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The COVID-19 pandemic through the lens of humanitarian logistics

Stelacelly Coelho Toscano Silveira¹
Universidade do Estado do Pará
e-mail: stelacellytoscano@yahoo.com.br
ORCID: https://orcid.org/0000-0003-2006-7686
Hélio Raymundo Ferreira Filho²
Universidade do Estado do Pará
e-mail: helio.ferreira@uepa.br
http://orcid.org/0000-0002-4802-9166
Altem Nascimento Pontes³
Universidade do Estado do Pará
altempontes@hotmail.com
ORCID: https://orcid.org/0000-0002-9001-4603
Harlenn dos Santos Lopes4
Universidade Federal do Pará
ORCID https://orcid.org/0000-0002-7171-8621
e-mail: harlenn@ufpa.br
Gisele Cristina Manfrini5
https://orcid.org/0000-0003-0445-1610
Universidade Federal de Santa Catarina
e-mail: gisele.manfrini@ufsc.br


ABSTRACT
An Integrative Literature Review (ILR) was conducted to identify the relationship between humanitarian logistics and the development of the COVID-19 pandemic based on research in the SCOPUS, MEDLINE and ENEGEP databases in April and May 2022. In all, 61 articles were evaluated according to the following criteria: original article or review of literature published in a scientific journal; abstract and full text available; article on humanitarian logistics in relation to the COVID-19 pandemic. The resulting sample comprised eleven publications organized and analyzed through a synthesis matrix, where 72% were published in international journals and mostly in 2021 (56%). The presence of the supply chain defines the course of action of economic and social sectors, which in turn determine, by means of an interdisciplinary approach, humanitarian operations in the face of the COVID-19 pandemic. The lack of studies narrows down humanitarian logistics to mitigate the impacts caused by these disasters, both in the context of the current pandemic and in future events of the same nature. However, as a global emergency, it suggests the need to increase scientific knowledge on the subject of humanitarian logistics related to disaster events.

Key words: Humanitarian logistics; COVID-19; disasters.


INTRODUCTION

Humanitarian logistics (HL) is a branch of logistics that emerged as a branch of knowledge and scientific research in the mid-2002 to provide support to places in need of humanitarian aid in situations of war, political crises, natural disasters and other events involving a disaster context. Thus, HL is defined as a set of plans and actions aimed at saving lives and developing strategies to meet human and material requirements by spreading information and acquisition, storage, transport and distribution of inputs in disaster situations¹.
According to the Terminology of the United Nations Strategy for Disaster Reduction² (p.11), disaster is the
Disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources.

