Lessons for the Age of Consequences: COVID-19 and the Macroeconomy

Comparative empirical evidence for 22 OECD countries shows that country differences in cumulative mortality impacts of SARS-CoV-2 are caused by weaknesses in public health competences, pre-existing variances in structural socio-economic and public health vulnerabilities, and the presence of fiscal constraints. Remarkably, the (fiscally non-constrained) U.S. and the U.K. stand out, as they experience mortality outcomes similar to those of fiscally-constrained countries. High COVID19 mortality in the U.S. and the U.K. is due to pre-existing socio-economic and public health vulnerabilities, created by the following macroeconomic policy errors: (a) a deadly emphasis on fiscal austerity (which diminished public health capacities, damaged public health and deepened inequalities);(b) an obsessive belief in a trade-off between ‘efficiency' and ‘equity', which is mostly used to justify extreme inequality;(c) a complicit endorsement by mainstream macro of the unchecked power over monetary and fiscal policy-making of global finance and the rentier class;and (d) an unhealthy aversion to raising taxes, which deceives the public about the necessity to raise taxes to counter the excessive liquidity preference of the rentiers and to realign the interests of finance and of the real economy. The paper concludes by outlining a few lessons for a saner macroeconomics.

COVID-19 and its impacts: The situation in Niger republic.

COVID-19 being a public health emergency of international concern has emerged in most African countries including Niger. Niger, a landlocked country, is tasked with controlling the pandemic. However, of the big challenges the country faced is the fragility of healthcare system which posed limitations to the fight against the virus. The virus overwhelmed the fragile healthcare system which led to inaccessibility of quality healthcare to the citizens coupled with issues of flooding and economic recession that happened during the pandemic. The healthcare sectored has further been crippled by exposure and infection of the already insufficient healthcare workers. In addition to this, there was the burden of NTDs and other communicable and non-communicable diseases that subverted the country in the depths of difficulties. As per the predictions of World Bank, the poverty curve is likely to escalate due to the outrageous impacts of COVID-19. Adding on to this, the occurrence of natural disasters such as flooding has further stretched the country. It's no coincidence that the country would confront plethora of challenges amidst the second wave. Therefore, timely decision and necessary interventions are needed to strengthen the country's fight against the pandemic. However, this is only feasible when Nigerien government, international allies and other wealthy nations work closely to ensure that the challenges faced by the healthcare system are tackled.

Post-acute sequelae of COVID-19 in older persons: multi-organ complications and mortality.

INTRODUCTION: Evidence on long-term associations between COVID-19 and risks of multi-organ complications and mortality in older population is limited. This study evaluates these associations. RESEARCH DESIGN AND METHODS: The cohorts included patients aged ≥60 year diagnosed with COVID-19 infection (cases), between 16 March 2020 and 31 May 2021 from the UK Biobank (UKB cohort, n = 11 330); and between 01 April 2020 and 31 May 2022 from the electronic health records in Hong Kong (HK cohort, n = 213 618). Each patient was randomly matched with up to 10 individuals without COVID-19 infection based on age and sex (UKB, n = 325 812; HK, n = 1 411 206) and were followed for up to 18 months until 31 August 2021 for UKB, and up to 28 months until 15 August 2022 for HK cohort. Caracteristics between cohorts were further adjusted with propensity score-based marginal mean weighting through stratification. For evaluating long-term association of COVID-19 with multi-organ disease complications and mortality after 21-days of diagnosis, Cox regression was employed. RESULT: Older adults with COVID-19 were associated with a significantly higher risk of cardiovascular outcomes [major cardiovascular disease (stroke, heart failure and coronary heart disease): hazard ratio (UKB): 1.4 (95% Confidence interval: 1.2,1.7), HK:1.2 (95% CI: 1.1,1.3)]; myocardial infarction: HR (UKB): 1.8 (95% CI: 1.4,2.5), HK:1.2 (95% CI: 1.1,1.5)]; respiratory outcomes [interstitial lung disease: HR (UKB: 3.5 (95% CI: 2.6,4.7), HK:6.6 (95% CI: 2.1,21.2); chronic pulmonary disease: HR (UKB): 1.6 (95% CI: 1.2,2.1), HK:1.7 (95% CI: 1.4,2.1)]; neuropsychiatric outcomes [seizure: HR (UKB): 2.7 (95% CI: 1.7,4.2), HK:1.8 (95% CI: 1.4,2.3)]; and renal outcomes [acute kidney disease: HR (UKB): 1.4 (95% CI: 1.1,1.6), HK:1.7 (95% CI: 1.4,2.1)]; and all-cause mortality [HR (UKB): 4.8 (95% CI: 4.4,5.4), HK:2.7 (95% CI: 2.6,2.8)]. CONCLUSION: COVID-19 is associated with long-term risks of multi-organ complications in older adults (aged ≥60). Infected patients in this age-group may benefit from appropriate monitoring of signs/symptoms for developing these complications.

