The Governance of Resilience. How the Health Systems Have Coped with The Covid-19 Pandemic



After considering the reasons why pandemics are destined to remain also in the near future in our late industrial societies, a conceptual framework for the analysis of governance of resilience of health systems is described and then applied in details following its main four dimensions to the ways various health systems have coped with the pandemic of COVID-19, with specific reference to the Italian National Health Service. In the conclusions, an overall assessment of the ways in which the health systems have responded to the pandemic of COVID-19 is traced on the basis of three different levels of resilience governance and their implications.


Agamben, G. (2003). Stato di eccezione, Homo sacer, II, I.Torino: Bollati Borighieri.

Blanchet K., Nam S.L., Ramalingam B., Pozo-Martin F. (2017). Governance and capacity to manage resilience of health systems: Towards a new conceptual framework”. Inter-national Journal of Health Policy and Management, 6, 8, pp. 431-435.

Borgatti, S.P., Mehra A. et al. (2009). Network analysis in the social sciences, Science, 323 (5916), pp. 892-895.

Crutzen, P.J. (2002). Geology of mankind: The Anthropocene. Nature, 415, p. 23.

European Environmeet Agency (2015). Air Quality in Europe, EEA Report No 5. Luxem-boug, European Union.

European Respiratory Society (2010). Qualità dell’aria e salute. Lausanne: ERS.

Ferrera, M. (2005). The Boundaries of Welfare: European Integration and the New Spatial Politics of Social Protection. Oxford: Oxford University Press.

French, M., Mykhalovsky, E. (2013). Public health intelligence and the detection of poten-tial pandemic, Sociology of Health and Illness, 35, 2, pp. 174-187.

International Agency for Research on Cancer (2016). Outdoor Air Pollution, Vol.109, IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Lyon: IARC.

IPCC (2013). Climate Change 2013: The Physical Science Basis, Intergovernmental Panel on Climate Change. Cambridge: Cambridge University Press.

ISTAT & ISS (2020). Impatto dell’epidemia COVID-19 sulla mortalità totale della popolazione residente, primo trimestre 2020. Roma: Istituto Nazionale di Statistica e Istituto Superiore di Sanità,

Jones, D.S. (2020). History in a crisis – Lessons from Covid-19. The New England Journal of Medicine. DOI: 10.1056/NEJMp2004361: 1-3.

Kahn,A., Fleischauer, A., Casani, J., Groseclose, S. (2010). The next public health revolu-tion: public health information fusion and social networks. American Journal of Public Health, 100, 7, pp.1237-1242.

Lebel L., Anderies JM., Campbell B., et al.(2006). Governance and the capacity to manage resilience in regional social-ecological systems. Ecology & Society, 11 (1), p.19.

Maciocco, G. (2020). Un’altra medicina di famiglia., 20 maggio,

Moore, J.W. (ed.) (2016). Anthropocene or Capitalocene? Nature, History, and the Crisis

of Capitalism. Oakland (CA): PM Press.

Olshansky, S.F. e Ault, A.B. (1986). The fourth stage of the epidemiological transition: The age of delayed degenerative diseases. The Milbank Quarterly, 64, pp. 355-391.

Omran, A.R. (1971). The epidemiological transition: A theory of the epidemiology of population change. The Milbank Quarterly, 49, pp. 509-538.

Rosenberg, C.E. (1989). What is an epidemic? AIDS in historical perspective. Daedalus,

, p. 1-17.

Setti L., Passarini F., De Gennaro G., et al. (2020). SARS-Cov-2 RNA found on particulate

matter of Bergamo in Northern Italy: First preliminary evidence. British Medical Jour-nal, April 18, doi:

Wu, X. et al. (2016). Impact of climate change on human infectious diseases: Empirical

evidence and human adaptation. Environment International, 86, pp. 14-23.

Xiao Wu, M.S. et al. (2020). Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study. British Medical Journal, April 5, doi: