Emergency response to the COVID-19 pandemic and beyond: Qualitative content analysis

2.1 Pandemic management

A pandemic refers to an epidemic of an infectious disease that spreads over a broad region and affects a large number of people. Several pandemics have impacted human societies throughout history, including tuberculosis, smallpox, the Black Death, the Spanish flu, and COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first (officially) caused COVID-19 in Wuhan, China, at the end of 2019 (Hu et al., 2021). Since then, the COVID-19 outbreak has had catastrophic consequences for humankind as it spread rapidly through global connectivity.

Some pandemics are caused by animal viruses, such as Ebola, Zika, and SARS-CoV-2, being transmitted to humans. The diseases caused by these viruses are known as zoonoses. Humans generally have little to no immunity against them. Considering that COVID-19 is a zoonosis, no patient was safe from it. Furthermore, as COVID-19 was a newly discovered disease, no established or clear guidelines were initially available regarding response measures against this disease in terms of medical science or emergency management.

Pandemic management is the managerial function of coping with a pandemic to reduce related vulnerabilities. Similar to other types of emergency management, the lifecycle of pandemic management comprises four phases: emergency prevention/mitigation, preparedness, response, and emergency recovery (FEMA, 2006). The emergency response phase begins when an outbreak becomes imminent. This phase addresses not only the short-term but also the direct effects of the pandemic, considering that dire pandemics with infectious agents and toxins occur within a relatively short period.

2.2 Previous studies

Many scholars and practitioners have discussed the societal implications of the COVID-19 outbreak in terms of pandemic management, including Deborah Lupton, Richard Horton, Julie Swann, and Anthony Fauci. Their studies frequently utilized government reports (Watson, 2020; WHO, 2020). Several international organizations, including the World Health Organization (WHO), World Bank Group, Organization for Economic Co-operation and Development, and World Economic Forum, addressed this issue for their own purposes, and their individual efforts significantly reflected the need for a rapid response to the COVID-19 outbreak.

Most of the aforementioned scholars and practitioners support certain principles of pandemic management. Similarly, in the whole-society approach, various stakeholders in a society progressively deal with unpredictable and wide-ranging threats to their regions over time (USAID et al., 2021). These stakeholders aim to link traditional partners, such as emergency managers, firefighters, and civil engineers, as well as nontraditional partners, such as health workers, farmers, soldiers, and ordinary citizens.

Moreover, the whole-society approach supports the role of multiple sectors in society, rather than only one or two stakeholders, during an emergency response to a pandemic. This approach facilitates the participation of diverse sectors in pandemic management, including government institutions at all levels, the health sector (e.g., healthcare services and public health), non-health sectors, voluntary organizations, families, and individuals.

The importance of comprehensive emergency management has often been emphasized in COVID-19 research. The U.S. National Governors Association introduced the term “comprehensive emergency management” as a guideline for the newly established Federal Emergency Management Agency (FEMA) during President Jimmy Carter’s administration (National Governors’ Association, 1979). Since then, comprehensive emergency management has been a fundamental principle in pandemic management, regardless of national boundaries. Particularly, the idea has evolved into one of the guiding concepts for pandemic management in the field.

Comprehensive emergency management comprises four major elements. While stakeholders include various professional entities—such as governments, the private sector, non-governmental organizations, and local communities, each with their own priorities—comprehensive emergency management transcends organizational boundaries and addresses all types of emergencies, including natural disasters (or natural hazards) and man-made emergencies. It also encompasses all four phases of emergency management. Finally, it addresses all types of risks, including the physical and social impacts of an emergency (Carson, 2024).

The term “integrated policy” has a context similar to that of comprehensive emergency management (World Bank Group, 2020). Integration entails forming various networks or interrelationships among stakeholders in pandemic management. The integrated policy incorporates not only the public sector but also the private sector and other groups in the fight against the COVID-19 outbreak. Simultaneously, such policies flexibly collect, collate, and analyze information, data, and experiences from multiple sectors to achieve effective pandemic management.