Disasters are major public health challenges. They may be classified either as Technological (related to work accidents, transport...) or Natural (climatic, meteoro¬logi-cal, geophysical, biological, hydrological); they are further classified according to their intensity, development and origin1,2 .
Emergency crises with significant impacts on public health are included, such as the COVID-19 pandemic, which requires us to think about humanitarian crises and the complexity of local, organic and participatory responses³.
One notices that the current sociopolitical course of action puts the discussions on that topic to a high level of concern given the consequences and damages caused by natural disasters. In addition, the massive publicity caused by that type of event requires measures to mitigate resulting damages.
Especially in Brazil, the highest incidence of disasters is related to climatic actions and anthropogenic reflexes that are directly or indirectly caused by man. However, although they are less common, pandemics and epidemics are more complex to monitor due to uncertainties, instability and gaps, which makes it more difficult to elaborate a precise and effective response in advance.
The World Health Organization (WHO) highlighted the occurrence of pneumonia events in Wuhan, China, in December 20194 . The SARS-CoV-2 virus they identified causes a significant viral infection which is transmitted by respiratory droplets. Due to its high incidence and a high rate of cases, the WHO declared a pandemic situation on March 11, 20205,6. The spread of the virus on a global scale resulted in 496 million confirmed cases and 6 million deaths by April 20225.
Identified and verified disease symptoms range from asymptomatic cases to others that are characterized by mild, moderate or critical respiratory failure8. In this sense, the occurrence of a health crisis is defined by the development of the disease and consequently by its geographical spread. The impact of infectious diseases, more precisely the fact that the world is still fighting the COVID-19 pandemic and that studies are incomplete, in progress and not yet fully developed in terms of medium and long-term reflections increases the degree of uncertainty regarding measures of prognosis, prevention, prophylaxis and possibilities that have been adopted to treat the disease. This combination of aspects results in a massive and sustained mobilization of resources at global level and strongly impacts people’s lives9.
Studies10 show that HL has become more important during the COVID-19 pandemic, as it helps tackle supply disruptions of global supply chain flows and \'interfaces\' with higher quality with the supply chain.
Disaster classification is made according to a variety of features and presented in different ways, which has global consequences such as shortage of supplies and humanitarian assistance11, highlighting the need to expand concepts and the discussion about humanitarian operations and logistics in public health crisis scenarios in the context of pandemics12.
Additionally, in natural disasters, HL is significant due to its substantial impact on people, goods and services to solve an emergency or crisis, both in the humanitarian area and during interruptions of the global supply chain13. Regardless of the type of disaster or crisis, humanitarian logistics organizations cannot fail to operate in either local or global networks.
In this sense, studies focusing on pandemic contexts have gained greater visibility since 2015 and increased considerably after 2020. New outbreaks of previously unknown diseases are reported every day, resulting in devastating and hidden effects on our social and economic way of living and health14.
The increasing intensity of disasters around the world in recent decades impacts urbanization, political stances and environmental concerns, affecting people’s vulnerability and resulting risks15. Thus, not only disaster probability, but also the possibility of their occurrence requires developing a system that helps not only to detect an event but also to address its impacts. Given that situation, the following question arises: how does international literature relate HL to the context of the COVID-19 pandemic?
In Brazil, this topic is recent and its discussion is rather limited16, especially in the northern region of the country, where no related studies were found. Therefore, the present article aims to contribute to the field of HL research by focusing on health to find answers to questions regarding \'present\' and future impacts and minimize them during the COVID-19 pandemic and others that may occur in the future. This study further aimed to identify the relationship between HL and the development of the COVID-19 pandemic in international literature.

METHODOLOGY
According to Vosgerau and Romanowski17 (p. 167), "literature reviews consist of organizing, clarifying and summarizing the most important existing works, as well as providing complete citations covering the spectrum of relevant literature in the field." This type of review analyses and summarizes knowledge produced on a given topic based on a key research question and seeks to identify studies that answer the question defined by researchers using primary sources17,18.
To perform a literature review, specific protocols need to be followed to organize a range of documents and analyze them in the studied context, requiring defined steps such as: 1) identifying the topic and defining the research question, 2) establishing inclusion and exclusion criteria, 3) identifying pre-selected studies, 4) categorizing selected studies and 5) creating a summarized presentation of current knowledge19.
Our literature review was based on articles located in databases such as PUBMED and SCOPUS – given the representativeness of the database of abstracts and citations of the peer-reviewed literature via the CAPES portal (CAFe access) and the relevance of the portal regarding Brazilian research, through an advanced search form – and ENEGEP, due to its expressiveness in the surveyed area. Web of Science and LILACS portals were also searched, but no articles on that topic were found.
This research was based on the intersection between HL and the COVID-19 pandemic using controlled and uncontrolled descriptors (free terms) in Portuguese and English. The exact descriptors were located in the controlled vocabulary systems: Medical Subject Headings (MeSH), terms in English, and Health Sciences Descriptors (HSD). In this sense, our search strategy included defining thematic filters in Portuguese and English: 1) “Humanitarian Logistics” and “Covid 19”. 2) “Humanitarian Logistics” and “Covid-19” or “SARS CoV 2 Infection”. Data collection by means of reference searches took place between March and April 2022. Regarding data production, the following inclusion criteria were used to select articles: 1) original article or literature review published by a scientific journal; 2) available abstract and full text; 3) discusses humanitarian logistics in relation to the COVID-19 pandemic. The following exclusion criteria were applied: 1) articles that did not consider the relationship of the topic; 2) articles written in the form of editorials, reviews, experience reports and text analyses that did not describe the method applied in detail.

