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Medicine (Baltimore) ; 100(15): e25495, 2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33847662


ABSTRACT: While the new Coronavirus Disease 2019 (COVID-19) pandemic rapidly spread across the world, South America was reached later in relation to Asia, Europe and the United States of America (USA). Brazil concentrates now the largest number of cases in the continent and, as the disease speedily progressed throughout the country, prompt and challenging operational strategies had to be taken by institutions caring for COVID-19 and non-COVID-19 patients in order to assure optimal workflows, triage, and management. Although hospitals in the USA, Europe and Asia have shared their experience on this subject, little has been discussed about such strategies in South America or by the perspective of outpatient centers, which are paramount in the radiology field. This article shares the guidelines adopted early in the pandemic by a nationwide outpatient healthcare center composed by a network of more than 200 patient service centers and nearly 2,000 radiologists in Brazil, discussing operational and patient management strategies, staff protection, changes adopted in the fellowship program, and the effectiveness of such measures.

Assistência Ambulatorial , Gestão de Mudança , Defesa Civil , Procedimentos Clínicos , Planejamento Estratégico , Tecnologia Radiológica , Assistência Ambulatorial/métodos , Assistência Ambulatorial/organização & administração , Assistência Ambulatorial/estatística & dados numéricos , Brasil/epidemiologia , /epidemiologia , Defesa Civil/organização & administração , Defesa Civil/estatística & dados numéricos , Procedimentos Clínicos/organização & administração , Procedimentos Clínicos/tendências , Humanos , Inovação Organizacional , Guias de Prática Clínica como Assunto , Planejamento Estratégico/normas , Planejamento Estratégico/estatística & dados numéricos , Tecnologia Radiológica/métodos , Tecnologia Radiológica/organização & administração , Tecnologia Radiológica/estatística & dados numéricos
Ann Glob Health ; 87(1): 23, 2021 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-33665145


Introduction: Rwanda has made significant advancements in medical and economic development over the last 20 years and has emerged as a leader in healthcare in the East African region. The COVID-19 pandemic, which reached Rwanda in March 2020, presented new and unique challenges for infectious disease control. The objective of this paper is to characterize Rwanda's domestic response to the first year of the COVID-19 pandemic and highlight effective strategies so that other countries, including high and middle-income countries, can learn from its innovative initiatives. Methods: Government publications describing Rwanda's healthcare capacity were first consulted to obtain the country's baseline context. Next, official government and healthcare system communications, including case counts, prevention and screening protocols, treatment facility practices, and behavioral guidelines for the public, were read thoroughly to understand the course of the pandemic in Rwanda and the specific measures in the response. Results: As of 31 December 2020, Rwanda has recorded 8,383 cumulative COVID-19 cases, 6,542 recoveries, and 92 deaths since the first case on 14 March 2020. The Ministry of Health, Rwanda Biomedical Centre, and the Epidemic and Surveillance Response division have collaborated on preparative measures since the pandemic began in January 2020. The formation of a Joint Task Force in early March led to the Coronavirus National Preparedness and Response Plan, an extensive six-month plan that established a national incident management system and detailed four phases of a comprehensive national response. Notable strategies have included disseminating public information through drones, robots for screening and inpatient care, and official communications through social media platforms to combat misinformation and mobilize a cohesive response from the population. Conclusion: Rwanda's government and healthcare system has responded to the COVID-19 pandemic with innovative interventions to prevent and contain the virus. Importantly, the response has utilized adaptive and innovative technology and robust risk communication and community engagement to deliver an effective response to the COVID-19 pandemic.

Controle de Doenças Transmissíveis , Assistência à Saúde , Regulamentação Governamental , Gestão de Riscos , /epidemiologia , Gestão de Mudança , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Comunicação , Assistência à Saúde/organização & administração , Assistência à Saúde/tendências , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Inovação Organizacional , Gestão de Riscos/métodos , Gestão de Riscos/organização & administração , Ruanda/epidemiologia
JAMA Netw Open ; 4(3): e212382, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33739431


