ORIGINAL RESEARCH article
Front. Public Health
Sec. Disaster and Emergency Medicine
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1652309
This article is part of the Research TopicInnovative Strategies for Urban Public Health Resilience in Crisis SituationsView all 25 articles
Towards resilience for public health emergency response system during COVID-19: qualitative comparative analyses of 40 countries
Provisionally accepted
- 1Research Center of Smart City, Nanjing Tech University, Nanjing, China
- 2Department of Management Science and Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
- 3Department of Applied Physics and Electronics, Umea Universitet, Umeå, Sweden
- 4School of Civil Engineering, Nanjing Forestry University, Nanjing, China
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As a critical defense mechanism against COVID-19, the national public health emergency response system (PHERS) with high resilience enables effective identification, absorption, and resistance of epidemic crises. This resilience is essential for safeguarding public health and rapidly restoring social stability. However, existing studies primarily focus on single-aspect strategies in specific countries, lacking a systematic understanding of how resilience strategies influence PHERS resilience outcomes. Therefore, this study aims to establish evidence-based and configurational resilience strategies to improve the effectiveness of PHERS in responding to epidemic threats. This study proposes a theoretical framework to characterize resilience strategies and resilience outcomes for PHERS. The fuzzy-set quali-tative comparative analysis (fsQCA) method is applied to analyze data from 40 countries during the COVID-19 crisis. The findings reveal three configuration paths to enhance robustness and three paths to enhance rapidity. These re-sults emphasize the importance of the synergistic implementation of containment and closures, travel control, public personal protection, and early virus detection in improving PHERS resilience. This study provides a structured ap-proach to understanding PHERS resilience by identifying key configuration paths that enhance robustness and ra-pidity. The results offer actionable insights for designing resilient PHERS to better respond to future epidemics.
Keywords: COVID-19, Public health emergency response system (PHERS), resilience, Fuzzy set qualitative comparative analysis, Configuration analysis
Received: 23 Jun 2025; Accepted: 05 Sep 2025.
Copyright: © 2025 Li, Tang, Zhu, Chen and Cui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yudi Chen, Department of Management Science and Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, China
Peng Cui, Department of Applied Physics and Electronics, Umea Universitet, Umeå, Sweden
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