Systems analysis of the effects of the 2014-16 Ebola crisis on WHO-reporting nations’ policy adaptations and 2020-21 COVID-19 response: a systematized review

Abstract

Background Recent case studies indicate that the 2014-2016 Ebola outbreak, one of the worst pre-2020 global biological catastrophes in modern history, helped some nations to better prepared their responses for the COVID-19 pandemic. While such national case studies explore how specific nations applied EVD-related policies in their domestic battle against the COVID-19 pandemic, there is no known study that assesses how many WHO nations learned from the West African crisis and to what scale. Objective Applying the policy legacies analytical framework and a systematized literature review, this research examines how prior policy experiences with the 2014-16 EVD crisis as a large-scale emergent outbreak helped to inform and to condition WHO nations to proactively prepare their national policies and health systems for future threats, including ultimately COVID-19. Methods A systematized literature review of 803 evaluated sources assesses to what extent Ebola-affected and non-affected nations directly modified governmental health systems in relation to this warning. The study further evaluates how nations with documented Ebola-related changes fared during COVID-19 compared to nations that did not. We present a categorical theoretical framework that allows for classifying different types of national response activities (termed conditioned learning). Results Ten (90.9%) of 11 nations that were affected by 2014-16 Ebola crisis have documented evidence of repurposing their EVD-related policies to fight COVID-19. 164 (70.0%) of 234 non-EVD-affected nations had documented evidence of specifically adapting national systems to incorporate policy recommendations developed from the 2014-16 crisis, which informed their COVID-19 responses in 2020. Conclusions The shock of 2014-16 EVD outbreak affected most nations around the world, whether they experienced Ebola cases. We further develop a categorical framework that helps characterised nations previous experiences with this biological catastrophe, providing a means to analyse to what extent that individual nations learned and how these EVD-related changes helped inform their COVID-19 response. Nations that demonstrated EVD-related conditioned learning nations tended to have more stringent COVID-19 responses before April 2020 and utilized documented response mechanisms developed out of the West African crisis.

Digital Mass Hysteria during Pandemic? A Study of Twitter Communication Patterns in the US during the Stages of COVID-19 Vaccination

“…This strategy eventually contributed to rebuilding public trust and streamlined collective action using a hybrid policy implementation approach to combat Ebola [15][16][17]. Such efforts indicate how coordinated communications over different media platforms can help create order and meaning out of chaotic events like pandemics [18].…”

“…While Ebola was an epidemic, it was a transcontinental epidemic, meaning that as a health crisis, it took on the threat of becoming a pandemic in the eyes of many experts. Ebola-based policies informed 70% of all WHO national health policies and planning prior to COVID-19 [18]. Ebola and COVID-19 were thus interrelated and both transnational and transcontinental health crises, with misinformation and disinformation breaking out in relation to COVID-19.…”

“…The COVID-19 vaccine includes specific groups or individuals creating and spreading false information to intentionally denigrate the vaccine's effectiveness or promote distrust of the vaccine [21]. In this way, as misinformation and disinformation about COVID-19 spread, these can lower the vaccination rate and lead to results that run counter to public health goals, ultimately leading to a mass hysteria against the COVID-19 vaccine, like Ebola cases [18].…”