The COVID-19 quandemic.

BACKGROUND: The terms syndemic and infodemic have both been applied to the COVID-19 pandemic, and emphasize concurrent socio-cultural dynamics that are distinct from the epidemiological outbreak itself. We argue that the COVID-19 pandemic has exposed yet another important socio-political dynamic that can best be captured by the concept of a quandemic - a portmanteau of "quantification" and "pandemic". MAIN TEXT: The use of quantifiable metrics in policymaking and evaluation has increased throughout the last decades, and is driven by a synergetic relationship between increases in supply and advances in demand for data. In most regards this is a welcome development. However, a quandemic, refers to a situation where a small subset of quantifiable metrics dominate policymaking and the public debate, at the expense of more nuanced and multi-disciplinary discourse. We therefore pose that a quandemic reduces a complex pandemic to a few metrics that present an overly simplified picture. During COVID-19, these metrics were different iterations of case numbers, deaths, hospitalizations, diagnostic tests, bed occupancy rates, the R-number and vaccination coverage. These limited metrics came to constitute the internationally recognized benchmarks for effective pandemic management. Based on experience from the Nordic region, we propose four distinct dynamics that characterize a quandemic: 1) A limited number of metrics tend to dominate both political, expert, and public spheres and exhibit a great deal of rigidity over time. 2) These few metrics crowd-out other forms of evidence relevant to pandemic response. 3) The metrics tend to favour certain outcomes of pandemic management, such as reducing hospitalization rates, while not capturing potential adverse effects such as social isolation and loneliness. 4) Finally, the metrics are easily standardized across countries, and give rise to competitive dynamics based on international comparisons and benchmarking. CONCLUSION: A quandemic is not inevitable. While metrics are an indispensable part of evidence-informed policymaking, being attentive to quandemic dynamics also means identifying relevant evidence that might not be captured by these few but dominant metrics. Pandemic responses need to account for and consider multilayered vulnerabilities and risks, including socioeconomic inequities and comorbidities.

Investigating the conditions of vulnerability experienced by migrant workers during the COVID-19 pandemic in Kerala, India.

This paper analyses findings of the 'PROWELLMIGRANTS'2 project, which qualitatively investigated COVID-19 impacts on migrants' well-being and mental health in Kerala, India. It draws on a novel conceptual framework that combines assemblage-thinking with theories of social contracts in disasters. The paper first explores how past development processes and contemporary migration policies in Kerala, and India more widely, generated conditions of vulnerability for migrant workers in Kerala prior to the pandemic. Next it shows that Government of Kerala interventions, in some cases supported by the central Government of India, temporarily addressed these vulnerabilities during the pandemic. In acknowledging the helpful response of the Kerala government, we problematise its stance on migrant workers during 'normal' times and speculate that permanently addressing these conditions of vulnerability would be a more logical approach. We acknowledge this involves overcoming many wider barriers. Thus, the paper also contains national-level policy implications.

The influence of cash assistance on the localisation agenda in Kenya's humanitarian sector.

Cash and voucher assistance (CVA) has gained importance as a modality for humanitarian disaster response during the last decade. Research has documented its benefits and listed challenges for implementation. Simultaneously, humanitarian organisations have committed to the localisation agenda to better serve people affected by disasters through local actors. These two ongoing transformations in the humanitarian sector may support or challenge each other. The authors use Kenya as a case study to analyse how CVA influences the localisation agenda in the humanitarian sector. Semi-structured key informant interviews were conducted with national and international organisations to gain insights on how the international organisations and their local implementing partners view and experience the mutual support or potential tensions between CVA implementations and the localisation agenda. The analysis is based on seven dimensions of localisation applied to CVA in Kenya based on existing frameworks. The findings indicate that CVA can support the localisation agenda if properly managed. It provides smaller organisations an opportunity to get involved without expensive structures. International organisations need to redefine their role and withdraw from direct implementation and be willing to give up power. The local organisations benefit from forming national networks that give them a voice within the humanitarian system. These transformations rely on personal leadership and on capacity development focusing on coordination, collaboration and organisational strengthening beyond the technical skills needed for implementation. Contribution: This study identifies how CVA and the localisation agenda affect each other in Kenya. This contributes to the understanding of the future development of the humanitarian sector.

The stagnation of innovation in humanitarian cash assistance.

