition to address the transnational nature of security threats. We discuss the relevance of this paradigm in broadening the concept of health security in view of the contemporary and future threats to public health.
Vaccine hesitancy (delay in obtaining a vaccine, despite availability) represents a significant hurdle to managing the COVID-19 pandemic. Vaccine hesitancy is in part related to the prevalence of anti-vaccine misinformation and disinformation, which are spread through social media and user-generated content platforms. This study uses qualitative coding methodology to identify salient narratives and rhetorical styles common to anti-vaccine and COVID-denialist media. It organizes these narratives and rhetorics according to theme, imagined antagonist, and frequency. Most frequent were narratives centered on “corrupt elites” and rhetorics appealing to the vulnerability of children. The identification of these narratives and rhetorics may assist in developing effective public health messaging campaigns, since narrative and emotion have demonstrated persuasive effectiveness in other public health communication settings.
The COVID-19 vaccination is effective and safe with the currently available vaccines. There are benefits and reservations of undertaking COVID-19 vaccination. A lot of doubt still exists about their routine use across the population. Hence, although we believe that it could be offered and made universally available to confer better immunity against COVID-19, we also agree it should be a shared decision-making process. Public education and developing trust in vaccination may be a preferred choice at the current time.
Background: Vaccination is considered to be a key public health intervention to end the COVID-19 pandemic. Yet, the success of the intervention is contingent on attitudes toward vaccination and the design of vaccination policies.
Methods: We conduct cross-sectional analyses of policy-relevant attitudes toward COVID-19 vaccination using survey data of a representative sample of Austrian residents collected by the Austrian Corona Panel Project (ACPP). As outcomes, we examine the individual readiness to get vaccinated, the support for compulsory vaccinations, and the preference for making the vaccine available free of charge. The independent variables include demographics, objective and perceived health risks, and social and political factors.
Results: Although there is broad public support for making the vaccine available free of charge, vaccine hesitancy and the opposition to a vaccine mandate are widespread. The protective function of the vaccine for the individual only motivates limited support for vaccinations. Opposition to COVID-19 vaccination also stems from a lack of sense of community and an ongoing politicization of the issue through conspiracy theories and party politics.
Conclusion: We propose that overcoming the inherent free-rider problem of achieving sufficiently high vaccination rates poses a potential dilemma for policymakers: Given the politicized nature of the issue, they may find themselves having to choose between making vaccinations compulsory at political costs and a lingering pandemic at high costs for public health and the economy. We propose that promoting a sense of community and addressing potential practical constraints will be key in designing an effective COVID-19 vaccination policy.
Since the end of the Cold War, the UN’s collective security model has been questioned as to whether it has been well equipped to respond to the changing landscape of global security. By using the UN Security Council’s response to the COVID-19 pandemic as a case study, this paper traces the discursive contestations of the traditional understanding of the UN Charter-based collective security model. It examines what meanings the member states collectively attach to public health crises, how they frame the COVID-19 pandemic, and, finally how they consider the role of the Security Council in responding to non-military emergencies. An analysis of the debates by the Council members suggest that there is a slow normative change in the recognition of health security as an indivisible aspect of peace. We argue that the pandemic has created a normative environment for the Council’s members to rethink ‘broadening’ and ‘deepening’ collective security beyond military conflicts to emphasize the Council’s role in addressing health issues, structural inequalities, and other human security threats.
The Covid-19 caused by the SARS-CoV-2 virus has shown how inadequate institutional strategies interact with, and exacerbate, social inequalities, thus impacting upon the intensity of the harm produced and amplifying negative consequences. One of the lessons from this pandemic, which happens against the background of other, interconnected systemic crises, is the urgency of adopting a 'whole-of-society' approach to determining what does and what does not work in the context of a health emergency response. However, how can institutional performance in health emergency response be assessed? How to make sense of success or failure? We argue that the adoption of a risk governance approach sheds light on institutional performance in the response to health emergencies. Risk governance is particularly pertinent in situations where the potential for extreme consequences is considered high, where there are enormous uncertainties regarding the consequences and where different values are present and in dispute. Based on a documentary evidence review, we analyse the Brazilian response to Covid-19 by considering: (1) how the Brazilian federal government performed on its central role of managing the national response, (2) the reactions from other actors prompted by this performance and (3) the main observed effects emerging from this scenario. We argue that the Brazilian federal government response was weak in five risk governance parameters that are essential in a health crisis response: risk communication, transparency and accessibility of data, negotiation between actors, social cohesion and public participation and decisions based on technical and scientific evidence, resources and contexts. The neglect of risk governance parameters, combined with an attempt to spread doubt, confusion and disinformation-which could be termed a 'governance by chaos'-is an important element for making sense of the effects and controversies surrounding Covid-19 in Brazil.
