Managing regional logistics in times of crisis: a COVID-19 case study Open Access

Crises loom over regions around the world. Natural disasters (e.g. hurricanes, earthquakes, and torrential storms) continue to increase in frequency with major disruptions to everyday life and represent the raison d'être for humanitarian logistics and supply chains (HLSCs) (Kovács et al., 2010). Here, the term crisis means a crucial and unstable state of affairs “characterised by disruption of normality and steadiness of processes, thus creating chaos of various degrees” (Penuel et al., 2013, p. 186). Although cases of humanitarian emergencies and disasters tend to be regional in nature (such as the 2010 earthquake in Haiti, conflicts in Syria and Yemen that began in 2011 and 2014 respectively, and the Ebola virus outbreak in Congo during 2017), humanitarianism in response to these crises tends to have a global focus. Inter-governmental agencies such as the World Health Organisation (WHO) and the United Nations (UN) play central roles in global response to public health, financial and political crises, while non-governmental bodies such as the United Nations High Commissioner for Refugees (UNCHR) and the International Rescue Committee (IRC) oversee HLSC management for disaster and humanitarian relief.

Coronavirus Disease 2019 (COVID-19) is a pandemic posing a unique context for the regional management of HLSCs. Coronaviruses are “enveloped, positive single-stranded large RNA (RNA) viruses that infect humans, but also a wide range of animals” (Velavan and Meyer, 2020, p. 278). Viewed as a super-spreader (Wong et al., 2015) with devastating socio-economic effects, the COVID-19 pandemic is a global crisis with regional logistics challenges to cope with disruptions, maintain essential services, and mitigate the spread of the virus (Blackmon et al., 2021; Ivanov, 2020; Ivanov and Dolgui, 2020). COVID-19 is the latest in a series of global health emergencies and scholars (e.g. Fauci et al., 2020; Kahn, 2009) note that due to previous logistical successes in combating plagues such as cholera, smallpox and yellow fever, new infections and diseases are emerging and re-emerging. In terms of COVID-19 containment, there are evident regional disparities in context-dependent stringent measures. For instance, England introducing new legislature to restrict or detain individuals suspected of carrying COVID-19, France banning gathering of more than 5,000 people, Italy placing the entire country under quarantine, and Saudi Arabia temporarily halting religious local and foreign pilgrimages to the holy Islamic places of Makkah and Madinah (Hellewell et al., 2020). Intuitively, these disparities imply variations in RLM needs and strategies. Although medical knowledge on the clinical presentation, epidemiology, treatment and prognosis continues to emerge and evolve, there is limited scientific knowledge on strategy underpinning RLM for the COVID-19 response. RLM offers an on-going and contemporary focus for management scholarship, yet there are limited studies exploring conventional RLM strategy (e.g. Al-Balushi and Durugbo, 2020; Demirbag et al., 2020) and far fewer studies concentrating on RLM strategy in times of crisis. Additionally, a scrutiny of the HLSC literature suggests a gap in knowledge on RLM and potential priorities that underpin crisis-driven RLM strategies for HLSCs. This paucity constitutes the research gap and motivation for this study.

The aim of this study is to explore RLM in times of crisis from the perspective of public authorities responsible for combating the COVID-19 pandemic and to develop a conceptual RLM model of strategies for enhancing HLSCs. The main objective here is not to revisit or engage in the discourse and debate on the epidemiology of COVID-19 or the soundness, effectiveness or efficiency of RLM in times of crisis, but rather reflect on RLM responses and insights so far from mitigating the spread of COVID-19. The scope of this study is limited to RLM for crisis, with discussions on the significance of RLM for HLSC management.

Topically, this research argues for regional perspectives on crisis-driven strategies that advance HLSC “viability” and “integrity”. Viability is a higher-order construct that incorporates agility, resilience and sustainability (Ivanov, 2020) while integrity involves maintaining the wholeness of operating principles and priorities (Schröder and Mceachern, 2002). Analysis of the HLSC literature suggests contexts for boosting viability and integrity remain unclear. Rather, HLSC research lays emphasis on agile supply chains (Oloruntoba and Gray, 2006) with interests in areas such as collaborative relationships (Shaheen and Azadegan, 2020), performance management (Abidi et al., 2014), technology use (Cardia et al., 2017), preparedness plans (Rodríguez-Espíndola et al., 2018), logistics intermediaries (Dufour et al., 2018), and swift trust (Dubey et al., 2019; Lu et al., 2018). This research seeks to enrich the HLSC discourse by using lessons on RLM for COVID-19 to offer insights on opportunities for promoting HLSC viability and integrity.

Fundamentally, this research is unique in its focus on RLM in times of crisis. Studies of RLM in times of normality suggest the adoption of intra- and inter-regional strategies for economic development and environmental sustainability with goals of boosting operational resilience (Durugbo et al., 2020b). The RLM focus on crisis in this study is unique and reflects recent crisis-driven challenges within studies of cross-functional integration (Poberschnigg et al., 2020), high reliability organisations (Sawyerr and Harrison, 2019), logistics service network design (Dufour et al., 2018), and supply risk dependencies in supply networks (Al-Balushi and Durugbo, 2020).

In view of these considerations, the rationale for this research is that a model of RLM in times of crisis can contribute to a better understanding of viability and integrity for enhancing HLSC management. With insights from public health authorities responsible for RLM, this research seeks to answer the following questions:

In order to address these questions, this article presents a qualitative RLM case study that sheds light on knowledge and lessons learnt by public health authorities responsible for RLM during the COVID-19 response. The study applies an inductive, constructivist approach that involves semi-structured interviews with these managers and strategists, and thematically analyses the perspectives of the interviewees to discuss how RLM in times of crisis relates to HLSC management.