RESULTS
Initially, we found 61 articles but retained only 41 after reading their title and abstract. Four were excluded due to repetition and six for not meeting the other inclusion criteria. A double-blind peer review reduced the final sample to 11 scientific articles.

Figure 1

A Microsoft Excel® spreadsheet (version 2019) was used to organize the literature review and create the database, as suggested by the Synthesis Matrix.18
The selected articles we read in detail to identify the data required and establish a bibliometric profile of the sample, as summarized in Table 1.

Table 1

Three journals were retained as a result of this review. SCOPUS provided the largest number of articles 63.63% (n=7), followed by ENEGEP, 27.27% (n=3) and PUBMED, 9.09% (n=1). Of these, 72.72% (n=8) were published by international journals (36.36% by the Journal of Humanitarian Logistics and Supply Chain Management, 27.27% by the Annals of Operations Research and 9.09% by Frontiers in Public Health), whereas 27.27% (n= 3) were published by Brazilian journals.
Review findings show that 54.54% (n=6) of the sample were published in 2021, followed by 27.27% (n=3) and 18.18% (n=2) in 2022. Regarding study methodology, 66.63% (n=6) of the articles were in some kind of review category, 18.18% (n=2) were case studies and 9.09% (n=1) were field studies and exploratory researches. Qualitative studies are most often performed to investigate areas that have been less often studied to date, whereas the quantity of literature reviews has been the result of the second stage of the COVID-19 pandemic.

Table 2
Table 3

DISCUSSION
Humanitarian Logistics is considered a "new" discipline due to lack of research before the year 2000 and it has only recently been highlighted and documented by several academic studies. Constant disasters draw the attention to improving acclimatization and response infrastructure in affected areas, as well as to assisting affected populations20.
The following two decades should contribute to the expansion of this field of study, stimulate scientific production and expand the field of logistics due to the COVID-19 pandemic. Some proposals have already analyzed the impacts or risk of disaster development but the scope and intentionality of research on the relationship between disasters and humanitarian logistics have greatly increased, especially in the last three years.
Table 2 summarizes the goals, study limitations and conclusion of previously published articles. Studies were conducted as part of projects that develop a relationship with the current supply chains that support the social and economic sectors. The present literature review explores the various aspects of humanitarian logistics and supply chain management, such as concepts, management, contributions and resilient perspectives of humanitarian operations regarding decision-making, political possibilities and inter- organizational relationships.
Challenges in the field of logistics processes still need to be overcome to implement effective humanitarian logistics associated with infrastructure, assistance centers, resource distribution and coordination of human and logistical processes related to the supply chain.
As a natural disaster based on a biological factor, spreading of the disease and increase in deaths, associated with the precariousness of public health, social and economic aspects, have affected several segments worldwide, requiring the intervention and operationalization of humanitarian logistics to minimize damages in supplies, basic services, and hospital services21.
The research sample shows first of all a lack of studies corelated to humanitarian logistics, supply chain and the COVID-19 pandemic, especially of studies involving practical application methods and damage analysis tools or the need to establish research agendas for future projects. Table 3 shows the scope of study of the selected articles and the insights mentioned by the authors in their research agenda proposals.
It becomes clear that public health needs to move from a reactive health management sector to developing service logistics management so as to provide not only care support to patients, but also to address elements that result (before, during and after) from disaster episodes in order to meet the global needs of the population22.
Primary Care (PC) is essential in this context and is established as a strategic element in the first stages of response in disaster risk management, hence the relevance of the sector for health care, as there is a complexity in Primary Care in disaster scenarios caused by reflexes of factors that define and condition people’s health23,24. However, the study24 related the impact of disasters in the field of public health worldwide and denounced - before the COVID-19 pandemic - the poor performance and response capacity of Primary Care in dealing with these events.
In another segment of public health, a study highlights the importance of field hospitals as an emergency response21. It underlines the need for investments in the hospital/health context, which ranges from elaborating targeted diagnoses, training schedules and permanent education of professionals to care protocols and service flows, evaluation of human, material and technological resources, psychological support for professionals and the development of advanced skills through the context of disasters and risk management25.
The Sustainable Health Agenda for the Americas (2018-2030) develops a commitment to work with emerging public health challenges connected to the Sustainable Development Goals (SDGs) by means of strategic plans and policies for access to health services.
Study26 highlights the need to adopt specific measures to characterize different disasters based on studies that show that epidemiological disasters of natural origin have done more harm than wars. In this sense, generalized reproduction of logistics loses its efficiency. For example, more vulnerable populations are more affected, which means that they need a better standard of response27,22. After all, acknowledging the “beneficiary” emerges as a tool and subterfuge to deal with diversity, given that one of the aim of SDGs is to provide equal access to populations that require health services. Researchers emphasize in their studies that social inequality is a potential factor for the occurrence and/or worsening of disasters28.
Points of interest were identified that reassert the need for interdisciplinarity as a key component for good management of human resources and results. Thus, the shared collaboration of sectors and areas of knowledge is a strategy that has played an essential role in the development of humanitarian logistics, guided by aspects of multiple areas of knowledge. In addition, resources, supplies, materials and financing need not be supplied by states alone, but may also be provided by NGOs, private institutions and international institutions21.
Sectors involved do not respond in an isolated manner, but rather based on their involvement and relationship with cross studies and discussions on concepts that adopt a rather transversal look to contribute to the process of operations management, mobilization of institutions, public authorities, policies, resources and provision of services21,22.
Scientific literature on humanitarian logistics is limited and shows a wide range of gaps, as research has only just started in this field of study. Despite the growing and notorious internationalization of data collected, insertion of Brazilian researchers in this field was evident. The lack of a more cohesive sharing network that might favor production of knowledge may result in a certain fragilization26, 29.
Concerning research sample, study limitations were often related to the prevalence of the methodology of articles and their timeframes, since most of the data (samples) were based on secondary data collected during the COVID-19 pandemic. Limitations were also due to failure to account for the direct impact on public health and its connections with vulnerable populations.
However, systematic reviews have emerged as a start to guide future research by recognizing the main theoretical implications and proposals of research agendas created by grouping of data found in the studies produced so far.