Cash and voucher assistance (CVA) has been gaining traction among humanitarian organizations as the preferred aid modality in disaster relief and complex emergencies. While the advantages of cash are well documented, the ongoing digitalization of cash and the emergence of innovative financial instruments can be associated with new operational challenges and a stagnation in innovation. This paper reflects on the changing environment in CVA as a result of technological breakthroughs in the global financial system. The concept of humanitarian innovation is introduced to differentiate it from a similar process in the private sector and to investigate factors, contributing to a slower pace of acceptance, a reluctant implementation, or a complete rejection of innovative approaches in the humanitarian organization. The purpose of the study is to conceptualize the challenges of new technology adoption and scaling, as well as to analyze the direction and current stage of the diffusion of innovation in the humanitarian sphere. Ten interviews with informants representing humanitarian agencies and the private sector were conducted to discuss their experiences with new CVA tools and perspectives on innovation in cash and voucher assistance. The results demonstrate that there is no uniform perception of innovation across the field, and the challenges of diffusion can be associated with several domains, including internal and external capacities, inherent characteristics of new financial technology (fintech), and a wider social, political, and regulatory context. According to the cyclical model of technological change, the innovative CVA fintech is currently at the ferment stage characterized by a high level of uncertainty and competition. The subsequent emergence of several dominant designs followed by incremental innovation is plausible in the future.

The making of India's COVID-19 disaster: A Disaster Risk Management (DRM) Assemblage analysis.

This article analyses the suite of policies and measures enacted by the Indian Union Government in response to the COVID-19 pandemic through apparatuses of disaster management. We focus on the period from the onset of the pandemic in early 2020, until mid-2021. This holistic review adopts a Disaster Risk Management (DRM) Assemblage conceptual approach to make sense of how the COVID-19 disaster was made possible and importantly how it was responded to, managed, exacerbated, and experienced as it continued to emerge. This approach is grounded in literature from critical disaster studies and geography. The analysis also draws on a wide range of other disciplines, ranging from epidemiology to anthropology and political science, as well as grey literature, newspaper reports, and official policy documents. The article is structured into three sections that investigate in turn and at different junctures the role of governmentality and disaster politics; scientific knowledge and expert advice, and socially and spatially differentiated disaster vulnerabilities in shaping the COVID-19 disaster in India. We put forward two main arguments on the basis of the literature reviewed. One is that both the impacts of the virus spread and the lockdown-responses to it affected already marginalised groups disproportionately. The other is that managing the COVID-19 pandemic through disaster management assemblage/apparatuses served to extend centralised executive authority in India. These two processes are demonstrated to be continuations of pre-pandemic trends. We conclude that evidence of a paradigm shift in India's approach to disaster management remains thin on the ground.

A global mental health opportunity: How can cultural concepts of distress broaden the construct of immobility?

(Im)mobility studies often focus on people on the move, neglecting those who stay, are immobile, or are trapped. The duality of the COVID-19 pandemic and the climate crisis creates a global mental health challenge, impacting the most structurally oppressed, including immobile populations. The construct of immobility is investigated in the context of socio-political variables but lacks examination of the clinical psychological factors that impact immobility. Research is beginning to identify self-reported emotions that immobile populations experience through describing metaphors like feeling trapped. This article identifies links in the literature between Cultural Concepts of Distress drawn from transcultural psychiatry and immobility studies. Feeling trapped is described in mental health research widely. Among (im)mobile people and non-mobility contexts, populations experience various mental health conditions from depression to the cultural syndrome, nervios. The connection of feeling trapped to CCD research lends itself to potential utility in immobility research. The conceptualisation can support broadening and deepening the comprehension of this global mental health challenge - how immobile populations' experience feeling trapped. To broaden the analytical framework of immobility and incorporate CCD, evidence is needed to fill the gaps on the psychological aspects of immobility research.

Models of care for non-communicable diseases for displaced populations in Iraq: a scoping review.