The remainder of the article unfolds as follows. First, the article presents the background of the research in terms of crisis and HLSCs, regional logistics in times of crisis and the initial framing for the research. Next, the article presents the methodology and findings of the case study. The article concludes with a discussion of the implications, limitations and future directions for research.

Generally, HLSCs involve organisations and actors (e.g. donors, armed forces, private sector relief actors, governments, non-governmental agencies) delivering humanitarian relief and confronting potential logistical bottlenecks and inadequacies due to major weaknesses in infrastructure within aid-receiving regions (Kovács and Falagara Sigala, 2021; Oloruntoba and Gray, 2006). These actors tend to have differing motivations, directives, capabilities, and expertise (Balcik et al., 2010; Mutebi et al., 2020), and the logistics problems worsen in less-developed regions with serious consequences on victims (Dufour et al., 2018). Humanitarian emergencies tend to also require additional national and global actors, e.g. public health experts for pandemics (Enria, 2019). Furthermore, logistics in a humanitarian context, much like the logistics demanded of the COVID-19 response (Blackmon et al., 2021; Kovács and Falagara Sigala, 2021), is often unstable (Oloruntoba and Gray, 2006), dormant for lengthy periods (Shaheen and Azadegan, 2020), and challenging for coordination (McLachlin and Larson, 2011), unlike conventional business, corporate or commercial logistics.

The involvement of an array of private and public, multilateral and bilateral actors during crisis that requires humanitarianism (e.g. natural disasters and pandemics) poses a catch-22 for HLSC management. On the one hand, collaborative relationships resulting from the involvement of different participants tend to infuse energy and dynamism for responding effectively during crisis (Balcik et al., 2010; Minear, 2002; Mutebi et al., 2020). In this context, coordination remains a core HLSC management challenge due to the multiplicity and diversity of regional actors and agencies with limited standardisation among involved parties (Comes et al., 2020; Dubey et al., 2019; Dufour et al., 2018; Rodríguez-Espíndola et al., 2018; Sheppard et al., 2013; Villa et al., 2017). On the other hand, the involvement of a plethora of HLSC partners adds to complexity, disarray and chaos for crisis coordination – creating “crisis theatres” (Minear, 2002). These situations stem from different procedures of HLSC partners in on-going capacity management struggles and challenges to avoid duplication of effort (Eftekhar et al., 2017; McLachlin and Larson, 2011). Institutionally, structurally and managerially, there are also coordination obstacles concerning disparity in governance structures, competition for scarce resources and political influence on managerial decisions (Reindorp and Wiles, 2001; Stephenson, 2005).

Due to increasing awareness of the network age, HLSC research (Cardia et al., 2017) notes the increasing potentials of digital technologies (e.g. the Internet, smartphones and social media), in HLSCs, especially by “digital humanitarians”, i.e. remote volunteers and technical communities working remotely using digital tools and techniques such as geolocation and data analytics. Using these technologies, HLSC communications tend to involve strategies for one-way and two-way (interactional and transactional) communications (Villa et al., 2017) with considerations for humanity, neutrality, impartiality and independence, as “humanitarian principles” (Cardia et al., 2017). An alternative view of HLSC communication gives prominence to fundraising (Krause, 2017), highlighting the use of imageries and accounts of hardships in campaigns and appeals seeking to raise funds. For instance, research (Eftekhar et al., 2017) suggests immediate impacts of media exposure on fundraising. However, this view struggles with a tension between instrumental goals of raising funds and ethical goals of stimulating social change (Orgad, 2017).

From a theoretical perspective, analysing the COVID-19 response offers unique opportunities to develop knowledge on HLSC management. For instance, Craighead et al. (2020) argue for intra-disciplinary focus on sharpening of theories applicable to supply chain and operations management through contextualising and/or combining theories, particularly in regards to the nature of disruptions due to crises. HLSC literature also argues for “borrowing and testing theory from other disciplines” (Oloruntoba et al., 2019, p. 544) with specific focus on internationalisation, behavioural, and organisational theories. This triadic groupings of likely theories for HLSC research stem from their emphasis on environmental influences that tend to be endogenous, exogenous or mixed (i.e. endogenous and exogenous) to an organisation. The authors also argue for combining, contrasting and extending these theories to gain multiple, complementary and advanced perspectives that shed light on HLSC sourcing relationships, competitiveness, echelons of production and distribution, etc. Following a similar line of reasoning, Prakash et al. (2020) use criticisms of limited theoretical grounding in current HLSC research to argue primarily for organisation theory as a lens to shed light on orchestration for the unique contexts posed by cases of humanitarian emergencies and disasters. The authors review applied theories in HLSC settings (resource-based, resource dependence, social exchange and contingency theory) and propose additional theories (institutional, stakeholder, transactional cost and information theories) for future studies based on conceptual similarities with supply chains and applicability for explaining information asymmetry within HLSCs. A different view on theoretical development argues for a multi- and inter-disciplinary approach with theoretical framings potentially encompassing domains of entrepreneurship, supply chain management and strategic management (Ketchen and Craighead, 2020). This viewpoint poses questions on the prospects of entrepreneurship enhancing supply chain management, and vice versa, through concepts such as omni-channel distribution, service recovery, bricolage, etc. Irrespective of the foci for theoretical framings, there is a need for researchers to apply “theoretical contextualisation” that adapts existing theories to investigated situations, “temporal capturing” that reflects and presents the timing of situations, and “theoretical calibration” that gives a measure of consistency to key theory tenets (Craighead et al., 2020).