Governments and organizations establishing and subsequently embracing e-health systems during the COVID-19 outbreak is a good example of integrated policy (Chilunjika & Chilunjika, 2023). The COVID-19 pandemic has profoundly altered the delivery of health services around the world and the legislative actions taken to combat it. E-health systems, which provide quick, easy, safe, and efficient care options while reducing the spread of viruses, have now become essential tools for guaranteeing people’s continuous access to healthcare. Through interoperable networking, e-health systems have the potential to strengthen public health systems globally (Jilani et al., 2023).

A multidisciplinary approach requires various disciplines to address specific research questions, including medicine, public health, psychology, law, climatology, and engineering. To define an unexpected problem or provide a revolutionary solution beyond traditional boundaries, multidisciplinary research in this context is required in complicated fields (Gomez-Cantarino et al., 2024). Nevertheless, some scholars have explained the rationale behind not opting for a multidisciplinary approach in certain areas, such as pushing further within a subject, mastering a specialty, or working on single-discipline-based research. Scholars with a strong belief in disciplinary approaches have emphasized the issue of logical sequences within the same subject.

The field of pandemic management has also recognized the significance of a multidisciplinary approach to the COVID-19 outbreak in terms of capacity enhancement, risk assessment, and all activities in the emergency management cycle (Romei et al., 2020). While creating a comprehensive framework, scholars have encountered various challenges and alternatives during data interpretation, program evaluation, and decision-making. Notably, a multidisciplinary approach is known to be applicable to pandemic management.

Based on the above principles, the modeling approach has been widely applied in several cases (Shearer et al., 2020). Modeling helps represent the abstractions of a complicated reality. For example, Fox and Kilbourne (1973) proposed a pandemic simulation model to examine the effects of extensive school vaccinations. In 2009, many official documents elaborating related models included various assumptions regarding pandemic management. During the outbreaks of the H1N1 virus, West African Ebola virus, and other diseases over the last decade, a few models have contributed to improving emergency response capabilities in some regions.

Creating an appropriate model can solve specific problems in pandemic management. Although some models, such as computer and mathematical models, can be complicated and difficult to understand, others, which include diagrams, pictures, and flowcharts, tend to be simpler and easier to grasp. Considering that knowledge and information regarding the COVID-19 outbreak should be accessible or easily understandable to the general public, a simplified model is preferred in this research field.

Additionally, the proposal of a theoretical framework(s) is considered one of the most significant aspects of the research field (Grant & Osanloo, 2014). By literally or metaphorically integrating a wide range of knowledge into the research, a theoretical framework can serve as a structure for research questions, objectives, and alternatives. Therefore, supported by a theoretical framework, an organized flow of emergency responses to the COVID-19 outbreak may be more easily understood by the general public.

2.3 Features of this study

This study proposes the “Earth as a comprehensive system” approach toward a more efficient response to the COVID-19 outbreak than the one currently in place. This approach views the emergency response to the COVID-19 outbreak as an organic system or a unitary whole comprising interdependent factors (Chand, 2023). The term “comprehensive” flexibly includes all those factors. The phrase “Earth as a comprehensive system” implies that the entire field of pandemic management (or the Earth) comprehensively responds to the outbreak of COVID-19 as a robust system while also enhancing pandemic management principles, modeling techniques, and theoretical frameworks.

What distinguishes this study from others is its potential merits, in that it attempts to include all the major factors of the COVID-19 emergency response into the framework. Specifically, the “Earth as a comprehensive system” approach explores important factors regarding pandemic management more comprehensively than previous studies, as the approach is not oriented toward an individual or institutional goal but a universal one. Therefore, the theoretical model proposed in this study will be easy to understand and comprehend for any individual, institution, or nation that urgently requires a big picture of the emergency response to the coronavirus infection.

