Nor was sufficient attention being devoted to variations in the impact of family composition and living arrangements on the transmission of the disease and its outcomes. Relatively little reliable information was available at this early stage in the pandemic about the differential impact of lockdown measures on the everyday lives and relationship of family members within and across societies. The pandemic presented greater challenges for policymakers in regions where these underlying conditions were associated with entrenched socio-economic and political divisions, unstable or dysfunctional governments, skeptical electorates and hostile media. Poorly funded and equipped public healthcare provision, and underdeveloped technological infrastructures, crowded living conditions in multigenerational households, risky lifestyles, and precarious working arrangements in low-paid public-facing jobs, particularly when carried out by ethnically diverse populations, compounded the risk of contracting and dying from the disease. Countries, or areas within them, with densely populated, high urban concentrations and internationally connected populations, in conjunction with high old-age dependency ratios and high rates of underlying health conditions (obesity, diabetes), were more likely to record larger numbers of COVID-19 cases and deaths. Social science evidence collected in the early phase of the pandemic in Europe identified a wide range of socio-demographic, economic, political and environmental factors that were affecting vulnerability to the disease (Hantrais and Letablier, 2021). WHO and national governments were accused of being ill-prepared for a global pandemic, of reacting too slowly in closing their borders and then implementing stringent lockdowns that caused irreparable damage to the economy and to the livelihoods of families and communities (Boin et al., 2020 Capano et al., 2020). The relative success of East Asian countries in containing COVID-19 at its onset was widely attributed to their capacity to learn from previous experience of epidemics, their preparedness to deal with new threats to health, and public acceptance of the need to comply unquestioningly with stringent public health measures (Cairney and Wellstead, 2021). Unlike earlier pandemics and global crises, older people with co-morbidities quickly became a focus for attention as the most vulnerable population category with the greatest likelihood of being hospitalised and dying from the disease.Įvidence was also sought from earlier pandemics about the most effective ways of controlling the spread of the virus. Comparisons with death rates in the Spanish flu pandemic in 1918 and both world wars showed how COVID-19 was affecting very different age groups (Spinney, 2017). When the World Health Organisation (WHO, 2020) declared that Europe had become the epicentre of the COVID-19 pandemic in March 2020, the disease was recognised as a novel and virulent strain of coronavirus, presenting an unprecedented global threat to humanity, against which populations had no natural immunity.
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