Crises plague regional logistics. Demand patterns created by crisis events prompt decisiveness to fulfil regional demand through core areas of production, supply, control, technology, competition, energy and project management (Baldini et al., 2012; Kumar and Havey, 2013). Convoluting the process for fulfilling crisis-driven demands are regional pressures that force firms to operate far from nominal conditions with potentially persistent low-demand (Manenti et al., 2013). Introspective and retrospective rhetoric suggest shifts in future demand, markets and purchasing intra- and post-crisis (Gereffi and Lee, 2012; Leeuw et al., 2015) with logistics challenges to innovate along value chains, pricing strategies and distribution channels. Here, the uncertainties centre on potential disparities in the anticipated, perceived and actual attitudes, beliefs, choices, and behaviour of customers intra- and post-crisis.

Concomitantly, in times of crisis, complex systems for regional logistics face additional pressures to engage in processes of crisis-driven transitions (Kuokkanen et al., 2017) for re-organisation (Li et al., 2011) or strategic enterprise transformation (Parry and Roehrich, 2013). These pressures manifest in mandates for competitive priorities due to the sheer scale and complexities of public sector supply chains (Meehan et al., 2017), as well as proactivity in foresight-based practices (Allal-Chérif and Maira, 2011) and contingency programs (Richey, 2009). There are also complexities of corporate logistics management for capital goods, e.g. a Boeing 747 contains over 6,000,000 parts (Levine, 2012), in sophisticated holistic or inter-industrial supply chains warranted for preparedness and responsiveness during crises (Natarajarathinam et al., 2009; Wang et al., 2018). Alternate perspectives on complex networks for distribution and coordination during crisis focus on recognising and reducing the crisis-driven problems of geographical dispersion, network congestion, poor communication between HLSC actors, unique pressures to satisfy donors and misalignment in the configuration of operations (i.e. centralised-formal networks vs decentralised-informal networks) (Desoutter and Lavissière, 2018; Dufour et al., 2018; Oloruntoba and Gray, 2006).

Grounded on core constructs from the literature, this subsection proposes a preliminary framing for the study, shown in Figure 1. The framework includes a set of management mechanisms, i.e. coordination, communication and containment (i.e. 3Cs of crisis-driven logistics), that reflect logistics strategy for crisis response. Craighead et al. (2020) offer an alternative 3Ss framing that scrutinises the context of the geographical and sectorial nature of disruptions (scope), the unfolding of disruptions with shocks across regions and sectors (spillover) and volatilities regarding supply and demand patterns (shifts). Suggesting that organisations prioritise “transiliency” (a portmanteau of resiliency and transformability), the authors challenge supply chain researchers to apply a mix of well-established and emergent theories for enhanced knowledge on pandemics. However, the focus of Craighead et al. (2020) is on supply chain disruptions while this study seeks to analyse the response to a crisis such as COVID-19, in line with the research questions.

Coordination enables interactions and integration of resources needed to produce anticipated deliverables and to tolerate inadvertent and indeterminable results. Coordination represents RLM configurations applied with collective strategies to define partnerships (Chandes and Paché, 2010) and inform decision-making (Barnes and Oloruntoba, 2005). For crisis coordination, RLM strategists prescribe systems-based approaches with a strong centralised structure for coherent and collective leadership along with solidarity (Chanaron, 2013). Accordingly, coordination in an HLSC context is a multifunctional activity involving the application of policy instruments (e.g. strategic planning, information management and organisational accountability) for delivering humanitarian aid, with efficacy and coherency (Minear, 2002). Coordination in this context acts a springboard for multi-agent collaboration, rapid deployment of capacities, and resource management using digital technologies (Baldini et al., 2012; Mohanty and Chakravarty, 2013). Motivated by obligations to apply coordination policies (Reindorp and Wiles, 2001), there are proposals for HLSCs to prioritise cluster thinking (Jahre and Jensen, 2010) with focus on areas of activity (e.g. water and sanitation), and chain coordinators (Akhtar et al., 2012) as dedicated roles that act as stimulus, support and stalwarts for enhanced flow and control of resources. Research also suggests that swift trust, i.e. trust in collaborations within hastily constructed inter-organisational networks, facilitates coordination (Dubey et al., 2019; Lu et al., 2018) and that coordination in turn influences self-organisation, networking and adaptability for HLSC (Mutebi et al., 2020). In practice, efficacy in the coordination of regional logistics for HLSCs is the mandate for agencies such as the Office of the Coordinator for Humanitarian Affairs (OCHA), United Nations Joint Logistics Centre (UNJLC) and the Inter-Agency Standing Committee (IASC) (Balcik et al., 2010). In addition, agencies like the United Nations Humanitarian Response Depot (UNHRD) act as important logistics service providers for coordinating efforts by HLSC actors.