“Earth as a comprehensive system” offers an innovative perspective of pandemic management. However, many components of the model have already been identified in previous studies (Aljuneidi et al., 2023). Still, the distinctive feature of this work is the way it unifies and integrates these components into a coherent model that views the emergency response to COVID-19 as a global, interconnected system rather than a collection of discrete or sector-specific initiatives. The goal of this approach is to provide a more approachable and internationally relevant viewpoint by eschewing a limited emphasis on individual or institutional outcomes.

3.1 Qualitative content analysis

A qualitative content analysis comprises three steps: preparation, organization, and reporting (Elo et al., 2014). In this study, the preparation step included data collection (e.g., collecting textual data on pandemic management and COVID-19), sampling (e.g., choosing appropriate emergency management principles and one country from each of six continents), and selection of the unit of analysis (e.g., using appropriate search words, such as coronavirus infection, emergency response failures, and system approach). Thus, a major criterion for text exclusion/inclusion was a work’s relation to the pandemic management principles, COVID-19 outbreak, emergency response frameworks, system approach, six continents, and others.

The organization step includes categorization (e.g., creating four categories—stakeholders, foundational attributes, core functions, and environment—from the eight overarching factors) and interpretation (e.g., classifying the eight underlying factors into eight overarching factors and interpreting other text data for the main theme). This step is critical for structuring text data to align with the study’s objectives and allows for an in-depth examination of the interaction of these factors within pandemic management.

Lastly, the reporting step offers improved results and process reporting (this includes summarizing systematic results and processes in the suggested Earth system model, for example) (Fabiano et al., 2024). Simultaneously, this step highlights the importance of disclosing methods and findings transparently to enhance reproducibility and rigor in the analysis. Providing insights for future studies on a worldwide, systemic approach to pandemic management entails synthesizing findings to represent the comprehensive framework used.

3.2 Text analysis and synthesis

This study focused on text analysis and synthesis out of the three steps mentioned above. Likewise, to create a theoretical framework for the emergency response to the COVID-19 outbreak, we initiated the identification of important issues (i.e., the eight underlying factors) on various websites. These eight issues usually comprise the negative aspects of the topic. Two criteria were considered for selecting the eight issues. First, each issue had to have significant implications in terms of the emergency response, particularly based on the subjective perspective of the author and the evaluation of each website. In short, these underlying factors were selected because they could broadly influence and directly contribute to response inefficiencies. Second, to achieve comprehensiveness, at least one issue had to originate from each of these six continents: South America (Brazil), North America (the United States), Europe (Sweden), Asia (China), Africa (South Africa), and Oceania (Australia). Russia and several international organizations were included because of their unique and significant features.

We identified eight overarching factors that, when combined, made up the “Earth as a comprehensive system” approach, building on the eight underlying factors. The selection of the overarching factors was based on their representation of core qualities that could balance challenging problems by promoting a comprehensive framework for pandemic response (Arani et al., 2024). This Earth perspective aims to bridge isolated actions into a unified response framework, addressing the pandemic’s complexities through synergy.

To capture the essential aspects of global emergency response, these overarching factors were organized into four categories: stakeholders (three key participants), foundational attributes (two basic characteristics), core functions (two critical emergency functions), and environment (major circumstances). These four categories thoroughly covered the who, what, how, and where of emergency response, ensuring that every important component was considered. These categories provided a comprehensive basis that could be applied to a variety of international contexts.

Both PRISMA checklist and flow diagram were used in this work to support the entire methodology approach (please see Data Availability Statement) (Ha, 2025). The qualitative content analysis in this study is substantially more transparent, accurate, and comprehensive, thanks to the PRISMA checklist and flow diagram (Innocenti et al., 2022). Several databases and search engines, such as SCOPUS, ProQuest, PubMed, Web of Science, Oxford University Press, and Google.com, were employed in the process. In the end, 54 texts were included in this study, which comprised research articles (38), books (1), government documents (9), and webpages (6).