Importance: The 2017-2018 influenza season in the US was marked by a high severity of illness, wide geographic spread, and prolonged duration compared with recent previous seasons, resulting in increased strain throughout acute care hospital systems. Objective: To characterize self-reported experiences and views of hospital capacity managers regarding the 2017-2018 influenza season in the US. Design, Setting, and Participants: In this qualitative study, semistructured telephone interviews were conducted between April 2018 and January 2019 with a random sample of capacity management administrators responsible for throughput and hospital capacity at short-term, acute care hospitals throughout the US. Main Outcomes and Measures: Each participant's self-reported experiences and views regarding high patient volumes during the 2017-2018 influenza season, lessons learned, and the extent of hospitals' preparedness planning for future pandemic events. Interviews were recorded and transcribed and then analyzed using thematic content analysis. Outcomes included themes and subthemes. Results: A total of 53 key hospital capacity personnel at 53 hospitals throughout the US were interviewed; 39 (73.6%) were women, 48 (90.6%) had a nursing background, and 29 (54.7%) had been in the occupational role for more than 4 years. Participants' experiences were categorized into several domains: (1) perception of strain, (2) effects of influenza and influenza-like illness on staff and patient care, (3) immediate staffing and capacity responses to influenza and influenza-like illness, and (4) future staffing and capacity preparedness for influenza and influenza-like illness. Participants reported experiencing perceived strain associated with concerns about preparedness for seasonal influenza and influenza-like illness as well as concerns about staffing, patient care, and capacity, but future pandemic planning within hospitals was not reported as being a high priority. Conclusions and Relevance: The findings of this qualitative study suggest that during the 2017-2018 influenza season, there were systemic vulnerabilities as well as a lack of hospital preparedness planning for future pandemics at US hospitals. These issues should be addressed given the current coronavirus disease 2019 pandemic.

Fortalecimento Institucional , Gestão de Mudança , Defesa Civil/organização & administração , Planejamento em Desastres/métodos , Surtos de Doenças , Influenza Humana , /epidemiologia , Fortalecimento Institucional/métodos , Fortalecimento Institucional/organização & administração , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Mão de Obra em Saúde/organização & administração , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Influenza Humana/terapia , Administração de Recursos Humanos/métodos , Pesquisa Qualitativa , Estações do Ano , Índice de Gravidade de Doença , Estados Unidos/epidemiologia
Lancet Gastroenterol Hepatol ; 6(5): 381-390, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33713606


BACKGROUND: The COVID-19 pandemic has led to a substantial reduction in gastrointestinal endoscopies, creating a backlog of procedures. We aimed to quantify this backlog nationally for England and assess how various interventions might mitigate the backlog. METHODS: We did a national analysis of data for colonoscopies, flexible sigmoidoscopies, and gastroscopies from National Health Service (NHS) trusts in NHS England's Monthly Diagnostic Waiting Times and Activity dataset. Trusts were excluded if monthly data were incomplete. To estimate the potential backlog, we used linear logistic regression to project the cumulative deficit between actual procedures performed and expected procedures, based on historical pre-pandemic trends. We then made further estimations of the change to the backlog under three scenarios: recovery to a set level of capacity, ranging from 90% to 130%; further disruption to activity (eg, second pandemic wave); or introduction of faecal immunochemical testing (FIT) triaging. FINDINGS: We included data from Jan 1, 2018, to Oct 31, 2020, from 125 NHS trusts. 10 476 endoscopy procedures were done in April, 2020, representing 9·5% of those done in April, 2019 (n=110 584), before recovering to 105 716 by October, 2020 (84·5% of those done in October, 2019 [n=125 072]). Recovering to 100% capacity on the current trajectory would lead to a projected backlog of 162 735 (95% CI 143 775-181 695) colonoscopies, 119 025 (107 398-130 651) flexible sigmoidoscopies, and 194 087 (172 564-215 611) gastroscopies in January, 2021, attributable to the pandemic. Increasing capacity to 130% would still take up to June, 2022, to eliminate the backlog. A further 2-month interruption would add an extra 15·4%, a 4-month interruption would add an extra 43·8%, and a 6-month interruption would add an extra 82·5% to the potential backlog. FIT triaging of cases that are found to have greater than 10 µg haemoglobin per g would reduce colonoscopy referrals to around 75% of usual levels, with the backlog cleared in early 2022. INTERPRETATION: Our work highlights the impact of the pandemic on endoscopy services nationally. Even with mitigation measures, it could take much longer than a year to eliminate the pandemic-related backlog. Urgent action is required by key stakeholders (ie, individual NHS trusts, Clinical Commissioning Groups, British Society of Gastroenterology, and NHS England) to tackle the backlog and prevent delays to patient management. FUNDING: Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) at University College London, National Institute for Health Research University College London Hospitals Biomedical Research Centre, and DATA-CAN, Health Data Research UK.