CONCLUSION

A Systematic Literature Review was conducted to evaluate and synthesize information, as well as to analyze future prospects. In this sense, this article surveys and presents what the scientific community has been working on in the field of HL to minimize natural disaster impacts, especially COVID-19, to solidify an accumulation of scientific capital and help fill research gaps by connecting emerging research agendas and those proposed by the literature by considering the development of the pandemic and its impacts on human life.
In a context of disasters, it is essential to know the model of humanitarian structure used to support strategies that address epidemic periods, based on the support that the structure of humanitarian logistics may provide to public health. Therefore, the scenario of the COVID-19 pandemic, as a global emergency, has shown its relevance and surveying scientific production facilitates or instructs taking efficient and more assertive measures in humanitarian logistics.
Therefore, among the contributions of the present work are the suggestion of research for future investigations and systematization of the literature related to the interaction between humanitarian logistics and COVID-19, not only in Brazil, but on a global scale through its challenges and opportunities, observing the development, impact and contribution of HL in these crisis and disaster scenarios, especially in Brazil.
Study limitations are due to a lack of research on the effects of the pandemic on health/humanitarian logistics and few possibilities for research comparisons. In addition, the query used to perform the research and the choice of keywords are related, as they may have been an obstacle to exploring other topics, as well as the fact that the pandemic occurred at the same time as the study.

LITTERATURE

1. Samed MMA, Gonçalves MB. Introdução a Logística Humanitária. Rio de Janeiro: Elsevier, 2017.

2. Terminology on Disaster Risk Reduction. International Strategy for Disaster Reduction (UNISDR) – United. Nations. 2009.

3. Matta GC, Rego S, Souto EP, Segata J. Os impactos sociais da Covid-19 no Brasil: populações vulnerabilizadas e respostas à pandemia. FIOCRUZ. [online] 2021 [accessed: May 12, 2022]. Available at: https://books.scielo.org/id/r3hc2/pdf/matta-9786557080320.pdf

4. Gill, D. (2020), “Gartner releases report on how to secure supply chains amidst the COVID 19 Outbreak”, Logistics Manager, March 10, available at: https://www.logistics-manager.com/gartner-releases-report-on-how-to-secure-supply-chains-amidst-the-COVID_19-outbreak/.

