Matthew M. Kavanagh

Bio: Matthew M. Kavanagh is an academic researcher from Georgetown University. The author has contributed to research in topics: Global health & Health policy. The author has an hindex of 14, co-authored 41 publications receiving 483 citations. Previous affiliations of Matthew M. Kavanagh include University of Washington & University of North Carolina at Chapel Hill.

Democracy, Capacity, and Coercion in Pandemic Response: COVID-19 in Comparative Political Perspective.

Abstract: The COVID-19 pandemic has challenged governments around the world. It also has challenged conventional wisdom and empirical understandings in the comparative politics and policy of health. Three major questions present themselves: First, some of the countries considered to be most prepared-having the greatest capacity for outbreak response-have failed to respond effectively to the pandemic. How should our understanding of capacity shift in light of COVID-19, and how can we incorporate political capacity into thinking about pandemic preparedness? Second, several of the mechanisms through which democracy has been shown to be beneficial for health have not traveled well to explain the performance of governments in this pandemic. Is there an authoritarian advantage in disease response? Third, after decades in which coercive public health measures have increasingly been considered counterproductive, COVID-19 has inspired widespread embrace of rigid lockdowns, isolation, and quarantine enforced by police. Will these measures prove effective in the long run and reshape public health thinking? This article explores some of these questions with emerging examples, even amid the pandemic, when it is too soon to draw conclusions.

Mobility restrictions were associated with reductions in COVID-19 incidence early in the pandemic: evidence from a real-time evaluation in 34 countries.

Abstract: Most countries have implemented restrictions on mobility to prevent the spread of Coronavirus disease-19 (COVID-19), entailing considerable societal costs but, at least initially, based on limited evidence of effectiveness. We asked whether mobility restrictions were associated with changes in the occurrence of COVID-19 in 34 OECD countries plus Singapore and Taiwan. Our data sources were the Google Global Mobility Data Source, which reports different types of mobility, and COVID-19 cases retrieved from the dataset curated by Our World in Data. Beginning at each country's 100th case, and incorporating a 14-day lag to account for the delay between exposure and illness, we examined the association between changes in mobility (with January 3 to February 6, 2020 as baseline) and the ratio of the number of newly confirmed cases on a given day to the total number of cases over the past 14 days from the index day (the potentially infective 'pool' in that population), per million population, using LOESS regression and logit regression. In two-thirds of examined countries, reductions of up to 40% in commuting mobility (to workplaces, transit stations, retailers, and recreation) were associated with decreased cases, especially early in the pandemic. Once both mobility and incidence had been brought down, further restrictions provided little additional benefit. These findings point to the importance of acting early and decisively in a pandemic.

The Right to Health: Institutional Effects of Constitutional Provisions on Health Outcomes

Abstract: The “right to health” is increasingly enshrined in national constitutions around the world—present today in a slight majority of written constitutions. Whether this trend is good, bad, or meaningless is considerably debated. Contrary to skeptics’ worries, this study finds empirical evidence of a positive role of the right to health in the production of population health. Estimating the most widely promulgated theories of the economic and social determinants of health, and the role of electoral democracy, provides a foundation from which to evaluate the effect of the right to health. This study assembles and analyzes data for 144 countries between 1970 and 2010 and finds that, controlling for these factors, a constitutional right to health contributes significantly to wellbeing. Assembled quantitative and case-study evidence both support the idea that institutional environments shaped by a right to health encourage more and better delivery of health services, which in part account for positive impact on health outcomes. These results suggest that focusing research on political institutions primarily on democratic participation rights ignores important impacts of “entitlement” rights on norms and actors in health policy-making. Overall, the right to health is both an important contextual factor for health research and meaningful institutional innovation.

Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study.

Abstract: Summary Background A range of public health measures have been implemented to suppress local transmission of coronavirus disease 2019 (COVID-19) in Hong Kong. We examined the effect of these interventions and behavioural changes of the public on the incidence of COVID-19, as well as on influenza virus infections, which might share some aspects of transmission dynamics with COVID-19. Methods We analysed data on laboratory-confirmed COVID-19 cases, influenza surveillance data in outpatients of all ages, and influenza hospitalisations in children. We estimated the daily effective reproduction number (Rt) for COVID-19 and influenza A H1N1 to estimate changes in transmissibility over time. Attitudes towards COVID-19 and changes in population behaviours were reviewed through three telephone surveys done on Jan 20–23, Feb 11–14, and March 10–13, 2020. Findings COVID-19 transmissibility measured by Rt has remained at approximately 1 for 8 weeks in Hong Kong. Influenza transmission declined substantially after the implementation of social distancing measures and changes in population behaviours in late January, with a 44% (95% CI 34–53%) reduction in transmissibility in the community, from an estimated Rt of 1·28 (95% CI 1·26–1·30) before the start of the school closures to 0·72 (0·70–0·74) during the closure weeks. Similarly, a 33% (24–43%) reduction in transmissibility was seen based on paediatric hospitalisation rates, from an Rt of 1·10 (1·06–1·12) before the start of the school closures to 0·73 (0·68–0·77) after school closures. Among respondents to the surveys, 74·5%, 97·5%, and 98·8% reported wearing masks when going out, and 61·3%, 90·2%, and 85·1% reported avoiding crowded places in surveys 1 (n=1008), 2 (n=1000), and 3 (n=1005), respectively. Interpretation Our study shows that non-pharmaceutical interventions (including border restrictions, quarantine and isolation, distancing, and changes in population behaviour) were associated with reduced transmission of COVID-19 in Hong Kong, and are also likely to have substantially reduced influenza transmission in early February, 2020. Funding Health and Medical Research Fund, Hong Kong.

Pandemics, transformations and tourism: be careful what you wish for

Abstract: Disease outbreaks and pandemics have long played a role in societal and economic change. However, the nature of such change is selective, meaning that it is sometimes minimal and, at other times, and change or transformation may be unexpected, potentially even reinforcing contemporary paradigms. A comprehensive overview of pandemics and their effects is provided. This is used to help contextualise the COVID-19 pandemic, its impact on tourism and government, industry and consumer response. Drawing on the available literature, factors that will affect tourism and destination recovery are then identified. Some measures will continue or even expand present growth orientations in tourism while others may contribute to sustainability. It is concluded that that the selective nature of the effects of COVID-19 and the measures to contain it may lead to reorientation of tourism in some cases, but in others will contribute to policies reflecting the selfish nationalism of some countries. However, the response to planetary limits and sustainable tourism requires a global approach. Despite clear evidence of this necessity, the possibility for a comprehensive transformation of the tourism system remains extremely limited without a fundamental transformation of the entire planet.