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Delivery of health care, Disease outbreaks, Severe acute respiratory syndrome, Coronavirus infections, COVID-19, What&,rsquo s Known COVID-19 is the third coronavirus, after severe acute respiratory syndrome and Middle East respiratory syndrome , with highly pathogenic impacts to cause an outbreak. Only if healthcare systems are thoroughly prepared and responsive can they be relied upon to overcome such outbreaks. What&,rsquo s New Managerial interventions are the main priority during the COVID-19 outbreak, and health centers&,rsquo readiness is directly affected by plans proposed by health policymakers and managers. Macro external dimensions such as socioeconomic and environmental factors can also affect a healthcare system&,rsquo s readiness against COVID-19. IntroductionOn December 31, 2020, the World Health Organization (WHO) received reports on patients with pneumonia in Wuhan, China. After about a week, the Chinese government confirmed a new coronavirus termed &,ldquo the coronavirus disease 2019 (COVID-19)&,rdquo . Faced with the broad prevalence of the virus the world over, on March 11, 2020, the WHO declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to be a pandemic based on previous knowledge. 1, Because of the unknown nature of the disease, however, the identification of SARS-CoV-2 still depends on previous information regarding the severe acute respiratory syndrome (SARS) epidemic in 2003. 2, SARS-CoV-2 is considered the third coronavirus, after SARS and Middle East respiratory syndrome (MERS), with highly pathogenic impacts to have emerged during the past two decades. 3, Previous evidence from the epidemics of SARS and MERS has shown that only on the condition of readiness and responsiveness on a vast and sustainable level can governments and healthcare systems overcome outbreaks. 4, For instance, evidence on the epidemic of SARS indicated that certain factors were culpable for inappropriate control and high mortality among patients and healthcare providers these factors included insufficient interorganizational coordination, a lack of hierarchical command, inadequate allocation of resources to the healthcare systems involved in crises, weakness in risk management, and disorders in information flow. 5,, 6, Research has also laid emphasis upon actual and potential challenges that may occur at the time of such outbreaks. By way of example, Draper and colleagues concluded that potential health risks for healthcare staff working during a pandemic were greater than those in normal circumstances. 7, All these pieces of evidence greatly stress the value of preparedness and the power of disaster management in healthcare systems. This indication can assume greater significance, when the degree of the extensiveness and engagement of healthcare systems is compared between the recent outbreaks. Records show that although COVID-19 has thus far had lower mortality than SARS and MERS (2.3% vs. 9.5% and 34.4%, respectively), 8, healthcare systems at large have been more impacted by COVID-19. The picture seems even graver, when considering that despite the introduction of some medicines as candidates for COVID-19 therapy, highly effective medicines or vaccines have yet to be confirmed. 9, There is also evidence that in stark contrast to the previous epidemics, so rapid is the rise of the incidence of SARS-CoV-2 infections and related deaths, that a global panic is inevitalbe. 10, Effective prevention-based plans and policies and moving toward fair universal health coverage can lessen the social and economic burden of diseases. Also of vital importance is the complete protection and safety of healthcare workers during epidemics. 11, Invariably, epidemic crises complicate the process of control, which explains why improving the community engagement and investing in initial warning systems may lead to the betterment of the control and reduction of political, social, and economic impacts. 12,, 13, Tackling a pandemic viral outbreak needs a comprehensive collaboration between public and private sectors, and an extensive concentrated approach adopted by various organizations involved. Ministries of health may be considered the steward of community health, but surely they cannot manage pandemic circumstances alone. 14,, 15, It is, therefore, critical to forge an integrated powerful leadership among all the involved organizations and establish a central committee to direct and supervise activities. 16, Hawryluck and colleagues proposed an &,ldquo infectious disease outbreak disaster plan&,rdquo encompassing such necessary elements as education, manpower, data collection, research, surveillance, teamwork, communication, lobbying, and systems thinking. 17, Given the different experiences of various countries in encountering the epidemics/pandemics of SARS, MERS, and COVID-19, especially those regarded as underdeveloped or developing with low incomes and concomitant challenges in terms of financial procurement, resource allocation, and faulty managerial structures, it is advisable to draw upon such collective know-how with a view to identifying what influences the preparedness and alertness of healthcare systems. Accordingly, we sought to determine the factors affecting the readiness and responsiveness of healthcare systems during epidemic crises with the aim of utilizing the findings in the current battle against the COVID-19 outbreak. Materials and MethodsThis study was conducted as a scoping review based on the framework of Joanna Briggs. 18, In keeping with the Arksey and O&,rsquo Malley approach, this scoping review extracted diverse articles on the basis of their designs, methodology, and study populations. 19, Scoping reviews can potentially recognize the main components and related aspects of a certain concept, and thus, help to depict a comprehensive and thematic map from the gathered evidence and strongly identify the gaps of knowledge in the scope. 20, Accordingly, we moved through the following five steps,Identification of the Research QuestionThe research question was &,ldquo What are the main factors affecting the readiness and preparedness of countries during an epidemic crisis?&,rdquo The PPC (population, content, and context) for the scoping review was defined in the first step. The population was considered to include all countries involved in an epidemic crisis or somehow affected by the epidemic impacts the content was considered to encompass all the strategies, factors, and elements that affect the readiness and responsiveness of healthcare systems and the context was considered to consist of all the environmental, social, managerial, and political characteristics that influence healthcare systems during an epidemic crisis. The main emphasis of this scoping review was placed on the epidemic outbreaks of SARS, MERS, and COVID-19. Searching and Retrieving Relevant StudiesRelevant studies were found through a systematic search on three online databases, ISI Web of Science, Scopus, and ProQuest. PubMed search engine was also used to search two databases of PubMed Central and MEDLINE. All the stated databases were searched from January 1, 2000, to June 15, 2020. The search strategy is depicted in table 1,, according to which all the keywords were applied according to MeSH terms in two categories. The logical operator &,ldquo OR&,rdquo was used between all the synonym keywords. Then, the keywords in the first category were merged with those in the second by applying the logical operator &,ldquo AND&,rdquo . EndNote X7.1 (Thomson Reuters, USA) was employed to manage references. The inclusion criteria were all English full texts with quantitative, qualitative, or mixed-method designs and all papers in any kind of review. Proceedings, policy papers, guidelines, and instructions were excluded. Additionally, a hand-search was done in Google Scholar because it lacks the capacity of searching according to keywords or abstracts. Most of the results of this hand-search were not relevant and were, therefore, excluded (figure 1,).Search Engines and Databases, PubMed (PubMed Central and MEDLINE), ISI Web of Science, Scopus, ProQuest, and Google Scholar |