Containment keeps threats and hazards under control or limits the effects of a disaster or emergencies using targets and protocols set by crisis teams to enable smooth and efficient control. Security underlies containment by HLSCs due to imperatives for military action and health security measures (such as physical distancing), which curb the spread of viruses (Enria, 2019). However, the loci for containment is wide-ranging with crisis management scholars emphasising biocontainment capabilities (Lacroix, 2012), damage containment (Desoutter and Lavissière, 2018), cost containment (Gilpin and Murphy, 2008; Luft, 2008) and containment for infectious diseases particularly for pandemics such as SARS (van Baalen and van Fenema, 2009; Tan and Enderwick, 2006) and COVID-19 (Baveja et al., 2020; Ivanov, 2020). Due to the severity and potential fatalities associated with crisis situations, scholars suggest “rapid containment” based on joint assessments by public agencies and international bodies (Adem et al., 2018; Lacroix, 2012), “reasonable containment” of creative and innovative activities in certain segments (Dubina et al., 2012), and “reasoned containment” of emotions to avoid panicking the public (Davis and Lohm, 2020). There are also studies promoting the benefits of learning lessons from previous experiences such as harnessing better information about SARS to halt a SARS outbreak in Toronto within one week (Howitt et al., 2009; Labib et al., 2019).

Communication proactively prepares stakeholders for crisis events or gives and receives feedback during crises and on crisis states, e.g. delivering warnings, disseminating updates and requesting support. Studies of crises note the importance of communication characteristics like leadership, participation, openness, conversation, community and connectedness (Cardia et al., 2017; Eftekhar et al., 2017; Johansson and Bäck, 2017; Krause, 2017; Maresh-Fuehrer and Smith, 2016; Yoo et al., 2016). According to Villa et al. (2017), communication in HLSCs facilitate the flow of information that regulates processes, aligns goals and fosters innovation.

Overall, the proposed framing argues that communication strategies aid crisis strategists and managers in establishing swift trust and monitoring the effectiveness of containment and coordination efforts. Current literature underscores the importance of the 3Cs in suggestions that crisis management of supply chains requires foci on higher-order constructs such as viability, integrity, reliability, availability and transiliency, (Craighead et al., 2020; Ivanov, 2020; Salehi et al., 2019; Schröder and Mceachern, 2002; Zhang et al., 2019). Underpinning these suggestions are theoretical perspectives on HLSC management derived from well-known theories such as institutional theory that frames crisis management in context of institutional pressures (Prakash et al., 2020) and internationalisation theory that posits on internationalised fundraising for managing crisis (Oloruntoba et al., 2019). Irrespective of the framing, the main concern for the 3Cs remains preparedness for proactivity (Craighead et al., 2020; Natarajarathinam et al., 2009) during response, relief and recovery phases of crises.

For this study, regionalisation theory (Rugman, 2005; Rugman et al., 2009) underlines RLM and shapes intra- and inter-regional strategies for setting competitive priorities and managing operational complexities (Durugbo et al., 2020a, c). Motivated by opportunities to gain insights on RLM in the context of the COVID-19 pandemic, this study conceptualises logistics strategy in times of crisis, as shown in Figure 1, and analyses this model empirically from the perspective of public authorities responsible for combating the COVID-19 pandemic. The next section presents the research methodology regarding the case study rationale, adopted methods, and research philosophy.

Case study methodology (Yin, 2017) offers the exploratory approach for this qualitative research. The rationale for using a case-based approach over quantitative approaches, such as surveys and experiments, was due to its relevance for capturing perspectives, garnering data from information-rich cases and confronting the “how” and “what” of RLM phenomena posed by RQ1 and RQ2. This research also adopts an inductive approach (Denzin, 2007) geared towards using observations of contexts (i.e. crisis-driven logistics) and supporting framings for research (as conceptualised in Figure 1) as a starting point for alternating between collecting data and building theory. Constructivism serves as the research epistemology and is a perspective arguing that individuals are active in generating scientific knowledge and capable of deep learning with unique insights for researchers based on analytical reasoning (Glasersfeld, 2005; Groome, 2014). The preference for constructivism further supports the research focus on knowledge and lessons learnt by people such as public health logistics managers and strategists, because “people make society, and society makes people. This is a continuous, two-way process” (Onuf, 2013, p. 4).

For data collection, the research involves the Gulf Cooperation Council (GCC) region made up of six Arab and Islamic countries: The Kingdoms of Bahrain and Saudi Arabia, the Sultanate of Oman, and the States of Kuwait and Qatar, and the United Arab Emirates (UAE). With about 30% of the world's known oil reserves (0.496 out of 1.665 trillion bbl), the GCC region possesses strategic global importance (Durugbo et al., 2020a). Focus of data collection on the GCC region's COVID-19 response is unique due to the rich economic, socio-political, legal and cultural context that characterises how the region confronts crises (e.g. previous Middle East Respiratory Syndrome (MERS) outbreaks and grassroots-led upheavals connected to the Arab Spring).

Using purposive sampling (Barbour, 2001), the research applies semi-structured interviews with 15 managers and strategists from the Kingdom of Bahrain responsible for the RLM of COVID-19, as detailed by Table 1, during April and May 2020. This rationale for adopting this sampling approach was due to the latitude the approach affords researchers to think through eligibility criteria for involving participants in studies. In this study, sampling involves a typical case approach (Patton, 2014) with the intention of highlighting what is typical or normal for RLM in the case, and the interviewees are Bahraini public health logistics managers and strategists, identified purposively for their knowledge and involvement in the Bahrain COVID-19 response. Pre-screening and selection of interviewees, for consent and ascertaining their relevance to this study, stem from pre-consultations, via telephone conversations, with the Bahrain Institute for Public Administration, the Ministry for Health and the Supreme Council for Health in Bahrain.