4.1 Underlying factors for the Earth emergency

4.1.1 Leaders’ inability

Among several international organizations, the underfunded WHO is supposed to lead its member states in responding to the COVID-19 outbreak. During the initial phases of the outbreak, although many health experts suspected China as the origin of the novel coronavirus infection, the WHO Director-General, Tedros Ghebreyesus, failed to consider the related information in a timely manner (Cretois & Marbot, 2020). Moreover, the leader was overly cautious while considering the change in disease status from an epidemic to a pandemic, which hindered emergency responses in many regions.

4.1.2 Focus on economic recovery

President Jair Bolsonaro of Brazil maintained that economic recovery was more important than human losses during the COVID-19 outbreak. He argued that coronavirus restrictions, such as social distancing and lockdown measures, harmed the national economy and reasoned that people would die without jobs. Consequently, he opted to reopen businesses despite clashes with other politicians. While the Brazilian economy fared better than expected, the number of lives lost and infected individuals increased significantly.

4.1.3 Controversies on wearing a face mask

In the United States, cultural, political, medical, and scientific aspects caused divisions regarding the usage of face masks in public settings during the COVID-19 pandemic (Kahane, 2021). One group, including former U.S. President Donald Trump, dismissed the need for a face mask, while another group, including the then U.S. President Joe Biden, emphasized its importance. The Centers for Disease Control and Prevention changed its recommendation from one of not wearing face masks to one advocating their use. Due to unclear guidelines on this issue, the pandemic worsened considerably in the nation.

4.1.4 Unprecedented reliance on herd immunity

In contrast to other nations, Sweden did not implement early or strict measures to protect its population from the coronavirus outbreak. Instead, it took an unconventional path toward herd immunity, allowing a large enough number of people to be infected to develop natural immunity to COVID-19. Thus, Sweden did not make significant efforts to protect its citizens from the COVID-19 outbreak. Although many Swedish authorities self-evaluated herd immunity as common sense, the number of human losses in the country was much higher than that in neighboring nations.

4.1.5 Hasty R&D

Many nations competed in the race to develop effective COVID-19 vaccines and treatments, including Russia, which made efforts to develop vaccines using the Russian Direct Investment Fund. It became the first country to register a vaccine named Sputnik V. However, the small number of COVID-19 cases included in the Sputnik V trial hindered the interpretation of the results by neutral parties due to a lack of information and data about the vaccine (Callaway, 2020). Russia was hasty in officially registering its vaccine ahead of other nations, leading to uncertainty regarding its efficacy.

4.1.6 Late decision-making

Chinese ophthalmologist Li Wenliang worked at a hospital in Wuhan, China, in late December 2019, when he detected a coronavirus infection in his patients (BBC News, 2020). He gained attention after attempting to share this information on several internet platforms. However, local authorities initially dismissed his information as false and later punished him, preventing him from sharing his concerns. Had he been able to share his findings, the human losses due to the pandemic could have decreased.

4.1.7 Coordination failure

The challenges faced by South Africa included a shortage of personal protective equipment (PPE), such as face masks, gloves, and respirators. However, considering that the nation’s social division issues persisted even during the COVID-19 outbreak, the real challenge seemed to be the lack of coordination between stakeholders, as evidenced by the Eastern Cape PPE crisis (Mugabi, 2020). The nation continued to struggle with inequality between the rich and poor, as well as between races (black- and white-skinned individuals). The government policy of South Africa was oriented toward those with medical access or economic stability but lacked efforts to coordinate with regional leaders.

4.1.8 Occurrence of natural hazards

Australia did its best to respond to the COVID-19 outbreak without any contemporary precedents. However, the nation was also affected by natural hazards, such as bushfires, droughts, tropical cyclones, and storms (Attanayake et al., 2020). Dealing with the coronavirus infection alone was challenging for the nation, so simultaneously coping with multiple disasters made the pandemic response even more difficult due to a lack of personnel, resources, and strategies. Particularly, dual risks or double threats considerably challenged Australian emergency responses, as seen in the case of the 2020 Black Summer bushfires.