5. World Health Organization. WHO Coronavirus (COVID-19) Disease -Situation Report 94. WHO Reports 2020. [Internet]. 2022 [accessed: July 12, 2022]. Available at: https://covid19.who.int/.

6. World Health Organization. Director-General’s opening remarks at the media briefing on COVID-19. [Internet]. 2022 [accessed: July 12, 2022]. Available at: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.

7. Chavez S, Long BK, Liang, SY. Doença de Coronavírus (COVID-19): Uma cartilha para médicos de emergência. The American Journal of Emergency Medicine 2020; 757(20), 30178–30179.

8. Santos MLP, Lopes OPES. A logística humanitária no gerenciamento de desastres naturais: Revisão Sistemática da Literatura (RSL) orientada ao COVID-19. In: Anais do XL Encontro Nacional de Engenharia de Produção; 2020; Foz do Iguaçu. p. 1- 14.

9. Kovács G, Sigala IF. Lessons learned from humanitarian logistics to manage supply chain disruptions. Journal of Supply Chain Management 2021; 57(2): 41-49.

10. World Food Programme (WFP). Risk of hunger pandemic as COVID-19 set to almost double acute hunger by end of 2020. [Internet]. 2022 [accessed: July 12, 2022]. Available at: https://insight.wfp.org/covid-19-will-almost-double-people-in-acutehunger- by-end-of-2020-59df0c4a8072.

11. Soakt KY, Altay N. Serving vulnerable populations under the threat of epidemics and pandemics. Journal Of Humanitarian Logistics And Supply Chain Management 2021; 11(2):176-197.

12. Gonçalves MB, Lima FS. A logística humanitária no contexto da pesquisa, ensino e extensão universitária. Revista Gestão & Sustentabilidade Ambiental 2009; 7(1):19–30.

13. Qianying L, Shi Z, Daozhou G, Yijun L, Shu Y 5, Salihu SM, Maggie HW, Yongli C, Weiming W, Lin Y, Daihai H. A conceptual model for the coronavirus disease 2019 (COVID-19) outbreak in Wuhan, China with individual reaction and governmental action. International Journal of Infectious Diseases 2020; 93(1) :211–216.

14. Juliana FF, Aline SP, André AL, Débora GM, Milton LPL, Paulo RSM. Panorama atual da produção cientifica sobre a temática da logística humanitária: estudo bibliométrico. In: Anais Associação Nacional de Pós-graduação e pesquisa em Administração; 2017; São Paulo. p. 1- 16.

15. Vosgerau DSR, Romanowski JP. Estudos de revisão: implicações conceituais e metodológicas. Revista Diálogo Educacional 2014; 14(41): 165-171.

16. Botelho LLR, Cunha CCA, Macedo M. O método da revisão integrativa nos estudos organizacionais. Gestão e Sociedade 2011; 5(11): 121-130.

17. Galvão MCB, Ricarte ILM. Revisão sistemática da literatura: conceituação, produção e publicação. Logeion: Filosofia da Informação 2019; 6(1): 57–73.

18. Vilar CB, Santos EA, Burgarelli EC. Logística humanitária: Conceitos, relacionamentos e oportunidade. In: Anais Associação Nacional de Pós-graduação e pesquisa em Administração; 2012; São Paulo. p. 1- 16.

19. Batista HT, Santos LB, Guiliani PC. Logística humanitária: hospital de campanha de Mogi das Cruzes (SP) na ocorrência do novo coronavírus. Revista Eletrônica Anima Terra 2020; 12(1): 16-29.

20. Silveira LTC, Oliveira AB. Desafios e estratégias para a organização do setor saúde frente à pandemia de COVID-19. Research, Society and Development 2020; 9(8); 1-22.

21. Meneses AS. Gerenciamento Emergencial de Recursos da Atenção Primária a Saúde no Enfrentamento à Pandemia da COVID-19. Scielo Preprints, 2020.

22. Rocha MW, Oliveira AB, Araújo DF, Queiroz ABA, Paes GO. Safe intra-hospital care in context of vulnerability to socio-environmental disasters: implications for nursing. Rev Bras Enferm 2020; 74(1); 1-9.