Research on urban country parks based on emergency medical facilities for public health emergencies-a case study of Guangzhou, China.

As COVID-19 has swept across the world, the escalating number of confirmed and suspected cases overwhelmed the admission capacity of the designated hospitals. Faced with such a grim situation, governments made a quick decision to build emergency medical facilities to address the outbreak. However, the emergency medical facilities faced a huge risk of epidemic spread and improper site could lead to serious secondary transmission. Using the disaster prevention and risk avoidance function of urban green space can solve the problem of selecting the location of emergency medical facilities to a certain extent, with country parks having a high degree of compatibility with the latter. Based on the location requirements of emergency medical facilities, using Analytic Hierarchy Process and Delphi method, through analyzing the type of country parks, effective risk avoidance area, spatial fragmentation, distance from water sources, wind direction, and distance from the city, quantification of 8 impact factors such as hydrogeology and traffic duration was conducted to comprehensively compare 30 country parks in Guangzhou. The results showed that the overall quality of country parks approximated a normal distribution, with Lianma Forest Country Park having the highest comprehensive score and the most balanced distribution of scores for various impact factors. Considering safety, expandability, rehabilitation, convenience, pollution prevention, and fecal isolation, it is a preferred destination for emergency medical facility construction.

Barriers and Enablers to Using an Emergency Operations Center in Public Health Emergency Management: A Scoping Review.

OBJECTIVES: The aim of this study was to review the role of public health emergency operations centers in recent public health emergencies and to identify the barriers and enablers influencing the effective use of a public health emergency operations center (PHEOC) in public health emergency management. METHODS: A systematic search was conducted in 5 databases and selected grey literature websites. RESULTS: Forty-two articles, consisting of 28 peer-reviewed studies and 14 grey literature sources matched the inclusion criteria. Results suggest that PHEOCs are used to prepare and respond to a range of public health emergencies, including coronavirus disease (COVID-19). Factors found to influence the use of a PHEOC include the adoption of an incident management system, internal and external communications, data management, workforce capacity, and physical infrastructure. CONCLUSIONS: PHEOCs play an important role in public health emergency management. This review identified several barriers and enablers to using a PHEOC in public health emergency management. Future research should focus on addressing the barriers to using a PHEOC and looking at ways to evaluate the impact of using a PHEOC on public health emergency outcomes.

A scoping review of non-professional medication practices and medication safety outcomes during public health emergencies.

OBJECTIVES: Public health emergencies (PHE) can disrupt personal medication practices and increase the risk of medication-related harm and other negative medication-related outcomes. Our aim was to examine the extent and nature of published research on this topic to guide future research and practice. STUDY DESIGN: Scoping review. METHODS: Standard electronic databases were searched. PRISMA-ScR guidelines were followed. Extracted data were organised in response to review questions and narrative accounts developed. RESULTS: A total of 129 studies were included, conducted across 32 countries, mostly in the USA (n = 42). Sixty-eight (53%) reported on infectious events, 49 (39%) climatological or ecological events and the remainder a mixture of terrorism, war or other disasters. The studies described several medication safety outcomes (medication-related harm, adherence, supply) and adaptive medication practices (self-altering prescribed medications, sharing medications and changing healthcare providers). Challenges to maintaining routine medication practices during a PHE included transport, finance, quarantine and knowledge-related issues. Twenty-eight studies (22%) examined health inequalities pertaining to adverse medication-related outcomes, with findings suggesting that gender, age, ethnicity, educational and socio-economic status may be related to inequalities. Research gaps identified included carers', children's and minority communities' experiences and intervention studies. CONCLUSIONS: There is considerable evidence of disruptions to routine personal medication practices during PHEs and of medication-related harm and other negative outcomes. Maintaining medication supply for the management of chronic conditions is a universal problem across all emergency types. Research is needed to address these disruptions, particularly amongst people who experience health inequalities who may need additional support.

