The symmetric shock of the Covid-19 pandemic has come with heterogeneous consequences across the world. Within the common institutional framework of the European Union, the outbreak has put under extreme stress governance and interplay between the national and supranational level. Under some coordination, responses have remained largely in the hands and on the shoulders of the Member States. In this context, the article classifies pandemic outbreaks and responses along the containment and fiscal support dimensions to uncover whether a common model for Covid-19 crisis management arises across the EU27 or rather different policy choices patterns emerge within the continent. Based on indicators covering the three dimensions derived from the Oxford Covid Government response tracker, the John Hopkins CSSE Covid-19 database and the European Commission Autumn Forecasts, the paper employs hierarchical cluster analysis to uncover response group across countries and characterize them by the outbreak, containment and fiscal support strengths, delineating as well the geographical distribution across and within the clusters. The findings present the heterogeneity of response models, robust to alternative specifications and timeframes across the first and the second wave, deriving broader implications for the outlook for the vaccine-roll out and exit from the crisis. The dynamics in 2020 are also considered in the context of the shortcomings of supranational governance within the EU and the current policy reform debate, highlighting the high stakes for the upcoming Conference on the Future of Europe. The contribution of the work is furthered by offering a systematic methodology and framework to study heterogeneities of pandemic responses within the EU paving the way for further analysis of contributing factors explaining decision-makers policy choices as well as performance concerning political, social and economic outcomes across the models.

The Italian Parliament has excluded hospital physicians from the application of the European Work Time Directive (EWTD), which imposes a maximum workweek of 48 h and compulsory resting periods. This resulted in extended and excessive work time for the category. This paper is aimed at evaluating the impact of this legislation gap, by assessing the presence of excessive work-related stress and risk for burnout syndrome among Italian physicians working in public hospitals. This observational study is based on an on-line survey conducted on a sample of 1925 Italian doctors (covering a wide range of age, work experience and contractual positions) from October 2014 to February 2015. The questionnaire included 30 questions concerning their personal and professional life (e.g., assessment of workloads, number of uncomfortable or extra shifts, unused days-off, etc.). On the basis of the results, it can be inferred that the average Italian doctor working in public hospitals is under considerable stress at work with negative consequences on his health. He is exposed to high risk of suffering from sleep disorders and cardiovascular diseases (due to the lack of time for private practice and eating regular meals). Overall, his perception is that his job worsens his quality of life. This study shows the relevance of the risk of burnout among Italian physicians employed in public hospitals due to severe workload and work conditions. The resulting impact on the quality of care and the significant cost involved -both in human and economic terms -calls for significant emergency measures by the Italian health work organization. An important increase and prolonged working time is associated with a worsening of the objective cognitive performance and an increase of clinical risk, but also to an increased risk of diseases for operators and of the burnout syndrome. Our survey shows that lack of application of the EWTD has adverse effects on the quality of life and performance of Italian doctors. Failure to respond by all Italian doctors is the greatest limitation of our survey.

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