4.2 The Earth as a comprehensive system approach

4.2.1 Global leadership

The WHO leadership needs to fund and organize this approach through an association of the world’s high-income nations, since these nations have a shared responsibility due to their greater resources, compared to developing nations. Simultaneously, the organization must assist its member states in responding to the COVID-19 outbreak in a timely manner by decisively providing appropriate guidelines, such as norms, policy alternatives, research agendas, evidence articulation, and technical support. The WHO leadership may refer, in particular, to the World Food Programme, which has helped provide food for many communities affected by the COVID-19 outbreak.

4.2.2 National policies

The COVID-19 outbreak has caused not only human loss but also economic damage. However, national policies should prioritize the issue of human loss, as nothing is more important to society than human lives. Disregarding the issue of human losses and focusing on economic recovery instead to strengthen his bid for reelection in 2022, the Brazilian president indirectly caused the increase in the number of infected individuals and deaths among his people (Stott et al., 2021). Thus, Brazilian leaders should first address public health issues before considering unemployment and economic damage, as opposed to the current policy.

4.2.3 Individual strategies

A face mask is a simple object; however, its use became a source of serious controversy in the United States during the COVID-19 pandemic, involving issues such as the impairment of individual freedom and the possibility of local governments mandating its use (Bir & Widmar, 2021). The fact that the majority of health experts agreed that wearing face masks helped prevent viral transmission, as supported by scientific evidence, should have convinced Americans of the need to wear face masks during the emergency response to the COVID-19 outbreak. Without awareness of this need, individuals would be less capable of evading the impacts of coronavirus infection.

4.2.4 Culture

Emergency cultures may explain why Sweden depended on herd immunity during the COVID-19 outbreak (Hassan et al., 2022). Swedish citizens tend to socialize without drawing attention to themselves. They, even the kings and superstars, do not regard themselves as special. The nation places a high priority on children’s rights and ensures that children have free time and large spaces to play. Moreover, the trust between the people and the government is strong. Thus, the Swedish people are willing to follow the lenient policies of public health agencies.

4.2.5 R&D

Governments and industries invested substantial amounts of money in the unprecedented development, manufacture, and eventual commercialization of effective COVID-19 vaccines and treatments. Appropriate research efforts were vital in stopping the worldwide spread of the coronavirus infection. However, some nations, such as Russia, should have conducted their research in a more organized manner, for instance, by implementing mid- or large-sized clinical trials for their COVID-19 vaccine, Sputnik V, instead of relying on small-sized or rushed clinical studies. After the successful development of vaccines and treatments, stakeholders must determine how to quickly and equitably distribute them to those in need in each region.

4.2.6 Timing

Many nations and institutions struggled to make rapid decisions during the initial response to the COVID-19 outbreak due to high levels of uncertainty, time constraints, a lack of standardized predictions, and the complexity of the infection, among other factors (Hariri-Ardebili & Lall, 2021). Following the COVID-19 outbreak and the tragic death of coronavirus whistleblower Li Wenliang, the Chinese government honored him as a martyr. However, it failed to make timely decisions to effectively halt the spread of the new disease.

4.2.7 Communication

Various stakeholders have conflicting interests regarding the contentious issue of the COVID-19 emergency response, and none, including the government, has been willing to compromise. Nevertheless, the COVID-19 pandemic thrust everyone in the middle of a public health crisis. Therefore, effective communication and coordination among all stakeholders is essential, which includes holding real-time dialogues, identifying priorities, and utilizing technological tools (FEMA, 2020). Without such coordination, the nation would continue to face increasing human losses.

4.2.8 Contingency

The contingency issue encompasses unexpected disruptions and problematic situations that may arise in the near future; thus, additional arrangements or plans must be developed for them (State of Colorado, 2012). Other unforeseen factors, aside from the previously mentioned seven overarching factors, fall under this contingency category. For instance, in the case of Australia’s COVID-19 response, the occurrence of a natural hazard can be considered a contingency that the nation should address through rigorous and advanced planning to manage all risks related to planning, supplies, training, and exercises (Hariri-Ardebili, 2020).

