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In this paper we explore the impact of the emerging COVID-19 pandemic on the governance of healthcare in the Netherlands. In doing so, we re-examine the idea that a crisis necessarily leads to processes of transition and change by focusing on crisis as a specific language of organizing collective action instead. Framing a situation as a crisis of a particular kind allows for specific problem definitions, concurrent solutions and the inclusion and exclusion of stakeholders. Using this perspective, we examine the dynamics and institutional tensions involved in governing healthcare during the pandemic. We make use of multi-sited ethnographic research into the Dutch healthcare crisis organization as it responded to the COVID-19 pandemic, focusing on decision-making at the regional level. We tracked our participants through successive waves of the pandemic between March 2020 and August 2021 and identified three dominant framings of the pandemic-as-crisis: a crisis of scarcity, a crisis of postponed care and a crisis of acute care coordination. In this paper, we discuss the implications of these framings in terms of the institutional tensions that arose in governing healthcare during the pandemic: between centralized, top-down crisis management and local, bottom-up work; between informal and formal work; and between existing institutional logics. • The COVID-19 pandemic is framed as a crisis of different kinds in healthcare. • Framing impacts decision-making and inclusion of stakeholders. • Ethnographic research provides insights into the consequences of these frames. [ABSTRACT FROM AUTHOR]

The information set from which individuals make their decision on vaccination includes signals from trusted agents, such as governments, community leaders and the media. By implementing restrictions, or by relaxing them, governments can provide a signal about the underlying risk of the pandemic and indirectly affect vaccination take-up. Rather than focusing on measures specifically designed to increase vaccine acceptance, this paper studies how governments' non-pharmaceutical policy responses to the pandemic can modify the degree of preventive health behavior, including vaccination. To do so, we use repeated waves of a global survey on COVID-19 Beliefs, Behaviors and Norms covering 18 countries from October 2020 to March 2021. Controlling for the usual determinants, we explore how individuals' willingness to get vaccinated is affected by changes in government restriction measures (as measured by the Oxford Stringency Index). This relationship is mediated by individual characteristics, social norms (social pressure to conform with what most people do), and trust in government institutions. Our results point to a complex picture as the implementation of restrictions is associated with increased acceptance in some contexts and decreased acceptance in others. The stringency of government restrictions has significant positive correlations with vaccine acceptance in contexts of weak social norms of vaccine acceptance and lower trust in government. In countries or communities with tighter social norms and high trust in health authorities, vaccine acceptance is high but less sensitive to changes in policies. These results suggest that the effect of government policy stringency is stronger among individuals who report lower trust and weaker social norms of vaccine acceptance. • Reports results from the analysis of an online survey on health behaviors during the COVID-19 • Provides evidence on the relationship between vaccine acceptance and lockdown policies • Finds stricter non-pharmaceutical interventions are associated with higher vaccine acceptance • Shows that this association is stronger for individuals with lower trust in health authorities [ABSTRACT FROM AUTHOR]