

Among the various actors within health system, this study specifically focuses on the executive branch of the government. The WHO has defined health system explicitly to capture “all the activities whose primary purpose is to promote, restore or maintain health ”. Exploring what drives timelier response may point future health system researchers in fruitful directions. This study aims to explore why health systems differ in their timeliness of issuing policy responses to COVID-19 before the epidemic took hold within their health system. Nevertheless, their work was focused on generating hypotheses rather than testing hypotheses, and as such, there is a dearth of literature that systematically tests a developed hypothesis on what affects timeliness of epidemic response. They concluded that more prepared health systems had pandemic response integrated into national disaster preparedness framework, lower public health official turnovers, previous pandemic exposures, and more political emphasis on preparedness. examined the six Asian health systems’ preparedness for an influenza pandemic. One study, however, did attempt such a methodology. The literature has typically shied away from rigorous frameworks to examine how timely response to epidemics could be enacted.

It mobilized its personnel to begin collecting more information, quickly developed briefings for staff members and the general public, and posting travel updates. For example, the United States (US) Center for Disease Control (CDC) documented that it responded quickly within the month that the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) case was reported to the online Program for Monitoring Emerging Diseases. Other attempts to explore epidemic response timeliness have typically drawn on sporadic post hoc reviews or case studies. However, these indices were constructed neither systematically nor empirically. They constructed operational readiness index based on select metrics from the domains of a) technical abilities, including the ability to conduct surveillance, contact tracing, and infection prevention b) governance capacity, marked by capacity for multisectoral collaboration, emergency risk communication and c) resource availability, defined in terms of finances, and human resources. examined in 2020 the capacity for 182 countries to respond to public health emergencies. However, there is little rigorous exploration on what drives timeliness of policy response to epidemics. There has been report of improving timeliness of disease outbreak recognition. Therefore, it is particularly important to examine how the pandemic could have been limited to earlier stages. Asymptomatic transmission as is the case for COVID-19 may elude effective containment strategies unless implemented universally, leading to exponential case growth that overwhelm the health system.

Later interventions may be also less effective.

In contrast, interventions once a disease has established a foothold may require expensive life-supporting therapies or aggressive public health measures that might cause significant socioeconomic disruptions. Earlier interventions are particularly worthwhile, as such policies might use simpler techniques such as border control or isolated case finding followed by quarantine. The drastic consequences of COVID-19 highlight the need to identify tactics that could have mitigated these outcomes.