5.1 Four major categories

The eight overarching factors discussed earlier can be classified into four categories under the “Earth as a Comprehensive System” approach. Global leadership, national policies, and individual strategies represent the three major stakeholders, while culture and R&D are considered foundational attributes of pandemic management. Timing and communication can be evaluated as core emergency functions, with the issue of contingency being akin to environmental considerations. Specifically, the eight overarching factors were classified into these four categories, either directly or indirectly.

Despite its breadth, the “Earth as a Comprehensive System” approach is reinforced by the dynamic interactions among its constituent parts, which adapt to the constantly evolving landscape of international crises (NASA, 2024). Each of the eight underlying factors, eight overarching factors, and four categories contributes to the interdependencies that create a coherent framework. When one component changes or adapts, the others realign, forming a resilient structure capable of handling complex pandemic events. Together, these components form an integrated system that adjusts fluidly to new challenges.

5.2 Significant implications

A high level of uncertainty and complexity characterizes the emergency response to the COVID-19 outbreak (Inghammar & Kahn, 2024). Individuals, nations, and international institutions have faced significant challenges in identifying the most effective factors or alternatives for pandemic management (Reimers & Schleicher, 2020). In this context, stakeholders may find the “Earth as a Comprehensive System” approach beneficial, particularly in navigating the various challenges they face in pandemic management. Thus, this approach serves as an effective problem-solving tool.

As a vital framework for pandemic management among multiple stakeholders, the “Earth as a Comprehensive System” approach can enhance situational analysis, rapid risk assessment, evidence-based emergency management, humanitarian management, and partnerships among major entities concerning the COVID-19 outbreak. Consequently, this approach may directly contribute to reducing human losses, economic damage, and psychological impacts resulting from the pandemic, transcending national boundaries.

Many stakeholders have made efforts to combat the COVID-19 outbreak within their jurisdictions; however, some attempts remained fragmented (Forman et al., 2020). Issues that hindered this included fights between customers and supermarket workers over face mask usage, former U.S. President Trump’s offer to buy from CureVac the exclusive rights to its coronavirus vaccine, and France’s ban on the export of PPE. Nevertheless, stakeholders can overcome these fragmented efforts by basing their actions on the comprehensive framework of the “Earth as a Comprehensive System” approach.

The “Earth as a Comprehensive System” approach can be implemented in various ways, depending on the situational focus. However, its implementation should prioritize integrating systems thinking into operations and avoiding unintended consequences (Bradley et al., 2020). Generally, the main steps for its implementation include overseeing the overall picture of the pandemic outbreak, identifying challenging problems and positive opportunities, synthesizing appropriate solutions by incorporating all factors, implementing these solutions with all stakeholders, and sustaining these solutions globally.

The concept of resilience in various communities aligns with the “Earth as a Comprehensive System” approach (Hariri-Ardebili et al., 2022). Resilience is defined as the ability to recover quickly from the effects of both natural hazards and manmade emergencies. It reflects the capacity to adapt to different vulnerabilities in situations involving multiple hazards. Recognizing that resilience is a combination of community and individual capacity necessitates the involvement of all parties in the field. Thus, resilience is situated at the center of an interdependent system, whether it be Earth or a comprehensive system.

The “Earth as a Comprehensive System” approach shares a context similar to that of social support (Taylor et al., 2017). Social support implies that when individuals provide personnel, resources, and other amenities for the benefit of society, it enables specific individuals, nations, or international institutions to respond effectively to the COVID-19 outbreak. For example, individuals maintain their social health during crises by relying on the support of friends or acquaintances. Social support has assisted individuals and organizations in various ways. Similarly, the “Earth as a Comprehensive System” approach acts as a form of systematic social support by providing societal buffer zones (e.g., integrated networks, mutual aid, etc.) against COVID-19, thereby enhancing the quality of pandemic management in many regions.