Fortalecimento Institucional , Endoscopia do Sistema Digestório , Gastroenteropatias , Utilização de Procedimentos e Técnicas , Triagem , /epidemiologia , Fortalecimento Institucional/métodos , Fortalecimento Institucional/organização & administração , Gestão de Mudança , Endoscopia do Sistema Digestório/métodos , Endoscopia do Sistema Digestório/estatística & dados numéricos , Gastroenteropatias/epidemiologia , Gastroenteropatias/terapia , Humanos , Imunoquímica , Controle de Infecções , Avaliação de Processos e Resultados em Cuidados de Saúde , Utilização de Procedimentos e Técnicas/estatística & dados numéricos , Utilização de Procedimentos e Técnicas/tendências , Medicina Estatal/organização & administração , Medicina Estatal/tendências , Triagem/métodos , Triagem/estatística & dados numéricos , Reino Unido/epidemiologia , Listas de Espera
Br J Gen Pract ; 71(704): e166-e177, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33558332


BACKGROUND: To reduce contagion of COVID-19, in March 2020 UK general practices implemented predominantly remote consulting via telephone, video, or online consultation platforms. AIM: To investigate the rapid implementation of remote consulting and explore impact over the initial months of the COVID-19 pandemic. DESIGN AND SETTING: Mixed-methods study in 21 general practices in Bristol, North Somerset and South Gloucestershire. METHOD: Longitudinal observational quantitative analysis compared volume and type of consultation in April to July 2020 with April to July 2019. Negative binomial models were used to identify if changes differed among different groups of patients. Qualitative data from 87 longitudinal interviews with practice staff in four rounds investigated practices' experience of the move to remote consulting, challenges faced, and solutions. A thematic analysis utilised Normalisation Process Theory. RESULTS: There was universal consensus that remote consulting was necessary. This drove a rapid change to 90% remote GP consulting (46% for nurses) by April 2020. Consultation rates reduced in April to July 2020 compared to 2019; GPs and nurses maintained a focus on older patients, shielding patients, and patients with poor mental health. Telephone consulting was sufficient for many patient problems, video consulting was used more rarely, and was less essential as lockdown eased. SMS-messaging increased more than three-fold. GPs were concerned about increased clinical risk and some had difficulties setting thresholds for seeing patients face-to-face as lockdown eased. CONCLUSION: The shift to remote consulting was successful and a focus maintained on vulnerable patients. It was driven by the imperative to reduce contagion and may have risks; post-pandemic, the model will need adjustment.

Controle de Doenças Transmissíveis/métodos , Padrões de Prática em Enfermagem/tendências , Padrões de Prática Médica/tendências , Atenção Primária à Saúde , Consulta Remota/organização & administração , Adulto , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , /prevenção & controle , Gestão de Mudança , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Clínicos Gerais/estatística & dados numéricos , Humanos , Recém-Nascido , Masculino , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/tendências , Reino Unido/epidemiologia
Rev. adm. pública (Online) ; 54(6): 1486-1497, Nov.-Dec. 2020.
Artigo em Inglês | LILACS | ID: biblio-1143909


Abstract This Thematic Special Issue on Policy Change and Policy Dynamics has as its main objective to present and discuss agenda setting, one of the most important issues for the study of public policies and the policy process. The agenda setting approach proposes an analytical approach on pre-decision processes to understand broader developments in public policy. To achieve that, it places the attention at the center of political action and relies on the fact that it is the change in attention that would cause, consequently, change in public policy. One of the most relevant aspects on the studies of policy agendas and policy change considers the diffusion occurred in the years 2000 with the application of its theoretical and methodological approaches to different societies and political systems beyond the United States. Consequently, another important achievement in the studies of agenda setting and policy change must be highlighted: studies of public policies in comparative perspective. Although agenda-setting studies have grown significantly in the international academic community, there are still some important points to be better explored. The intent of this Themed Special Issue of RAP is to contribute with the growing agenda-setting studies by highlighting the processes of policy changes and policy dynamics.