The choice and applicability of Bahrain as a proxy into the GCC region is supported by previous studies which argue that findings from a case GCC country pose significant generalisation potentials across the region due to comparable traits of GCC countries (Durugbo et al., 2020a). Similar use of case countries for RLM studies includes Turkey as a proxy for the Eastern European region (Burgess et al., 1998) and Brazil as a proxy for the South American region (Thürer et al., 2013, 2014).

Due to physical distancing guidelines for curbing the spread of COVID-19, all interviews took place virtually via telephone and video calls in an average time of 58 min (ranging from 45 to 90 min) using questions from the interview protocol (see  Appendix). The protocol contains questions around the 3Cs framing in the previous section. Recording all interviews with the permission of interviewees aids in transcription. For confidential reasons and at the request of participants, the research applies pseudonyms to characterise the participants. The research achieves triangulation with participants through informal follow-up phone calls and via email.

For data analysis, the research applies thematic analysis (Braun and Clarke, 2006) to decipher and interpret collective or distinctive themes from the transcribed interviews. Thematic analysis is favoured for this research because, in keeping with the research aim, the analysis uniquely focuses on themes within data as an avenue to learn lessons and gain insights from research studies (Guest et al., 2012). This analysis process entails the co-authors of this article reading the transcripts repeatedly as a clear picture of crisis-driven logistics strategies and crisis response steadily emerges based on explicit statements (verbally pronounced) and implicit notions (between the lines) in the transcripts. Data familiarity achieved through repeated reading aids in generating initial codes, clustering (or reducing) these codes into coherent themes, reviewing themes separately and collectively to ensure consistency and inclusiveness, and marking texts in transcripts to support themes. For reliability and validity of themes, two independent researchers reviewed the documents containing developed themes. In accordance with the inductive approach (Denzin, 2007) and constructivist perspective (Groome, 2014) of this research, the analysis process aids building up views of the world from incomplete sensory input, treating evidence fairly, examining causal links about the phenomenon, producing inductive analytic conclusions and eliminating alternative interpretations.

Focused on themes associated with links (shown as arrows) in Figure 1, this section presents the case study findings in terms of (1) triggering logistics, and (2) navigating challenges for the 3Cs of crisis-driven logistics, as summarised in Table 2.

Health authorities in the Kingdom of Bahrain detected the first case of COVID-19 on February 24, 2020. “Patient zero” was a man of Bahraini descent returning from a visit to Iran with symptoms reported two days after returning to Bahrain. Beforehand, Bahrain had

Decree 5/2013 (amended by Decree 35/2019) issued by His Majesty King Hamad bin Isa Al Khalifa, the King of Bahrain, established the Supreme Council of Health (SCH) and detailed the composition and duties of the SCH for overseeing RLM for the Kingdom's public health system. Recognising the RLM requirements for COVID-19, the SCH setup a high-level National Taskforce to Combat COVID-19 (NTFCC) on February 4, 2020, with the approval of the Government Executive Committee (GEC). The NTFCC

Headed by the chair of the SCH, the NTFCC set up a “war room” to formulate logistics strategies, meet daily and deliver direct, periodic reports to the GEC. The NTFCC's war room serves as an operational command centre with a taskforce team for combating the virus in a RLM policy that reflects centralised control from the GEC, SCH and NTFCC. According to a public health physician, for RLM,

Interviewees note that to ensure relevance for COVID-19, the team had a transdisciplinary and integrated RLM focus to provide:

Acknowledging that “teamwork is the trump card in a crisis” (Int_13) and the need for “readiness to control the pandemic” (Int_4), the NTFCC acts as the locus for triggering operational teamwork and readiness strategies that focus on the unique crisis-driven demands of COVID-19 for public health (i.e. tracing, testing and treating) and welfare (i.e. response, relief and recovery). Regular and multiple assessments overseen by the war room provide support for crisis readiness, and according to interviewees, there was a need for

Premised on pre-existing infrastructure within the national health system, the logistics strategy involved a surveillance system that scans and traces COVID-19 related news and works closely with the WHO's Regional Office for the Eastern Mediterranean (EMRO). This capability of Bahrain's Ministry of Health (MOH) is commented on as follows:

Motivated by uncertainty on epidemiology of COVID-19, acquisition of information plays a central role in mitigating the spread and transmission of the virus. Limited information influences both the level of preparedness and response because it contributes to assessments for making resource estimations and informs decisions for supporting readiness. Data suggests that:

Protocols based on adaptive and creative technology-oriented monitoring practices tended to be at the heart of medical and clinical logistics strategy with interviewees noting that:

Due to the physical distancing guidelines for mitigating the spread of COVID-19, digitalisation plays a major crisis-driven transition role for formulating crisis protocols. Since the crisis restricted mobility locally and globally, digitisation as an avenue to maintain socio-economic activities extends to the delivery of services in public and private sectors with the case noting that “most of marketing and shopping now is being done on-line” (Int_2). In terms of maintaining healthcare logistics in Bahrain during COVID-19, the interviewees noted the widespread adoption, infusion and routinisation of telemedicine (Int_1, Int_6, Int_13 and Int_15) for offering medical consultation and check-ins remotely using video-conferencing. According to a nurse practitioner and a physician in a public hospital:

Fundamental to orchestrating the COVID-19 response is computations and estimations for capacities needed for roll-out plans to contain and combat the outbreak. A physician explained how COVID-19 cases triggered,

Interviewees noted the need to prepare hospitals, specifically public hospitals, in rollout plans for COVID-19 sites that use government hospital facilities. Using calculations of public needs, the public health response began with using Salmaniya Medical Complex before extending to the Bahrain Defence Force and King Hamad hospitals. The response sites also involved the use of private hospital facilities, developed with specific phases as per the increase in required capacity, with a senior public health physician observing the projection-based work of the NTFCC in:

Overall, due to the sheer scale and impact of the outbreak, the crisis-driven problem of human resource shortage demanded different contributions, i.e.