Investigating the cumulative lag effects of environmental exposure under urban differences on COVID-19.

Although all walks of life are paying less attention to COVID-19, the spread of COVID-19 has never stopped. As an infectious disease, its transmission speed is closely related to the atmosphere environment, particularly the temperature (T) and PM2.5 concentrations. However, How T and PM2.5 concentrations are related to the spread of SARS-CoV-2 and how much their cumulative lag effect differ across cities is unclear. To identify the characteristics of cumulative lag effects of environmental exposure under city differences, this study used a generalized additive model to investigate the associations between T/PM2.5 concentrations and the daily number of new confirmed COVID-19 cases (NNCC) during the outbreak period in the second half of 2021 in Shaoxing, Shijiazhuang, and Dalian. The results showed that except for PM2.5 concentrations in Shaoxing, the NNCC in the three cities generally increased with the unit increase of T and PM2.5 concentrations. In addition, the cumulative lag effects of T/PM2.5 concentrations on NNCC in the three cities reached a peak at lag 26/25, lag 10/26, and lag 18/13 days, respectively, indicating that the response of NNCC to T and PM2.5 concentrations varies among different regions. Therefore, combining local meteorological and air quality conditions to adopt responsive measures is an important way to prevent and control the spread of SARS-CoV-2.

The stochastic evolutionary game analysis of public prevention and control strategies in public health emergencies

PurposeThe COVID-19 epidemic is still spreading globally and will not be completely over in a short time. Wearing a mask is an effective means to combat the spread of COVID-19. However, whether the public wear a mask for epidemic prevention and control will be affected by stochastic factors such as vaccination, cultural differences and irrational emotions, which bring a high degree of uncertainty to the prevention and control of the epidemic. The purpose of this study is to explore and analyze the epidemic prevention and control strategies of the public in an uncertain environment.Design/methodology/approachBased on the stochastic evolutionary game model of the Moran process, the study discusses the epidemic prevention and control strategies of the public under the conditions of the dominance of stochastic factors, expected benefits and super-expected benefits.FindingsThe research shows that the strategic evolution of the public mainly depends on stochastic factors, cost-benefit and the number of the public. When the stochastic factors are dominant, the greater the perceived benefit, the lower the cost and the greater the penalty for not wearing masks, the public will choose to wear a mask. Under the dominance of expected benefits and super-expected benefits, when the number of the public is greater than a certain threshold, the mask-wearing strategy will become an evolutionary stable strategy. From the evolutionary process, the government's punishment measures will slow down the speed of the public choosing the strategy of not wearing masks. The speed of the public evolving to the stable strategy under the dominance of super-expected benefits is faster than that under the dominance of expected benefits.Practical implicationsThe study considers the impact of stochastic factors on public prevention and control strategies and provides decision-making support and theoretical guidance for the scientific prevention of the normalized public.Originality/valueTo the best of the authors' knowledge, no research has considered the impact of different stochastic interference intensities on public prevention and control strategies. Therefore, this paper can be seen as a valuable resource in this field.

Ophthalmic manifestations of monkeypox infection.

After the global COVID-19 pandemic, there has been an alarming concern with the monkeypox (mpox) outbreak, which has affected more than 110 countries worldwide. Monkeypox virus is a doublestranded DNA virus of the genus Orthopox of the Poxviridae family, which causes this zoonotic disease. Recently, the mpox outbreak was declared by the World Health Organization (WHO) as a public health emergency of international concern (PHEIC). Monkeypox patients can present with ophthalmic manifestation and ophthalmologists have a role to play in managing this rare entity. Apart from causing systemic involvement such as skin lesions, respiratory infection and involvement of body fluids, Monkeypox related ophthalmic disease (MPXROD) causes varied ocular manifestations such as lid and adnexal involvement, periorbital and lid lesion, periorbital rash, conjunctivitis, blepharocounctivitis and keratitis. A detailed literature review shows few reports on MPXROD infections with limited overview on management strategies. The current review article is aimed to provide the ophthalmologist with an overview of the disease with a spotlight on ophthalmic features. We briefly discuss the morphology of the MPX, various modes of transmission, an infectious pathway of the virus, and the host immune response. A brief overview of the systemic manifestations and complications has also been elucidated. We especially highlight the detailed ophthalmic manifestations of mpox, their management, and prevention of vision threatening sequelae.

