Evidence map›Paper›PMID 34497031›Full record

ArticleHealth policy (Amsterdam, Netherlands)2022

A comparison of 2020 health policy responses to the COVID-19 pandemic in Canada, Ireland, the United Kingdom and the United States of America.

Lynn Unruh, Sara Allin, Greg Marchildon, Sara Burke, Sarah Barry, Rikke Siersbaek, Steve Thomas, Selina Rajan, Andriy Koval, Mathew Alexander and 3 more

Erratum issuedOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health policy (Amsterdam, Netherlands), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 70 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 2 pooled it
11.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 2 syntheses or guidelines pooled it, 151 citations in OpenAlex.

  1. Pooled it
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  14. SIRI+Q model with a limited capacity of isolation.Theory in biosciences = Theorie in den Biowissenschaften · 2025
    Article
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  17. Review
  18. Article
  19. Primary care in the COVID-19 pandemic and beyond: Lessons from Ontario.Canadian family physician Medecin de famille canadien · 2025
    Article
  20. Article

10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 5 countries.

Lynn UnruhDepartment of Health Management and Informatics, University of Central Florida, 12494 University Blvd, Orlando, FL, USA. Electronic address: lynn.unruh@ucf.edu.
Sara AllinInstitute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada. Electronic address: sara.allin@utoronto.ca.
Greg MarchildonInstitute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada. Electronic address: greg.marchildon@utoronto.ca.
Sara BurkeCentre for Health Policy and Management, School of Medicine, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland. Electronic address: burkes17@tcd.ie.
Sarah BarryCentre for Health Policy and Management, School of Medicine, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland. Electronic address: barrys6@tcd.ie.
Rikke SiersbaekCentre for Health Policy and Management, School of Medicine, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland. Electronic address: rsiersba@tcd.ie.
Steve ThomasCentre for Health Policy and Management, School of Medicine, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland. Electronic address: thomassd@tcd.ie.
Selina RajanDepartment of Health Services Research and Policy, The London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK. Electronic address: Selina.rajan@lshtm.ac.uk.
Andriy KovalDepartment of Health Management and Informatics, University of Central Florida, 12494 University Blvd, Orlando, FL, USA. Electronic address: Andriy.v.koval@ucf.edu.
Mathew AlexanderVirginia Commonwealth University, School of Medicine, Richmond, VA 23284, USA. Electronic address: alexandermv@mymail.vcu.edu.
Sherry MerkurEuropean Observatory on Health Systems and Policies, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK. Electronic address: s.m.merkur@lse.ac.uk.
Erin WebbDepartment of Health Care Management, Berlin University of Technology, Berlin, Germany. Electronic address: e.webb@tu-berlin.de.
Gemma A WilliamsEuropean Observatory on Health Systems and Policies, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK. Electronic address: g.a.williams@lse.ac.uk.
Trinity College Dublin · IELondon School of Economics and Political Science · GBUniversity of Central Florida · USUniversity of Toronto · CABerliner Hochschule für Technik · DELondon School of Hygiene & Tropical Medicine · GBVirginia Commonwealth University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This paper compares health policy responses to COVID-19 in Canada, Ireland, the United Kingdom and United States of America (US) from January to November 2020, with the aim of facilitating cross-country learning. Evidence is taken from the COVID-19 Health System Response Monitor, a joint initiative of the European Observatory on Health Systems and Policies, the WHO Regional Office for Europe, and the European Commission, which has documented country responses to COVID-19 using a structured template completed by country experts. We show all countries faced common challenges during the pandemic, including difficulties in scaling-up testing capacity, implementing timely and appropriate containment measures amid much uncertainty and overcoming shortages of health and social care workers, personal protective equipment and other medical technologies. Country responses to address these issues were similar in many ways, but dissimilar in others, reflecting differences in health system organization and financing, political leadership and governance structures. In the US, lack of universal health coverage have created barriers to accessing care, while political pushback against scientific leadership has likely undermined the crisis response. Our findings highlight the importance of consistent messaging and alignment between health experts and political leadership to increase the level of compliance with public health measures, alongside the need to invest in health infrastructure and training and retaining an adequate domestic health workforce. Building on innovations in care delivery seen during the pandemic, including increased use of digital technology, can also help inform development of more resilient health systems longer-term.

Indexed as

COVID-19CanadaHealth PolicyHumansIrelandPandemicsUnited KingdomUnited StatesCOVID-19EuropeGovernmentNorth AmericaPublic healthWorkforce

Identifiers

PMID34497031
PMCPMC9187506
OpenAlexW3175500537

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.