Resumen Este artículo es una breve presentación del número Temático Especial sobre Cambio y Dinámica de las Políticas Públicas, cuyo principal objetivo es plantear y discutir los conceptos involucrados en el proceso de establecimiento de la agenda (agenda-setting), uno de los temas más importantes para el estudio de las políticas públicas y de su proceso (policy process). Los modelos de agenda-setting proponen enfoques analíticos de los procesos predecisorios para el análisis y comprensión de aspectos más amplios en la construcción de problemas y soluciones en las políticas públicas. Para ello, pone la atención ‒un recurso escaso‒ en el centro de la acción política, indicando que es el cambio de atención lo que, en consecuencia, provocaría cambios en las políticas públicas. Uno de los aspectos más relevantes en los estudios de agenda-setting y cambios en las políticas públicas considera la difusión global de sus estudios que se dio en la década del 2000 con la aplicación de enfoques teóricos y metodológicos a diferentes países y sistemas políticos, más allá de Estados Unidos, donde dichos modelos y teorías surgieron en las décadas de 1980 y 1990. Consecuentemente, cabe destacar otro logro importante en los estudios de establecimiento de agenda y cambio de políticas: los estudios de políticas públicas en perspectiva comparada. Aunque los estudios de establecimiento de agendas han crecido significativamente en la comunidad académica internacional, todavía quedan algunos puntos importantes por explorar más a fondo. La intención de este Número Especial es contribuir a los crecientes estudios sobre agenda-setting, destacando los procesos de cambio y la dinámica de las políticas públicas.

Resumo Esse artigo é uma breve apresentação do número Especial Temático sobre Mudança e Dinâmicas de Políticas Públicas, que tem como objetivo principal apresentar e discutir os conceitos envolvidos no processo de agenda-setting, um dos temas mais importantes para o estudo das políticas públicas e do processo de políticas públicas (policy process). Os modelos de definição de agenda (agenda-setting) propõem abordagens analíticas sobre os processos pré-decisórios para a análise e compreensão de aspectos mais amplos na construção de problemas e soluções em políticas públicas. Para tanto, coloca a atenção, um recurso escasso, no centro da ação política, indicando que é a mudança de atenção que ocasionaria, consequentemente, mudanças em políticas públicas. Um dos aspectos mais relevantes nos estudos de agenda-setting e mudanças em políticas públicas considera a difusão global de seus estudos ocorrida nos anos 2000 com a aplicação de abordagens teóricas e metodológicas a diferentes países e sistemas políticos, para além Estados Unidos, de onde tais modelos e teorias surgiram nos anos 1980 e 1990. Consequentemente, outra conquista importante nos estudos de definição de agenda e mudança de políticas deve ser destacada: os estudos de políticas públicas em perspectiva comparada. Embora os estudos de definição de agendas tenham crescido significativamente na comunidade acadêmica internacional, ainda existem alguns pontos importantes a serem mais bem explorados. A intenção deste Número Especial, é o de contribuir com os crescentes estudos sobre agenda-setting, destacando os processos de mudanças e as dinâmicas das políticas públicas.

Humanos , Masculino , Feminino , Sistemas Políticos , Política Pública , Gestão de Mudança
Rev. adm. pública (Online) ; 54(6): 1691-1710, Nov.-Dec. 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1143905


Abstract The Brazilian presidential elections of 2018 brought large-scale changes in the Brazilian environmental policy subsystem. The purpose of this article is to analyze these changes through the lenses of the Advocacy Coalition Framework - ACF. First, we introduced some of the main characteristics of this subsystem, then we presented a hemerographic analysis to describe and analyze the effects of four recent shocks in this subsystem. Two of these shocks were external: (i) the election of a new political elite in power that brought a clear discourse of denial of the relevance of environmental policy and (ii) calamitous environmental events that occurred in Brazil in 2019. The other two shocks were internal: (i) the capture of key positions and resources by dominant coalition members and (ii) the rise of conflict and polarization among the coalitions in the subsystem. The results showed: (i) the rise of a hyper-adversarial environmental policy subsystem; (ii) a realignment between non-dominant coalitions in a cooperative direction; (iii) the imposition of clear barriers to negotiation; (iv) changes in the use of scientific information by more politicized discourses with a high degree of bias. The article contributes to the understanding of the processes of institutional change in environmental policy, especially in contexts of large-scale change generated by increasing electoral polarization and fierce political disputes. It also contributes to the analysis of the limits and possibilities of the ACF in the Brazilian environmental agenda.