Risk perception in the era of COVID-19 and related factors among nurses: A cross-sectional study.

AIM: Our study aimed at investigating the risk perception of nurses and related factors in the era of COVID-19 period. DESIGN: Cross-sectional study. METHODS: Four hundred and forty-two participants completed an online questionnaire relating to their risk perception on public health emergencies. Data were collected between 25 November 2020 and 1 December 2020. Kruskal-Wallis test, Mann-Whitney U test and Ordinal logistic regression analysis were used to examine factors impacting on risk perception. RESULTS: 65.2% of nurses' risk perception of COVID-19 was the moderate level even below the moderate level in the postperiod of COVID-19. Kruskal-Wallis test results indicated significant differences in gender, age, education status, working years, professional title, postlevel, COVID-19 contact experience, marital status and health status (p < 0.05). Ordinal logistic regression showed that gender, education status, professional title, work department, COVID-19 contact experience, character, health status and nursing work environment are associated with risk perception (p < 0.05). No Patient or Public Contribution.

Does Public Health Emergency Experience Have an Impact on Individual Reactions during COVID-19?

Local historical experience in public health emergencies has been perceived to largely affect COVID-19's social influence. Specifically, individuals' personal experience in public health emergencies would likely have an impact on their reactions to the next similar event. Herein, we combined life course and risk analysis frameworks to explore how individuals' experiences influence current risk perception and protective behaviors. We collected 1000 questionnaires of random network samples in six Chinese provinces of different risk levels from 29 April to 8 May 2020, and used the propensity score matching (PSM) model and multivariable linear regression to process the data. We categorized individual public emergency experience into three patterns: (1) having ever witnessed a public health emergency, (2) having ever experienced a public health emergency, and (3) currently experiencing a public health emergency. The study indicates that individuals' experiences had significant positive effects on protective behaviors against COVID-19. The average effects of the three patterns on behaviors were 0.371 (p < 0.001), 0.898 (p < 0.001) and 0.319 (p < 0.05), respectively. The study also shows that for those experiencing any one pattern, the effect of risk perception on protective behaviors appeared null in the early stage of the pandemic. We propose the potential interactive mechanism of risk factors in the life course at the individual level. Academically, this study develops the risk theory of perception and behavior and expands the application of the life course approach in the public health arena. Practically, our research indicates that public health emergency experiences are valuable for responding to a future pandemic and normalizing prevention policies.

The Emergence of Mpox: Epidemiology and Current Therapeutic Options.

The world recently witnessed the emergence of new epidemic outbreaks like COVID-19 and mpox. The 2022 outbreak of mpox amid COVID-19 presents an intricate situation and requires strategies to combat the status quo. Some of the challenges to controlling an epidemic include present knowledge of the disease, available treatment options, appropriate health infrastructures facilities, current scientific methods, operations concepts, availability of technical staff, financial funds, and lastly international policies to control an epidemic state. These insufficiencies often hinder the control of disease spread and jeopardize the health of countless people. Also, disease outbreaks often put a huge burden on the developing economies. These countries are the worst affected and are immensely dependent on assistance provided from the larger economies to control such outbreaks. The first case of mpox was reported in the 1970s and several outbreaks were detected thereafter in the endemic areas eventually leading to the recent outbreak. Approximately, more than 80,000 individuals were infected, and 110 countries were affected by this outbreak. Yet, no definite vaccines and drugs are available to date. The lack of human clinical trials affected thousands of individuals in availing definite disease management. This paper focuses on the epidemiology of mpox, scientific concepts, and treatment options including future treatment modalities for mpox.

Planning for the next pandemic: Reflections on lessons from the uncontained transmission phases of the COVID-19 pandemic and their impacts on emergency departments in Australia.

Australia was a world leader in managing the earlier waves of the COVID-19 pandemic. Subsequently, three major turning points changed the trajectory of the pandemic: mass vaccinations, emergence of more transmissible variants and re-opening of Australia's borders. However, there were also concomitant missteps and premature shifts in pandemic response policy that led to mixed messaging, slow initial vaccination uptake and minimal mitigation measures in response to the Omicron variant. The latter marked Australia's entry into a new phase of (or approach to) the pandemic: widespread transmission. This led to an exponential increase in cases and significant impacts on the health system, particularly, EDs. This paper reflects on this phase of the pandemic to urge for system-level changes that instal better safeguards for ED capacity, safety and staff well-being for future pandemics. This is essential to strengthening our health system's resilience and to better protecting our communities against such emergencies.