Within the transcripts, a dominant and emerging theme for coping with this shortage involves setting scenarios and envisioning possibilities with focus on planning and preparedness for extreme and worst-cases. For some strategists in the interviews, the RLM problem centres on knowledge tethered to the science of the crisis phenomenon (i.e. public health science), i.e.

Another focus for setting scenarios involves logistics problems to use daily calculations that realise agility-oriented stores and inventory, i.e.

The next set of themes concern how the public sector in Bahrain navigates challenges for the 3Cs of crisis-driven logistics of the COVID-19 crisis response. Here, the focus is on forward-thinking leadership, first-hand clarity and far-reaching solidarity, as presented in the next subsections.

Interviewees commented on socio-political and cultural characteristics of a crisis-driven leadership central to coalescing work for the 3Cs of crisis-driven logistics. Socio-politically, leadership stemmed from the clarity and candour of directives by the GEC and particularly the Crown Prince. The forward-thinking leadership of the Crown Prince entails critical and on-going reflections that originate in both preparedness and response with one strategist noting anecdotally that:

Although surprising and potentially puzzling for some attendees at the kick-off meeting for the NTFCC, the foresight and proactive RLM strategy of the Crown Prince and the GEC was acknowledged throughout the case study. Other characteristics of the forward-thinking leadership for RLM include a keen interest in establishing commitments from “ministries fulfilling their roles” (Int_15), “high levels of cooperation among the local public” (Int_5), and “political commitment for financial support” (Int_3).

Another facet of RLM leadership for COVID-19 is the key messaging role of religious leaders. According to a physician:

Though the pressures of the pandemic create mental challenges for public servants, viewed holistically, these crisis-driven leadership characteristics establish and encourage commitment that stems from strong cultural beliefs and affinity, as noted by another physician:

Early on and throughout in the COVID-19 response, a core facet of managing the 3Cs of crisis-driven logistics involved clear messages offered “first-hand” i.e. by designated and approved speakers by the GEC. According to a public health logistics strategist,

Similarly, commenting on the overall effects of clarity on messaging, a public health physician remarked:

Recognising the potential for undue panicking of citizens, navigating challenges for the 3Cs of crisis-driven logistics entailed using a multi-tier PR and media campaign plan for public compliance, raise public awareness and address public concerns for COVID-19. The plan involved a 24-h public hotline (444) that answers all concerns related to COVID-19 in Arabic and English Language, and a comprehensive COVID-19 multilingual (seven different languages) media campaign for complete transparency, disseminating advice that promotes healthy behaviour on different web (www.health.gov.bh) and social media channels (e.g. Instagram @schbahrain and @mohbahrain). Effectiveness of the media plan entails delivering a unified message and harnessing not only the knowledge capabilities of the appointed speakers but also the communication capabilities of media influencers, as a public health adviser remarked:

With goals of garnering culture-based commitments of the closely-knit and aware Bahraini society, the campaigns involved press conferences that happen “weekly to answer all what the public is wondering about and reduce their panic” (Int_9). Clear messaging strategies, according to the participants required timeliness (Int_3, Int_5 and Int_8), correctness (Int_3), consciousness (Int_13) and reassurance (Int_10). Focus on these traits in PR campaigns fosters public trust (Int_8 and Int_7) and mitigates the influences of potential rumours (Int_3, Int_11 and Int_15) and misleading information (Int_3) such as “linking the virus to a race or colour” (Int_15).

The interview data (Int_3, Int_5, Int_6 and Int_12) created an impression that compassion and empathy motivate contributions and aided in navigating the challenges for the 3Cs of crisis-driven logistics. The data indicates that the COVID-19 response elicited public support, societal partnership and community solidarity through volunteering and donations to augment the public contracting needed for crisis containment for specialised healthcare RLM involving clinical presentation, epidemiology, treatment and prognosis, as well as general RLM concerns for value chains (e.g. logistics, operations and service). According to an MOH physician,

Other contributions involved volunteered community clubs for conversion into shelters for the elderly, housing for expatriate workers and activities generated by the national “Feena-Khair” campaign that solicited donations for containing the outbreak. The scope for volunteering was extensive with calls for helpers from a wide spectrum of public and private sectors:

Using insights from the Bahrain response to COVID-19, this study confronts the RLM challenge for crisis preparedness and response. The study finds themes characterising the RLM strategies induced due to COVID-19. Figure 2 uses these themes to revise the initial framing of this research outlined by Figure 1, and the next subsections discuss the main implications of this revised model and overall study.

From a theoretical perspective, the findings have three core implications for scholarship. First, this research advances systems thinking combined with regionalisation (Rugman, 2005; Rugman et al., 2009) and centralisation (Rosenthal et al., 2001) theoretical framings for HLSC management. This amalgamation is in line with current arguments on the need for multiple theoretical perspectives as research strategies for scholars to enhance insights from their studies (Oloruntoba et al., 2019). In this context, the regionalisation–centralisation premise argued in this study stem from the regional contexts detailed by managers and strategists in the Bahrain case, i.e. the NTFCC for centralised coordination that triggers RLM for COVID-19 response and the socio-political and religious leadership that aids in navigating the challenges for the 3Cs. Such insights suggest implications for taskforces and leadership of HLSCs at a regional level, and complement but present a different stance to internationalisation and institutional perspectives (Oloruntoba et al., 2019; Prakash et al., 2020) on HLSCs that focus on organisational-level management of flows for resources.