Resumen Las elecciones presidenciales brasileñas de 2018 introdujeron cambios de gran escala en el subsistema de política ambiental del país. El propósito de este documento es analizar estos cambios a través de las lentes del Advocacy Coalition Framework - ACF. Para ello, exponemos algunas de las características principales de este subsistema y, luego, presentamos un análisis hemerográfico para describir y analizar los efectos de cuatro shocks recientes en este subsistema. Dos de estos shocks fueron externos: (i) el ascenso de una nueva élite política al poder, la cual ha traído un claro discurso de negación de la relevancia de la política ambiental y (ii) catastróficos eventos ambientales que ocurrieron en Brasil durante 2019. Otros dos shocks fueron internos: (i) la captura de posiciones y recursos claves por los miembros de la coalición dominante y (ii) el surgimiento de conflictos y polarizaciones entre las coaliciones del subsistema. Los resultados mostraron: (i) el ascenso de un subsistema de política ambiental hipercontradictorio; (ii) el realineamiento de las coaliciones no dominantes en una dirección cooperativa; (iii) la imposición de claras barreras en los procesos de negociación; y (iv) cambios en el uso de información científica por discursos más politizados con un alto grado de sesgo. Este artículo contribuye a la comprensión de los procesos de cambio institucional en la política ambiental, especialmente en contextos de cambios de gran escala generados por un aumento en la polarización electoral e intensas disputas políticas. También contribuye al análisis de los límites y posibilidades del ACF en la agenda ambiental brasileña.

Resumo As eleições presidenciais brasileiras de 2018 trouxeram mudanças em larga escala no subsistema de política ambiental do país. O objetivo deste artigo é analisar essas mudanças através do Advocacy Coalition Framework - ACF. Para isso, introduzimos algumas das principais características do subsistema de política ambiental e, a seguir, apresentamos uma análise hemerográfica para descrever e analisar os efeitos de quatro choques recentes no subsistema em análise. Dois desses choques foram externos: (i) a ascensão ao poder de uma nova elite política que trouxe um discurso claro de negação da relevância da política ambiental e (ii) eventos ambientais calamitosos que ocorreram no Brasil em 2019. Dois outros choques foram internos: (i) a captura de posições e recursos importantes pelos membros da coalizão dominante e (ii) o surgimento de conflitos e polarizações entre as coalizões no subsistema. Os resultados mostraram: (i) a ascensão de um subsistema hiper-contraditório; (ii) o realinhamento entre coalizões não dominantes em direção à cooperação; (iii) a imposição de barreiras claras à negociação; e (iv) mudanças no uso da informação científica por discursos mais politizados com alto grau de viés. O artigo contribui para a compreensão dos processos de mudança institucional na política ambiental, especialmente em contextos de mudança em larga escala gerados pelo aumento da polarização eleitoral e intensas disputas políticas. Contribui também para a análise dos limites e possibilidades do ACF na agenda ambiental brasileira.

Humanos , Masculino , Feminino , Gestão Ambiental , Jornalismo Ambiental/políticas , Política Ambiental , Gestão de Mudança
Rev. adm. pública (Online) ; 54(6): 1672-1690, Nov.-Dec. 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1143898


Abstract This article aims to advance the discussion about the influence of knowledge and policy learning on policy change, taking the Advocacy Coalition Framework as reference. We propose unlinking the comprehension of learning through change in two perspectives. First, we suggest apprehending the relation between knowledge and policy learning, through the use of knowledge, assuming that different forms of learning are possible, depending on the context of decision-making. Then, relying on the contributions of the theory of gradual institutional change, we suggest using the notion of institutional dynamics, in order to capture the explanatory power of knowledge and policy learning both in stasis and change situations. We aim to contribute to diminish the skepticism presented in the literature about the influence of knowledge and policy learning in the policy process.