Embracing the “Earth as a Comprehensive System” approach in various regions requires strategic application by stakeholders. Specifically, this approach should be employed in response to a specific plan. For instance, to manage the pandemic equitably among disadvantaged populations, stakeholders must consider not only economic factors but also equity within the broader framework of the “Earth as a Comprehensive System” approach. When addressing international cooperation among nations, stakeholders must take into account the diverse national contexts within the Earth system model.

Alternatively, the “Earth as a Comprehensive System” approach can assist various professionals, aiding both novice and experienced scholars in conceptualizing, organizing, and conducting related research and assignments. Given that all research is interconnected to theoretical frameworks (Rocco & Plakhotnik, 2009), applying the Earth system model as a foundational framework may address the needs of scholars and their contentious questions. When the interconnections among scholars are substantial through the newly established Earth system model, opportunities for increased research, funding, collaborative studies, shared information on research topics, diverse perspectives, technological diffusion, and societal contributions can be realized.

Similarly, the “Earth as a Comprehensive System” approach can enable a range of pandemic management practitioners to reach a consensus on various issues related to COVID-19 infections (Obuobisa-Darko & Sokro, 2023). Practitioners face considerable pressure regarding numerous challenges, such as a lack of management resources, the presence of invisible constraints, and various political demands. Under these conditions, they may establish a certain level of management standards while fully referencing the “Earth as a Comprehensive System” approach. Examples include pandemic planning, assessing pandemic preparedness, ensuring medical device safety, securing medical information, and packaging materials for vaccines.

When considering the pursuit of happiness on Earth, the “Earth as a Comprehensive System” approach serves as a transformative strategy that will ultimately lead to a sustainable world (Hariram et al., 2024). By acknowledging the interdependence of ecosystems, cultures, and economies, this approach prioritizes human welfare and environmental health. Furthermore, fostering cooperation between communities and disciplines will enhance resilience, enabling society to thrive and adapt to future pandemics. Ultimately, adopting this perspective can open the way for a sustainable world in addressing global health issues.

This study on the “Earth as a Comprehensive System” approach contributes to the existing literature and enhances the understanding of how the emergency response to the COVID-19 outbreak can be effectively managed by applying the Earth system model. The holistic model proposed in this study broadens the scope of pandemic management by systematically identifying eight underlying factors, eight overarching factors, and four categories within the “Earth as a Comprehensive System” approach. The findings of this study confirm the generalizability of the system proposed in the literature.

In terms of education, pandemic management must maintain the quality of education worldwide while also contributing to a peaceful, just, and tolerant human society through the mobilization of educational resources, context-specific solutions, and universal access (Dickinson & Gronseth, 2020). All stakeholders have diverse perspectives on the COVID-19 outbreak and are constantly faced with challenges and changes. Education can thus employ the “Earth as a Comprehensive System” approach as a framework to help students and trainees navigate and overcome the impacts of a pandemic flexibly.

Many stakeholders are eager to learn about the COVID-19 outbreak. Learning plays a crucial role in supporting these stakeholders and thus helps achieve the goals of pandemic management. However, learning should not be an end in itself; rather, it must be institutionalized (Sharma et al., 2021). This establishes the “Earth as a Comprehensive System” approach as the standard in the field of pandemic management. Related institutionalization can be fully realized through appropriate investments in motivation, resources, and policy.

5.3 Future studies

Many studies will be developed and subsequently practiced in the future, based on the concept that Earth is a comprehensive system. Researchers will further formalize the “Earth as a Comprehensive System” into a practical framework that is highly relevant to global health issues (Biyela & Utete, 2024). Future research will provide an integrated model in collaboration with the international community while improving multiple aspects of this approach. A fully functional model that is adaptive, data-driven, and flexible for use in actual pandemic management will be closer to realization through the efforts of researchers.

Future studies will also primarily investigate how socioeconomic and cultural factors have influenced pandemic management (Mansouri, 2023). These subsequent investigations will delve deeper into several relevant elements, regardless of geographical limitations. Both individual case studies and comparative perspectives will be employed flexibly. These studies will offer tailored options for specific communities, including important obstacles, optimal strategies, and additional socio-environmental factors.