Second, insights on the evolution of COVID-19 responses (i.e. from the setting up of the NTFCC by decree with authorisations overseen by the GEC through to the set of innovative health initiatives coordinated through the war room) suggest a “ripple-inspired inside-out” conceptual framing for crisis-driven logistics strategy. Figure 3 captures these different initiatives and aligns with the centralisation required for coordinating crisis response. As the figure shows, the Bahrain case applies operational centres, teams, technical solutions (testing, treatments and trials) and coordinates activities that harness collaborative models and technologies, social media and responsibility, operational agility and adaptability, and strategic leadership and adjustability. The findings also align with HLSC research arguing that crises, such as COVID-19 with threats to life, peace and security, requires securitisation (Enria, 2019), which the case study highlights through the “taskforce team” theme exemplified by the convening of the “war room” to secure Bahrain. These findings on an inside-out centralised model of crisis-driven logistics strategy induced by the pandemic offer a different context and framing to RLM “in times of normality” that is usually characterised by top-down and bottom-up models for governance and upgrading in global supply chains (Gereffi and Lee, 2012).

Third, the findings on the range of operational resources (existing, contracting and volunteering) offer a radical view for logistics framing and studying HLSC capabilities from a crisis perspective. Specifically, the study supports an “organic capabilities” framing of RLM in times of crises. Closely connected to current expositions on resource-based, resource-dependency and absorptive capacity perspectives on HLSC (Eftekhar et al., 2017; Leidner et al., 2009), a view on organic capabilities shifts the focus from exogenous to endogenous constructs at a community level and stresses organic wholes in contrast to dynamism in complex settings (Durugbo et al., 2020b). Although researchers note that HLSC actors may typically only engage during crisis (Shaheen and Azadegan, 2020), this research presents a regional context in which far-reaching solidarity as opposed to collaborative relationships plays a key role in crisis management. This by no means downplays the role of collaboration in formal structures but accentuates the value of contributions by local communities towards RLM in times of crisis. Previously undervalued and underutilised (Sheppard et al., 2013), local population have the potential to cultivate multiplex relationships and offer regional knowledge with insights on specific and evolving logistics needs. This case study concerns innate and evolving RLM constructs of culture-based commitments, compliance-based campaigns and compassion-based contributions – reflecting regional dependencies for sustaining logistics through emerging contributions (i.e. volunteering and donations) from public support, societal partnership and community solidarity in the COVID-19 response. Two main considerations reinforce these unique constructs in the case: (1) the interplay of rich economic, socio-political, legal and cultural context associated with the faith-based imperatives of a Muslim country like Bahrain, and (2) the pressures of crisis management as a “higher-order element” (Barnes and Oloruntoba, 2005) warranting operational repertoires embedded within regional norms. Cumulatively, these considerations advance an organic mind-set for mitigating crises associated with the RLM case. This organic capability view underscores a multi-faceted natural response to the crisis that is transparent and involves scanning and adopting crisis-driven logistics practices that are economical and in harmony with regional norms.

From a practical perspective, the findings also have some implications for RLM by public authorities and HLSCs. For a start, the study proposes a framing shown in Figure 2 with implications for boosting the viability and integrity of HLSCs. By delineation, crises jeopardise the viability of logistics due to the vulnerability and susceptibility of the complex collaborative networks required for sustaining agility, resilience, and sustainability of HLSCs (Dufour et al., 2018; Oloruntoba and Gray, 2006; Rodríguez-Espíndola et al., 2018). Similarly, crises threaten the integrity of logistics attributable to the unpredictability and instability of the complex systems needed for coordinating and maintaining wholeness of operating principles (Balcik et al., 2010; Minear, 2002). For RLM that represents the interests of regional businesses and citizens, there are imperatives to provide crisis responses promptly and swiftly, with HLSC contexts that reflect unique regional supports for demand fulfilment. Viewed from perspectives of the case study, HLSC integrity could harness support from a high societal, organic capacity to cope with operational uncertainty, explained by the culture-based commitment attributed to the local values and norms, in times of normality, and strengthened by forward-thinking leadership. Likewise, HLSC viability could benefit from a ripple-inspired inside-out, centralised approach that navigates regional humanitarian relief operations using orchestrated crisis scenarios tethered to the science of the crisis phenomenon (i.e. epidemiology) and capacity calculations for RLM based on fragmented and specialised practices for inventory (e.g. “agility stores”) and flexible, response-oriented procurement practices.

In advancement of discourse arguing that piecemeal measures produce unacceptable outcomes (Baveja et al., 2020), this study proposes HLSC management based on the 3Cs of crisis-driven logistics, presented by Figure 3. Concerning crisis coordination, the study encourages HLSC practitioners to espouse forward-thinking leadership and to adopt taskforce teams with a view to establishing centralised crisis readiness that harnesses culture-based commitments. Crisis communication as part of HLSC practice could also benefit from information infrastructure that offer insights into orchestration of crisis scenarios for use in compliance-based campaigns that espouse first-hand clarity. In term of crisis containment, the study suggests that HLSCs build from capacity calculations to devise digitalised crisis protocols and stresses the value of cultivating far-reaching solidarity to garner compassion-based contributions. The study also has relevance for HLSC messaging strategies and suggests the importance of first-hand clarity through unified, timely, correct, conscious and reassured communication strategies harnessing multimedia outlets and influencers to diffuse key messages to the public, e.g. for COVID-19 regarding public health practices, quarantine and scientific knowledge about the pandemic.

