Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent.
Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N = 49,968 across 67 countries), we investigated selfreported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19 pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N = 42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r = −0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics.
The global lockdown to mitigate COVID-19 pandemic health risks has altered human interactions with nature. Here, we report immediate impacts of changes in human activities on wildlife and environmental threats during the early lockdown months of 2020, based on 877 qualitative reports and 332 quantitative assessments from 89 different studies. Hundreds of reports of unusual species observations from around the world suggest that animals quickly responded to the reductions in human presence. However, negative effects of lockdown on conservation also emerged, as confinement resulted in some park officials being unable to perform conservation, restoration and enforcement tasks, resulting in local increases in illegal activities such as hunting. Overall, there is a complex mixture of positive and negative effects of the pandemic lockdown on nature, all of which have the potential to lead to cascading responses which in turn impact wildlife and nature conservation. While the net effect of the lockdown will need to be assessed over years as data becomes available and persistent effects emerge, immediate responses were detected across the world. Thus, initial qualitative and quantitative data arising from this serendipitous global quasi-experimental perturbation highlights the dual role that humans play in threatening and protecting species and ecosystems. Pathways to favorably tilt this delicate balance include reducing impacts and increasing conservation effectiveness. ; The Canada Research Chairs program provided funding for the core writing team. Field research funding was provided by A.G. Leventis Foundation; Agence Nationale de la Recherche, [grant number ANR-18-32–0010CE-01 (JCJC PEPPER)]; Agencia Estatal de Investigaci; Agência Regional para o Desenvolvimento da Investigação Tecnologia e Inovação (ARDITI), [grant number M1420-09-5369-FSE-000002]; Alan Peterson; ArcticNet; Arkadaşlar; Army Corp of Engineers; Artificial Reef Program; Australia's Integrated Marine Observing System (IMOS), National Collaborative; Research Infrastructure Strategy (NCRIS), University of Tasmania; Australian Institute of Marine Science; Australian Research Council, [grant number LP140100222]; Bai Xian Asia Institute; Batubay Özkan; BC Hydro Fish and Wildlife Compensation Program; Ben-Gurion University of the Negev; Bertarelli Foundation; Bertarelli Programme in Marine Science; Bilge Bahar; Bill and Melinda Gates Foundation; Biology Society of South Australia; Boston University; Burak Över; California State Assembly member Patrick O'Donnell; California State University Council on Ocean Affairs, Science & Technology; California State University Long Beach; Canada Foundation for Innovation (Major Science Initiative Fund and funding to Oceans Network Canada), [grant number MSI 30199 for ONC]; Cape Eleuthera Foundation; Centre National d'Etudes Spatiales; Centre National de la Recherche Scientifique; Charles Darwin Foundation, [grant number 2398]; Colombian Institute for the Development of Science and Technology (COLCIENCIAS), [grant number 811–2018]; Colombian Ministry of Environment and Sustainable Development, [grant number 0041–2020]; Columbia Basin Trust; Commission for Environmental Cooperation; Cornell Lab of Ornithology; Cultural practices and environmental certification of beaches, Universidad de la Costa, Colombia, [grant number INV.1106–01–002-15, 2020–21]; Department of Conservation New Zealand; Direction de l'Environnement de Polynésie Française; Disney Conservation Fund; DSI-NRF Centre of; Excellence at the FitzPatrick Institute of African Ornithology; Ecology Project International; Emin Özgür; Environment and Climate Change Canada; European Community: RTD programme - Species Support to Policies; European Community's Seventh Framework Programme; European Union; European Union's Horizon 2020 research and