Resumen Este artículo tiene como objetivo avanzar en la discusión sobre la influencia del conocimiento y del aprendizaje en el tema de los cambios en políticas públicas, tomando como referencia el Marco de las Coaliciones Promotoras. Para ello, proponemos desvincular la comprensión del aprendizaje a través del cambio en políticas públicas en dos perspectivas. En primer lugar, nos proponemos aprehender la relación entre conocimiento y aprendizaje en las políticas públicas, a través del uso del conocimiento, asumiendo que son posibles distintas formas de aprendizaje, dependiendo del contexto de toma de decisiones. Luego, con base en los aportes de la teoría del cambio gradual, proponemos utilizar la noción de dinámica institucional, con el fin de captar el poder explicativo del conocimiento y el aprendizaje en situaciones tanto de estasis como de cambio. Esperamos contribuir a reducir el escepticismo presente en la literatura sobre la influencia del conocimiento y el aprendizaje en el proceso de políticas públicas.

Resumo Este artigo tem como objetivo avançar a discussão sobre a influência do conhecimento e do aprendizado na mudança das políticas públicas, tomando como referência o Modelo de Coalizões de Defesa. Para isso, propomos desvincular a compreensão do aprendizado por meio da mudança em duas perspectivas. Primeiro, propomos apreender a relação entre conhecimento e aprendizagem em políticas públicas, por meio do uso do conhecimento, assumindo que diferentes formas de aprendizagem são possíveis, dependendo do contexto de tomada de decisão. Em seguida, a partir das contribuições da teoria da mudança gradual, propomos usar a noção de dinâmica institucional, a fim de captar o poder explicativo do conhecimento e da aprendizagem tanto em situações de estase quanto de mudança. Esperamos contribuir para diminuir o ceticismo presente na literatura sobre a influência do conhecimento e da aprendizagem no processo de políticas públicas.

Humanos , Masculino , Feminino , Política Pública , Gestão de Mudança , Aprendizagem
Ann Glob Health ; 86(1): 119, 2020 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-32983915


Background: Disease control involves multiple actions overtime to halt the spread of COVID-19. The role of a country's governance in slowing the spread of COVID-19 has not yet been well investigated. Objective: This study aims to investigate the association between governance and the trend of COVID-19 incidence in countries with the highest prevalence. We hypothesized that countries with better governance are more likely to mitigate the spread of COVID-19 than countries with worse governance. Methods: We analyzed 62 most prevalent countries with at least 10,000 accumulative confirmed cases from January 22 to June 15, 2020. Countries were further grouped into three different levels of governance (25 better governance, 24 fair governance, and 13 worse governance), identified outbreak and mitigation periods using the joinpoint regression model, and compared the number of days and average daily percent change in incidence in two periods by governance level using the one-way analysis of variance. Findings: The average outbreak period in the 62 countries lasted 84.0 days. Sixty percent of countries (N = 37) had experienced outbreak periods, followed by a mitigation period. In contrast, the rest forty percent of countries (N = 25) still had a rising trend. In the outbreak period, better governance countries had a more rapid increase but a shorter outbreak period (71.2 days) than countries with fair (93.5 days) and worse (90.8 days) governance. Most countries with better governance (84.0%) revealed a declining trend in COVID-19 incidence, while such a trend was less than half of fair and worse governance countries (38.5%-41.7%). Conclusions: Countries with better governance are more resilient during the COVID-19 crisis. While the mitigation of COVID-19 is observed in most better governance countries, the incidence of COVID-19 is still surging in most fair and worse governance countries, and the possibility of a recurring epidemic of COVID-19 in countries cannot be ignored.

Gestão de Mudança , Controle de Doenças Transmissíveis , Infecções por Coronavirus , Transmissão de Doença Infecciosa , Saúde Global/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral , Análise de Variância , Betacoronavirus/isolamento & purificação , Defesa Civil/métodos , Defesa Civil/organização & administração , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/estatística & dados numéricos , Humanos , Incidência , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Prevalência , Resiliência Psicológica , Controle Social Formal