The Impact of a Public Health Emergency on the Demand for Life Insurance – An Empirical Analysis Based on Severe Acute Respiratory Syndrome

We examined changes in personal life insurance purchase decisions after a public health event by incorporating perceived health risk and regret into the expected utility function. The model predicts that the epidemic will create incremental insurance demand. Based on the 2003 severe acute respiratory syndrome outbreak in China, we used a panel dataset of 30 provinces from 2000 to 2007 and applied the difference-in-differences method to confirm the prediction empirically. The results showed that the epidemic did not significantly impact the demand for life insurance in the short term but played a role in the long term. People increased their health-care expenditure and premiums for new policies after the severe acute respiratory syndrome event, suggesting that the epidemic changed people's perceived risk and triggered anticipated regret, which increased life insurance demand. Some robustness checks also supported our findings. © 2023 Institute of World Economics and Politics, Chinese Academy of Social Sciences.

Understanding factors related to decision making by state health officials in a public health emergency

Background and Purpose - State Health Officials (SHOs), as the leaders of state governmental public health agencies, play a critical role in their respective states. Their decisions guide the overall actions of their organizations in executing programs, policies and activities that ultimately affect the health of the state's population. This study will add to the research and serve as a potential guide to future SHO training, specific to decision making, in a public health emergencyMethods - Twenty-one individuals, who are either currently working as SHOs or who were former SHOs, were interviewed to understand their perspectives on issues that may impact their response to a public health emergency: decision-making, interaction with the public and the media and the role of politics in public health, and other areas of consequence. Results - While the study was focused more broadly, all of the respondents specifically mentioned the COVID19 pandemic as the most complicated public health emergency they have responded to as a SHO. All respondents also mentioned that they did not have a specific decision-making tool to utilize during this emergency and primarily relied on a consensus-driven decision-making process. Additionally, issues such as the challenges of managing the media and the politicization of public health during this pandemic, were mentioned by many of the respondents. Conclusion - These findings pointed to the need for a step-by-step decision-making tool to be utilized by SHOs in a public health emergency. This has the potential to lead to a more methodical approach to SHOs decision-making during a public health emergency, including a focus on various operational aspects such as understanding the role of the media in a public health emergency, managing elected officials in a public health emergency, and lessons learned from past public health emergencies. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Study on site selection of emergency medical facilities for rural public health emergencies

In order to improve the scientificity of site selection decision⁃making of emergency medical facilities for rural public health emergencies, based on the characteristics of public health emergencies with rapid spread and strong harmfulness of corona virus disease 2019(COVID-19), according to the design standards of emergency medical facilities, taking into account the characteristics of small rural medical budget and rugged emergency roads, firstly, six influencing factors of engineering geological conditions, unit cost, infection rate, arrival time, site scale and service coverage area of alternative sites of facilities were selected. The Entropy value method(EVM) method and analytic hierarchy process(AHP) method were effectively combined to determine the weight of influencing factors. Secondly, a multi⁃objective location model considering the minimum sum of the distance from patients to emergency medical facilities and the optimal comprehensive evaluation value of the selected emergency medical facilities was established. Then, an IPSO algorithm was designed to solve the model and get the location decision. Finally, some villages in Tianmen city were selected for empirical analysis to verify the effectiveness of the model algorithm. The results show that infection rate and unit cost are the main influencing factors for the construction of emergency medical facilities. IPSO algorithm selects three emergency medical facilities, which can meet the treatment needs of patients in eight villages, and ensure that patients can seek medical treatment within 4-7 minutes,providing guarantee for efficient epidemic prevention and control activities. © 2023 China Safety Science Journal. All rights reserved.