When the coronavirus disease 2019 (COVID-19) pandemic hit the world, many countries had no choice but restricting industrial and human activity and lockdown cities for preventing the spread of infection. However, COVID-19 has indirectly had a positive impact on our environments. Substantial evidence shows water and air quality improvements in many countries due to the lockdowns. The COVID-19 crisis has brought attention to new ways of thinking about sustainable planetary health and human health and security. Green infrastructure (GI) is desired as a new sustainable nature-based solution that helps people achieve better mental and physical well-being with improved air quality. GI incorporates natural or seminatural features, including parks, open spaces and blue/green spaces. What kind of green spaces function can be utilized at a specific place forms a critical issue for future GI planning. Thus, this chapter focuses on green spaces and examines the association between access to green spaces and air quality under the political mobility restrictions, and suggests more appropriate greenspace designs for addressing GI with/post-COVID-19 world.
COVID-19 has triggered unprecedented movement restrictions measure and disrupted to the lives, economic and social, around the world. Indonesia continues to be severely affected by COVID-19. Pandemic inevitably threatens food security particularly for poor and most vulnerable groups. The poor and most vulnerable groups including lower income workers and informal sectors have less protection than formal sectors. In addition, increasing of unemployment has lowered the purchasing power and may threaten to access to food. To anticipate and mitigate the emerging global food crises predicted by the Food and Agricultural Organization (FAO) of the United Nations as result of COVID-19. There are two keys priority policy taken by government, (1) social safety nets program to reduce the economic burden of the low income society during the pandemic and (2) food estate program to strengthening government food reserves at local level with mega food estate project outside Java started in October 2020. These two programs are not without controversies and critics.This chapter examines COVID-19 and its implications on food security in Indonesia. We examine government response and challenges in strengthening food security in times of COVID-19 and its implications on the achievements of the UN Sustainable Development Goals (SDGs) 1 and 2 zero poverty and hunger in Indonesia. This study uses literature review and published public materials to collect and analyze the data. We conclude that targeted social safety protection remains a critical policy in times of pandemic. In the implementation, it needs to be improved particularly on data of beneficiaries through one data policy to address food insecurity toward poor and vulnerable groups. Investing in a sustainable future forms a pillar of the COVID-19 response. Priority to strengthen resilience of the local food system and facilitate food production at local level with ensuring smallholders have financial support and minimizing the impact to the environment is critical rather than mega project with causing more land tenure conflicts and environmental degradation.KeywordsFood securityCOVID-19Poor and vulnerable groupsGovernanceLocal food systemSocial safety net and protectionSustainability
Justice is a core principle in bioethics, and a fair opportunity to achieve health is central to this principle. Racism and other forms of prejudice, discrimination, or bias directed against people on the basis of their membership in a particular racial or ethnic group are known contributors to health inequity, defined as unjust differences in health or access to care. Though hospital‐based ethics committees and consultation services routinely address issues of justice that arise in the course of patient care, there is variability in whether and how racism and other causes of health inequities are addressed. In this paper, we describe a novel structure and process for addressing health equity within clinical ethics consultation. In addition, we discuss the barriers and challenges to its success, many of which are rooted in the identities, norms and assumptions that underlie traditional clinical ethics consultation. We offer pragmatic recommendations and conclude with unresolved questions that remain as we work to adapt the structure of a clinical ethics consultation service to improve attention to issues of health equity and promote anti‐racism in patient care and institutional policy.
Shortly after the announcement of China's COVID-19 "case zero," several countries in Asia used their state's security mechanisms to combat the novel virus in order to protect their citizens as well as safeguard overall national security. Asian countries have claimed that the securitization of their respective COVID-19 crises was a success by pointing out that they have encountered only a tiny fraction of the number of reported COVID-19 cases, hospitalizations, and deaths compared to many countries in the West. At the same time, by promulgating very stringent emergency measures, these actions have adversely affected their citizens' human security especially in the areas of politics and economics. The following chapter examines the impact of the securitization of the new Coronavirus in the wake of the national emergency measures, which also created a negative impact on the overall human security of citizens living in Asia. The chapter draws lessons from the Chinese government’s management of the epidemic to other countries in the region and contextualizes these issues within the greater Asian theater.