innovation programme, Marie Skłodowska-Curie, [grant number 798091, 794938]; Faruk Eczacıbaşı; Faruk Yalçın Zoo; Field research funding was provided by King Abdullah University of Science and Technology; Fish and Wildlife Compensation Program; Fisheries and Oceans Canada; Florida Fish and Wildlife Conservation Commission, [grant numbers FWC-12164, FWC-14026, FWC-19050]; Fondo Europeo de Desarrollo Regional; Fonds québécois de la recherche nature et technologies; Foundation Segré; Fundação para a Ciência e a Tecnologia (FCT Portugal); Galapagos National Park Directorate research, [grant number PC-41-20]; Gordon and Betty Moore Foundation, [grant number GBMF9881 and GBMF 8072]; Government of Tristan da Cunha; Habitat; Conservation Trust Foundation; Holsworth Wildlife Research Endowment; Institute of Biology of the Southern Seas, Sevastopol, Russia; Instituto de Investigación de Recursos Biológicos Alexander von Humboldt; Instituto Nacional de Pesquisas Espaciais (INPE), Brazil; Israeli Academy of Science's Adams Fellowship; King Family Trust; Labex, CORAIL, France; Liber Ero Fellowship; LIFE (European Union), [grant number LIFE16 NAT/BG/000874]; Mar'a de Maeztu Program for Units of Excellence in R&D; Ministry of Science and Innovation, FEDER, SPASIMM,; Spain, [grant number FIS2016–80067-P (AEI/FEDER, UE)]; MOE-Korea, [grant number 2020002990006]; Mohamed bin Zayed Species Conservation Fund; Montreal Space for Life; National Aeronautics and Space Administration (NASA) Earth and Space Science Fellowship Program; National Geographic Society, [grant numbers NGS-82515R-20]; National Natural Science Fund of China; National Oceanic and Atmospheric Administration; National Parks Board, Singapore; National Science and Technology Major Project of China; National Science Foundation, [grant number DEB-1832016]; Natural Environment Research Council of the UK; Natural Sciences and Engineering Research Council of Canada (NSERC), Alliance COVID-19 grant program, [grant numbers ALLRP 550721–20, RGPIN-2014-06229 (year: 2014), RGPIN-2016-05772 (year: 2016)]; Neiser Foundation; Nekton Foundation; Network of Centre of Excellence of Canada: ArcticNet; North Family Foundation; Ocean Tracking Network; Ömer Külahçıoğlu; Oregon State University; Parks Canada Agency (Lake Louise, Yoho, and Kootenay Field Unit); Pew Charitable Trusts; Porsim Kanaf partnership; President's International Fellowship Initiative for postdoctoral researchers Chinese Academy of Sciences, [grant number 2019 PB0143]; Red Sea Research Center; Regional Government of the Azores, [grant number M3.1a/F/025/2015]; Regione Toscana; Rotary Club of Rhinebeck; Save our Seas Foundation; Science & Technology (CSU COAST); Science City Davos, Naturforschende Gesellschaft Davos; Seha İşmen; Sentinelle Nord program from the Canada First Research Excellence Fund; Servizio Foreste e Fauna (Provincia Autonoma di Trento); Sigrid Rausing Trust; Simon Fraser University; Sitka Foundation; Sivil Toplum Geliştirme Merkezi Derneği; South African National Parks (SANParks); South Australian Department for Environment and Water; Southern California Tuna Club (SCTC); Spanish Ministry for the Ecological Transition and the Demographic Challenge; Spanish Ministry of Economy and Competitiveness; Spanish Ministry of Science and Innovation; State of California; Sternlicht Family Foundation; Suna Reyent; Sunshine Coast Regional Council; Tarea Vida, CEMZOC, Universidad de Oriente, Cuba, [grant number 10523, 2020]; Teck Coal; The Hamilton Waterfront Trust; The Ian Potter Foundation, Coastwest, Western Australian State NRM; The Red Sea Development Company; The Wanderlust Fund; The Whitley Fund; Trans-Anatolian Natural Gas Pipeline; Tula Foundation (Hakai Institute); University of Arizona; University of Pisa; US Fish and Wildlife Service; US Geological Survey; Valencian Regional Government; Vermont Center for Ecostudies; Victorian Fisheries Authority; VMRC Fishing License Fund; and Wildlife Warriors Worldwide.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long- term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50-0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80-0·88; p<0·001), and full lockdowns (0·57, 0·54-0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.