Integrated socio-economic, political and health implications of COVID-19 and intervention strategies

3.1 Impacts of intervention strategies and physical distancing

Impacts of intervention strategies and physical distancing, including cultural and social value aspects, as well as behavioural, lifestyle, economic and ethical aspects (e.g. conflicts between generations). The aim would be to estimate changes in environmental, lifestyle (physical activity, change in diet) and socioeconomic factors (uncertainties, mixed messages from authorities in different media) due to COVID-19, during control measures/confinement and post-confinement, and effects on health including impact on social and health inequalities, focusing in particular on the most vulnerable population groups. Several objectives are relevant: evaluate or compare the impact of intervention strategies on post-traumatic stress and mental health and behaviour and their precursors of loneliness and isolation, depression and anxiety which undermine healthy and active lifestyles; evaluate impacts of intervention strategies on domestic violence; evaluate interventions that support resilience and recovery of citizens, communities and societies in the short-, medium- and long-term (e.g. extension of safer public spaces, green infrastructures, cycling lanes, local shops); assess the communication between affected populations, health professionals and authorities and the level and type of citizen engagement which is critical for the exit strategies.

3.2 Interaction between COVID-19 and the built environment.

There are still uncertainties on how COVID-19 pandemic will reshape the urban built environment and how the built environment influences the occurrence and severity of the disease. What has been the role of cities structure in transmission and impact of the disease? Specific questions are: evaluate transport modes in the post-confinement period; explore the role of urban density by e.g. assessing average person-to-person distance in different city 4 structures and lay-outs as well as various urban settings; how to redesign public spaces to enable safe outdoor physical and social activities for all while mitigating climate change (green/blue space); focus on the interaction between built environment, COVID-19 and vulnerable populations including the elderly and the maternal and child health and wellbeing.

3.3 COVID-19 and the work environment. The objective is to examine short term risks particularly infection, stress and burnout and develop evidence-based protocols for the prevention of those risks taking into account engineering, administrative/organisational approaches and use of personal protective equipment (PPE). Another objective is to assess and evaluate long term effects of the COVID-19 pandemic and the post-pandemic period on new economic settings, including types of employment, working patterns and unemployment.

3.4 Implementation research of integrated social, economic, and environmental policies.

In many cases discussed in this paper, scientific knowledge is available, but the implementation of decisions for successfully managing health risk is not straightforward. Therefore, implementation research is relevant as a cross-cutting proposal and several suggestions are discussed here. One direction would be to support the creation, synthesis, and application of interdisciplinary knowledge to strengthen research on implementation with a focus on integrated social, economic, and environmental policies. Implementation research should integrate small scale experimental settings as well as large scale cohorts mapping the Europe-wide setting and integrating ongoing long-term efforts across Europe to understand health impact related to COVID-19 and societal responses in populations and patients. Research should develop and examine novel concepts to integrate the continuum from wellbeing to therapeutic successes as potential outcomes and measures of healthy urban and rural environments. Implementation research is needed to guide future interventions and novel technological developments especially for mitigation of undesired effects of social/physical distancing and confinement measures. Research should focus on technologies, knowledge and stakeholder involvement to deliver win–win solutions and co-benefits, and rapid scale-up facilitated through research on implementation of potential solutions.

3.5 Political implications balancing economic and environmental strategies.

A major question is how to “steer” the economy towards a sustainable path during recovery, to avoid “rebound” of production and consumption harmful to public health and the environment. Other implications are to collect and assess the lessons learned from the COVID-19 crisis for the climate crisis and assess the factors that triggered a different response to the COVID-19 pandemic compared to the climate or other environmental crises. Research is needed to support the following objectives: to communicate urgency and uncertainty (incl. the precautionary principle) and to assess the role of scientists and experts, citizens and local authorities; to implement and evaluate intervention measures and define the conditions for public acceptance notably through citizen involvement in design and/or evaluation; to communicate science to the public, media and politicians (discuss role of scientists and experts); to balance between imposed changes though policies and laws and incentives and voluntary changes in informed and engaged populations; to implement sustainable changes and to promote triple wins - health, equity and environmental sustainability in policies and measures; to balance between health and environmental protection versus economic needs and interests; to achieve protection of vulnerable groups and reduction of social inequalities (vulnerability, exposure, cost of mitigation action, “leave no one behind”).