Non-communicable diseases (NCDs) are the leading cause of death and disability globally. Their importance in humanitarian settings is increasingly recognised, but evidence about how best to address NCDs in these setting is limited. This scoping review aimed to explore models of NCD care for displaced populations in Iraq, in order to build evidence to design context adapted models of care. A search of key databases (Medline, Embase, Scopus, EconLit, Global Health, Web of Science, and the Iraqi Academic Scientific Journals) was conducted and complemented with grey literature and snowballing searches. Documents were included if they referred to models of NCD care for displaced populations. We synthesised the data using a conceptual model of care framework. The findings were reported according to the PRISMA guidelines for scoping reviews. We identified 4036 documents of which 22 were eligible for inclusion. Only six documents were peer-reviewed studies with most being internal reports, commentaries, or press releases. Of the 14 documents that reported on their methods, most applied quantitative approaches (n = 7), followed by mixed-methods (n = 5) and qualitative approaches (n = 2). Only one document reported on outcome data and none applied longitudinal study designs. Documents generally described individual framework dimensions, mostly centring around medicines, facility-based services, and selected access dimensions. Most dimensions had few or no references. The most common model for displaced populations in Iraq was primary-level centred care that complemented or supported existing-mostly tertiary-public health system structures. Additionally, private facilities played an important role and were frequently accessed by displaced populations in most settings. Quality of care, particularly patient-perceived quality, emerged as a critical factor for designing context-adapted models of NCD care. This review also identified a strong regionality of NCD care, particularly in terms of access rates and barriers. We concluded that there is a scarcity of evidence on the effectiveness of models of NCD care for displaced populations in Iraq, calling for capacity building initiatives focused on implementation research and evaluation.

COVID-19 in India: Who are we leaving behind?

The COVID-19 pandemic has uncovered and intensified existing societal inequalities. People on the move and residents of urban slums and informal settlements are among some of the most affected groups in the Global South. Given the current living conditions of migrants, the WHO guidelines on how to prevent COVID-19 (such as handwashing, physical distancing and working from home) are challenging to nearly impossible in informal settlements. We use the case of India to highlight the challenges of migrants and urban slum dwellers during the COVID-19 response, and to provide human rights-based recommendations for immediate action to safeguard these vulnerable populations.

Exploring the impacts of social media and crowdsourcing on disaster resilience.

Social media and crowdsourcing (SMCS) are increasingly proving useful for addressing the effects of natural and human-made hazards. SMCS allow different stakeholders to share crucial information during disaster management processes and to strengthen community resilience through engagement and collaboration. To harvest these opportunities there is a need for better knowledge on SMCS for diverse disaster scenarios. These challenges are being addressed within the LINKS Horizon 2020 project. The project aims at strengthening societal resilience by producing advanced learning on the use of SMCS in disasters. This is done through an in-depth study across three knowledge domains (disaster risk perception and vulnerability, disaster management processes, SMCS technologies), the establishment of an interactive framework, and an online platform in which a community of relevant stakeholders can learn and share knowledge and experiences. This paper provides an overview of the project objectives and approaches and a summary of the initial results.

Technology and Information Sharing in Disaster Relief.

This paper seeks to examine the extent to which technological advances can enhance inter-organizational information sharing in disaster relief. Our case is the Virtual OSOCC (On-Site Operations Coordination Centre) which is a part of the Global Disaster Alert and Coordination System (GDACS) under the United Nations Office for Coordination of Humanitarian Affairs (UN OCHA). The online platform, which has been developing for more than a decade, provides a unique insight into coordination behaviour among disaster management agencies and individual actors. We build our study on the analysis of a complete database of user interaction including more than 20,000 users and 11,000 comments spread across approximately 300 disaster events. Controlling for types and severities of the events, location-specific vulnerabilities, and the overall trends, we find that the introduction of new features have led to increases in user activity. We supplement the data-driven approach with evidence from semi-structured interviews with administrators and key users, as well as a survey among all users specifically designed to capture and assess the elements highlighted by both interviews and data analysis.

Housing reconstruction in disaster recovery: a study of fishing communities post-tsunami in chennai, India.

Disaster recovery after the Indian Ocean tsunami in 2004 led to a number of challenges and raised issues concerning land rights and housing reconstruction in the affected countries. This paper discusses the resistance to relocation of fishing communities in Chennai, India. Qualitative research methods were used to describe complexities in the debate between the state and the community regarding relocation, and the paper draws attention to the dimensions of the state-community interface in the recovery process. The results of this study highlight the effects of differences in the values held by each of the stakeholders regarding relocation, the lack of community participation, and thereby the interfaces that emerge between the state and the community regarding relocation. The failure to establish a nexus between disaster recovery and the importance of a sustainable livelihood for fishing communities severely delayed housing reconstruction.