23. Villar CB, Santos EA, Burgarelli EC. Logística humanitária: conceitos, relacionamentos e oportunidades. In: Anais Associação Nacional de Pós-graduação e pesquisa em Administração; 2012; São Paulo. p. 1- 15.

24. Resiliência de catástrofes ferramentas de autoavaliação a nível local (UNDRR). 2015

25. Carvalho MM; Oliveira SS. Aspectos psicossociais em desastres socioambientais de origem geoclimática: uma revisão integrativa da literatura. Saúde em Debate 2020; 44(2): 334-352.

26. Fernandes GCM, Treich RS, Costa MFBNA, Oliveira AB, Kempfer SS, Abeldaño RA. Atenção primária à saúde em situações de desastres: revisão sistemática. Rev Panam Salud Publica 2019; 43(76): 1-8.

27. Thompson DDP, Anderson R. The COVID-19 response: considerations for future humanitarian supply chain and logistics management research. Journal Of Humanitarian Logistics and Supply Chain Management 2021; 11(2): 157-175.

28. Savage DA. A collaborative approach to maintaining optimal inventory and mitigating stockout risks during a pandemic: capabilities for enabling health-care supply chain resilience. Journal Of Humanitarian Logistics And Supply Chain Management 2021; 11(2): 248-271.

29. Sokat KY, Altay N. Serving vulnerable populations under the threat of epidemics and pandemics. Journal Of Humanitarian Logistics and Supply Chain Management 2021; 11(4) 176-197.

30. Altay N, Kovács G; Spens K. The evolution of humanitarian logistics as a discipline through a crystal ball. Journal Of Humanitarian Logistics and Supply Chain Management 2021; 11(4) 577-584.

31. Queiroz MM. Impacts of epidemic outbreaks on supply chains: mapping a research agenda amid the covid-19 pandemic through a structured literature review. Annals Of Operations Research 2020; [s. l]: 1-38, 16 jun. 2020.

32. Kumar S, Xu C, Childayal, N, Chandra C, Yang M. Social media effectiveness as a humanitarian response to mitigate influenza epidemic and COVID-19 pandemic. Annals of Operations Research 2021; [S.L.]: 1-30.

33. Lima IAS, Sames MMA. Análise das publicações da OMS sobre a COVID-19 no contexto da Cadeia de Suprimento Humanitária. In: Encontro Nacional de Engenharia de Produção; 2020; Foz do Iguaçu. p. 1-8.

34. Sá GLP, Andrade CTA, Silva RMA. Cadeias de suprimentos humanitária: levantamento das principais operações logísticas realizadas por organizações humanitárias durante a pandemia do COVID-19. In: Encontro Nacional de Engenharia de Produção; 2020; Foz do Iguaçu. p. 9-18.

35. Santos MLP, Lopes HSL. A Logística Humanitária no Gerenciamento de Desastres Naturais: Revisão Sistemática da Literatura (RSL) orientada ao COVID-19. In: .Encontro Nacional de Engenharia de Produção; 2020; Foz do Iguaçu. p. 22-31.

36. Bajar PM, Nicola S, Johan E, Taylor KW, Paul M, Constance MDT, Rafael R, Sahmbhu A, Peter G, Gina S. Serving the Vulnerable: the world health organization\'s scaled support to countries during the first year of the covid-19 pandemic. Frontiers In Public Health 2022; 10(1): 1-7.

37. Ali I, Kannan D. Mapping research on healthcare operations and supply chain management: a topic modelling-based literature review. Annals Of Operations Research 2022; [S.L.]: 1-27.

38. Kunz N, Reiner G. A meta-analysis of humanitarian logistics research. Journal of Humanitarian Logistics and Supply Chain Management 2012; 2(2): 116-147.

39. Pan American Health Organization (PAHO). Sustainable health agenda for the Americas 2018-2030: a call to action for health and well-being in the region. Washington: [Internet]. 2022 [accessed: July 12, 2022]. Available at: http://iris.paho.org/xmlui/bitstream/handle/123456789/49170 /CSP296-eng.pdf?sequence=1&isAllowed=y