How Previous Epidemics Enable Timelier COVID-19 Responses: A Cross-Sectional Study Using Organizational Memory Theory
Abstract
Introduction
There has been little systematic exploration of what affects timeliness of epidemic response, despite the potential for earlier responses to be more effective. Speculations have circulated that exposure to major epidemics helped health systems respond more quickly to COVID-19. This study leverages organizational memory theory to test whether health systems with any, more severe, more recent exposure to major epidemics enacted timelier COVID-19 policy responses.
Methods
A dataset was constructed cataloguing 846 policies across 178 health systems in total, 37 of which had major epidemics within the last twenty years. Hypothesis testing used OLS regressions with WHO region fixed effects, controlling for several health system expenditure and political variables.
Results
Results show that exposure to any major epidemics was significantly associated with providing earlier response in any category or for surveillance / response, distancing, and international travel policies when tested alone or with total number of cases. The effect was about six to ten days earlier response. The significance was largely nullified with additional independent variables. Both total cases and years since previous epidemics showed no statistical significance.
Conclusion
This study suggests that health systems may learn from past major epidemics. Policymakers ought to institutionalize lessons from COVID-19. Future studies can examine specific generalizable lessons and whether timelier responses correlated with lower health and economic impacts.
What is already known about this subject?
There has been little systematic exploration into what affects the timeliness of response to epidemics. For COVID-19, there has been speculation that previous exposure to major epidemics may have spurred timelier responses.
What are the new findings?
Applying organizational memory theory, this study identified policy response timeliness to COVID-19 was significantly associated with any past exposure to major epidemics within the last 20 years.
What are the recommendations for policy and practice?
The fact that any exposure to past epidemics is significantly associated with timelier responses suggest that health systems do learn from past mistakes. Institutionalizing the learnings through more permanent policies. Once COVID-19 fades, health systems may wish to revitalize the organizational memory through various exercises.
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