Methodological reflections highlight limitations of the research due to its qualitative, inductive case-based focus on knowledge and insights from Bahrain in the GCC region even though the case is unique due to its rich economic, socio-political, legal and cultural context, and previous experiences in dealing with the MERS outbreak. The Bahrain context has limits on the global generalisability of the findings even though research (Durugbo et al., 2020b) suggests regional applicability due to shared cultures and economies by other GCC countries. Although the 3Cs framing offers a model for exploring crisis responses and actions, the framing is limited in analysing the impact or disruptions (e.g. the 3Ss framing proposed by Craighead et al. (2020)). There are also sectorial limitations due to data sourcing from public health authorities responsible for combating COVID-19, and temporal capturing limitations stemming from the focus on crisis response – emphasising the need to consider other relief and recovery phases of crises along with multi-level framing at individual, organisational and societal levels of learning. Additionally, systems thinking with a regionalisation-centralisation premise for RLM serve as the theoretical contextualisation for this research and there are limitations regarding organisational or behavioural perspectives on HLSC management.

Motivated by these limitations, future research will concentrate on gaining quantitative, deductive insights using concepts from this study (e.g. the 3Cs of crisis-driven logistics, organic capabilities and ripple-inspired inside-out framing) to study crisis-driven variables and generalise from a larger sample population. Current work also involves continued tracking and longitudinal study of the COVID-19 response with intentions of integrating knowledge from subsequent relief and recovery intra-crisis phases and for extended post-crisis analysis to model cycles of strategies and the evolution of regional logistics. There are also prospects to study other possible project-, innovation- and technology-based theoretical framings of RLM for analysing HLSCs. Exploring RLM response failures in times of crisis could provide a path for future studies, with opportunities to enrich HLSC discourse with lessons learnt from managing potential supply chain disruptions during global crises (e.g. mask shortages during COVID-19). Additional suggestions for future studies include exploring RLM for recovery phases of crises (e.g. logistics for vaccination programs), (de)escalation management within HLSCs and the legacy/continuity of RLM within HLSCs.

This article explores RLM in times of crisis using the COVID-19 pandemic case and develops a conceptual RLM model of strategies for enhancing HLSCs. It posits on logistics for crisis response as involving coordination, communication and containment mechanisms (the 3Cs of crisis-driven logistics). Guided by an inductive, constructivist-based COVID-19 case study involving 15 Bahraini public managers and strategists responsible for combating the COVID-19 pandemic, the research sheds light on lessons learnt so far from mitigating the transmission and spread of COVID-19. This study confronts two main questions: “What is the nature of crisis-driven RLM for the COVID-19 response from the perspective of public health authorities responsible for RLM?” (RQ1) and “How does RLM in times of crisis relate to HLSC management?” (RQ2). Insights from the case study suggest that COVID-19 induces two sets of strategies as themes for crisis-driven RLM (addressing RQ1). The first set of themes trigger logistics in times of crisis and involve taskforce teams with centralisation for crisis readiness, information infrastructure with digitalisation for crisis protocols and capacity calculations with orchestration for crisis scenarios. The second set of themes navigate challenges for the 3Cs of crisis-driven logistics and entail forward-thinking leadership for culture-based commitments, first-hand clarity for compliance-based campaigns and far-reaching solidarity for compassion-based contributions. Similarly, RLM in times of crisis relates to HLSC management in two main ways (addressing RQ2). First, through a systems approach that links operational leadership, clarity and solidarity to strategic commitments, campaigns and contributions. Second, through a centralisation thesis that associates regional teams, infrastructure, and calculations to crisis readiness, scenarios and protocols that respond to crisis-driven demands, transitions and problems.

Theoretically, the findings imply a ripple-inspired inside-out framing that reinforces the centralisation thesis of crisis coordination, and an organic capabilities framing within a regionalisation context based on emerging contributions (i.e. volunteering and donations) from public support, societal partnership and community solidarity, with transparency in multi-faceted natural responses that scan and adopt adaptive and creative practices. Managerially, the findings offer practical relevance for HLSC practitioners in regards to bolstering viability through ripple-inspired inside-out, centralised approaches tethered to the science of the crisis phenomenon and boosting integrity through high societal, organic capacity attuned to local values and norms. There are also implications for cohesive HLSC strategies premised on the 3Cs of crisis-driven logistics and crisis messaging strategies built on first-hand clarity.

The authors acknowledge the support of the Ministry of Health, the Supreme Council of Health, the National Health Regulatory Authority, the National Taskforce to Combat Covid-19, the Bahrain Institute for Public Administration and the Arabian Gulf University for this research. The authors also thank the interviewees for giving their insights on Bahrain's COVID-19 response and the contributions of Mohamed Sabba, Rabab Habib, Lulwa Fareed, Deema Meshaal, Sara Bahmen, Aysha Alansari and Afnan Alkoheji for arranging interviews and conducting this study.

1. Please provide your name and job title.

2. How would you describe your working experience and role in logistics for the COVID-19 response?

1. How did other organisations coordinate in logistics with health organisations to curb COVID-19?

2. What actions were taken for logistics to contain and combat COVID-19?

3. What communication strategies were taken to reduce public panic about COVID-19?

4. Was media effective in communicating government messages?

1. What are the lessons learnt on logistics from dealing with COVID-19 up-to-now?

2. What strategy for logistics works and what does not work?