Relationship between Risk Perception, Emotion, and Coping Behavior during Public Health Emergencies: A Systematic Review and Meta-Analysis

Complex mechanisms exist between public risk perception, emotions, and coping behaviors during health emergencies. To unravel the relationship between these three phenomena, a meta-analytic approach was employed in this study. Using Comprehensive Meta-Analysis 3.0, 81 papers were analyzed after selection. The results of the meta-analysis showed that (1) risk perception (perceived severity, perceived susceptibility) and negative emotions (especially fear) are both correlated with coping behaviors;(2) risk perception is strongly correlated with fear and moderately correlated with anxiety;and (3) anxiety predicts the adoption of coping behaviors. The existing research provided an empirical basis for implementing effective coping behavior interventions and implied that management decisionmakers need to consider reasonable interventions through multiple channels to maintain the public's risk perception and emotions within appropriate levels. Finally, future research directions are suggested.

Multimodal negative sentiment recognition of online public opinion on public health emergencies based on graph convolutional networks and ensemble learning

To improve the effect of multimodal negative sentiment recognition of online public opinion on public health emergencies, we constructed a novel multimodal fine-grained negative sentiment recognition model based on graph convolutional networks (GCN) and ensemble learning. This model comprises BERT and ViT-based multimodal feature representation, GCN-based feature fusion, multiple classifiers, and ensemble learning-based decision fusion. Firstly, the image-text data about COVID-19 is collected from Sina Weibo, and the text and image features are extracted through BERT and ViT, respectively. Secondly, the image-text fused features are generated through GCN in the constructed microblog graph. Finally, AdaBoost is trained to decide the final sentiments recognized by the best classifiers in image, text, and image-text fused features. The results show that the F1-score of this model is 84.13% in sentiment polarity recognition and 82.06% in fine-grained negative sentiment recognition, improved by 4.13% and 7.55% compared to the optimal recognition effect of image-text feature fusion, respectively. © 2023 Elsevier Ltd

Genomics, metagenomics, and pan-genomics approaches in COVID-19

The coronavirus outbreak, which initially started in Wuhan China, has rapidly led to numerous morbidities and mortalities worldwide. Although potential antiviral and antiinflammatory medicines are available, several individuals are dying daily. In order to thoroughly tackle this deadly virus, the knowledge of genomics, metagenomics, and pan genomics is required, not only to devise new treatment regimens but also to improve the present approaches. Understanding the genomic organization, diversity and structural complexity of this virus can help to figure out several previously unanswered questions. SARS-CoV-2 corona virus comprises of four major structural proteins, namely, the spike surface glycoprotein, tiny envelope protein, matrix protein, and nucleocapsid protein along with accessory proteins that contribute to pathogenesis and persistence of the virus in one way or the other. This chapter covers genomics, metagenomics, and pan-genomics-based strategies that can facilitate to figure the possible mutational recombination and trace the phylogenetic background of the species. Sequencing has been performed and the hence derived viral sequences have been deposited into exclusive repositories to speed up research and explore targeted treatment options. Moreover, immunoinformatics approaches and reverse vaccinology have been applied to speed up the process of formulating reliable, safe, and specific therapeutic options, rapidly. © 2023 Elsevier Inc. All rights reserved.

COVID-19 uncertainty, pandemic management strategy, management control and public health performance

Purpose: Although the use of management control systems (MCS) in crisis management has received extensive attention, limited knowledge exists regarding the benefits of the broad scope, timeliness, integration and aggregation dimensions. This study aims at examining the performance implications of the context-structure combinations of pandemic management strategy (PMS), MCS use and pandemic-induced uncertainty of public health institutions (PHIs) in Ghana. Design/methodology/approach: Data were collected using online survey questionnaire where 246 public health managers qualified for the study. Data were analyzed using covariance-based structural equations modeling (version 23). Findings: PMS was found to have a significant and positive impact on three (broad scope, timeliness and aggregation) of the four dimensions. The integrated dimension was statistically insignificant. In addition, the three dimensions had a significant impact on top managers' satisfaction with MCS use, which in turn impact on cost containment and quality of care. Finally, COVID-19 uncertainty moderated the relationship between MCS use and operational performance. Practical implications: The three dimensions of broad scope, timeliness and aggregation are critical for PHIs when it comes to crisis management. Moreover, the presence of pandemics strengthens the relationship between top manager use of MCS and performance in health care. More sophisticated MCS information is required when managing pandemic-related crisis by PHIs. Originality/value: This study presents a theoretical framework that integrates PMS, MCS use and performance of public health care from a contingency perspective. It extends the benefits of contingency theory to include the three dimensions of MCS with respect to crisis management. © 2023, Emerald Publishing Limited.