Background
Living organ donation declined substantially in the United States during the COVID-19 pandemic due to concerns about donor and transplant candidate safety. COVID-19 vaccines might increase confidence in the safety of living organ donation during the pandemic. We assessed informational preferences and perspectives about COVID-19 vaccines among US living organ donors and prospective donors.
Methods
We conducted a national survey study of organ donors and prospective donors on social media platforms between December 28, 2020 and February 23, 2021. Survey items included multiple choice, visual analogue scale, and open-ended responses. Using multivariable logistic regression, we examined associations between information preferences, history of COVID-19 infection, influenza vaccination history, and COVID-19 vaccine acceptance, and performed a thematic analysis of open-ended responses.
Results
Among 342 respondents from 47 US states and the District of Columbia, 35% were between 51 and 70 years old, 90% were non-Hispanic White, 87% were women, 82% were living donors (94% kidney), and 18% were in evaluation to donate (75% kidney). The majority planned to, or had, received a COVID-19 vaccination (77%), whereas 11% did not plan to receive a vaccine, and 12% were unsure. Adjusting for demographics and donor characteristics, respondents who receive yearly influenza vaccinations had higher COVID-19 vaccine acceptance than those who do not (adjusted odds ratio [aOR], 5.06; 95% CI, 2.68 to 9.53). Compared with respondents who prioritized medical information sources ( e.g. , personal physicians and transplant providers), those who prioritized news and social media had lower COVID-19 vaccine acceptance (aOR, 0.34; 95% CI, 0.15 to 0.73). Low perceived personal benefit from vaccination and uncertainty about long-term safety were common themes among those declining COVID-19 vaccines.
Conclusions
Donor information-source preferences were strongly associated with the likelihood of accepting a COVID-19 vaccine. Vaccine guidance for organ donors who are unsure about COVID-19 vaccines could incorporate messaging about safety and benefits of vaccination for healthy people.
Objective:
The COVID-19 vaccine may hold the key to ending the pandemic, but vaccine hesitancy is hindering the vaccination of healthcare personnel (HCP).
Design:
Before-after trial.
Participants and setting:
Healthcare personnel at a 790-bed tertiary care center in Tokyo, Japan.
Interventions:
A pre-vaccination questionnaire was administered to HCP to examine their perceptions of the COVID-19 vaccine. Then, a multifaceted intervention involving (1) distribution of informational leaflets to all HCP, (2) hospital-wide announcements encouraging vaccination, (3) a mandatory lecture, (4) an educational session about the vaccine for pregnant or breastfeeding HCP, and (5) allergy testing for HCP at risk of allergic reactions to the vaccine was implemented. A post-vaccination survey was also performed.
Results:
Of 1,575 HCP eligible for enrollment, 1,224 (77.7%) responded to the questionnaire, 43.5% (n =533) expressed willingness to be vaccinated, 48.4% (n = 593) were uncertain, and 8.0% (n=98) expressed unwillingness to be vaccinated. The latter two groups were concerned about the vaccine's safety rather than its efficacy. Post-intervention, the overall vaccination rate reached 89.7% (1,413/1,575), with 88.9% (614/691) of the pre-vaccination survey respondents who answered "unwilling" or "unsure" eventually receiving a vaccination. In the post-vaccination questionnaire, factors contributing to increased COVID-19 vaccination included information and endorsement of vaccination at the medical center (26.4%; 274/1,037).
Conclusions:
The present, multifaceted intervention increased COVID-19 vaccinations among HCP at a Japanese hospital. Frequent support and provision of information were crucial for increasing the vaccination rate and may be applicable to the general population as well.
Emeritus Professor Alan Glasper, from the University of Southampton, discusses the issues raised by the recent government decision to make vaccination against the virus causing COVID-19 mandatory for care home staff
COVID-19 has elevated anew the import of holistically conceiving human-environmental well-being and tackling the overarching precarities of our ecologies, societies and public health in strategies of securitization. This paper considers the key challenge of reimagining securitization in the aftermath of COVID-19 and makes two core arguments. The first is that in addressing precarity a key starting point lies in being mindful of how it is differentially experienced across multiple social hierarchies in the human world. The paper draws upon Judith Butler’s work on ‘frames of seeing’ to consider how our current moment can elicit a contrapuntal concern for those who have always been precarious but not in view. The second core argument is that it is vital to move beyond a concern for human precarity to a concern for a broader sense of planetary precarity, which in turn prompts the need to strategize for a ‘more-than-human’ sense of security. Developing the concept of ‘human security’, the paper reflects on how we can usefully envision a ‘more-than-human security’ for a more biologically stable and sustainable planet.