Contested and Evolving Pandemic - A Follow-up Study on National Policymakers' Interpretations

Abstract Background The prolongation of the COVID-19 pandemic has shown that perceptions of the crisis change over time. In this follow-up study we explore how national level policymakers interpret COVID-19 pandemic as a past, present, and future event and crisis. By doing so the contested nature of pandemic governance reveals, i.e. that the interpretations of the on-going crisis shape the policy choices and health system response. National policymakers have been demanded to make sense of emergent and ambiguous events and to form public health actions accordingly. Different interpretations on pandemic have been in core of pandemic governance and have influenced public policy and pandemic responses. Methods We applied a qualitative follow-up research design. Study informants were identified by purposive sampling by their position as central government pandemic policymakers in Finland. The semi-structured interviews were collected in 2021 (n = 21) after the first two pandemic waves, and in winter 2022-2023 (n = 16) after full vaccinations of the population. Results Three interpretations of COVID-19 were identified: Underlining the hard work needed to overcome the crisis, pandemic as a past event was framed through undeniable success. As an ongoing crisis, pandemic was discussed as having become mundane and less important on the public health agenda. As future crisis the pandemic was merged into a continuum of other (non-public health related) crises instead of being reflected solely from health perspectives. Conclusions The way of interpreting a crisis has significant influence on public policy. Prolonged pandemic showed contested nature of public health crisis in general public policy agenda; and its’ ending was not represented as clear cut, as it dissolved and was entwined into other crises and agendas. Crisis interpretations effect on future, since they profoundly affect how crises responses, future pandemic preparedness, policies or evaluation of effects are framed and formed. Key messages • Conceptions on COVID-19 crisis evolve in time and they effect policies to be formed. • Contested nature of pandemic draws attention from solely public health policies into continuum of crises on public policy agenda.