Epidemics and local governments in struggling nations: COVID-19 in Lebanon

Jida M. Al-Mulki; Mahmoud H. Hassoun; Salim M. Adib

doi:10.1371/journal.pone.0262048

Peer Review History

Original SubmissionAugust 9, 2021
25 Nov 2021 Decision Letter - Rogis Baker, Editor PONE-D-21-23335EPIDEMICS AND LOCAL GOVERNMENTS IN STRUGGLING NATIONS: COVID-19 IN LEBANONPLOS ONE Dear Dr. Jida Mulki, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Jan 9, 2022. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables (should remain/ be uploaded) as separate "supporting information" files. 8. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: N/A ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This manuscript presents the findings of very timely research that can help local authorities around the world (and not just in countries facing similar challenges to Lebanon) in dealing with current and future pandemics. Overall, I thought the document was well-written and easy to follow. There were, however, a few points for the authors to consider. I will start with the major point to address: 1. My main concern relates to preserving the identity of respondents. The authors state in their “ethical considerations” section that “potential participants were informed that names will not be disclosed in any report”. However, I suspect that the identity of some of the respondents could be revealed from the description of their role. For example, “the Mayor of Khiyam, or the Mayor of Michmich”. I would strongly encourage respondents to either anonymise the names of all the municipalities or describe roles in more generic terms, for example “Official in municipality”. Alternatively, the authors could explain why there is no risk of the identity of respondents being revealed. 2. Other points for the authors to think about: a. The time period when the data were collected (i.e. interviews were conducted) is not clear. It would be helpful to know whether this was in the very early stages of the pandemic, or later on. It would also be helpful for the reader to know the duration during which data were collected, because I imagine some of the municipalities may have moved between the two categories (i.e. their response to the pandemic may have improved or become worse). b. The research was carried out in nine municipalities, however the authors restrict their analysis to four municipalities. It would be helpful to explain the rationale for this. c. One of the key discussion points relates to the proximity of municipalities from the capital. However, this is not described in sufficient detail in the results. It would be helpful to know, for example, whether both of the municipalities with adequate response were closer to the capital than those with inadequate response. The map may be helpful in this respect if it showed where capital was located on the map. d. Some of the statements in your discussion could have benefitted from references. For example, the entire discussion about the inequitable distribution of resources (on page 26) is not supported by existing literature. Finally, here are some miscellaneous issues for the authors to consider: a. Describing the central government as “eternally” broke is in my view too broad a statement, and a more specific time-frame will need to be provided. b. Similarly, the lack of awareness of religious leaders could perhaps be made more specific. I.e. is it ignorance of health issues rather than ignorance in general? Reviewer #2: The manuscript covers an interesting and important aspect of the pandemic. Below please find a few suggestions to further strengthen the manuscript. 1) Abstract (page 3) Please quantify "most municipalities" for example in % 2) (page 8) Please elaborate on "the felt presence to the virtually absent". It is difficult to understanding the meaning 3) (page 8) Please justify why SEM was used rather than other frameworks. And outline advantages and disadvantage 4) Methods (p1ge 11) Could you provide the IRB number? 5) The results and discussion sections are lengthy, making it challenging for the reader to focus on the core messages. Please try to modify/shorten the text to make it more coherent and succinct 6) Please carefully check for typos and correct grammar e.g. (page 8 SEM has been adapted ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. 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Revision 1
11 Dec 2021 Author Response Academic Editor: 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The manuscript is adjusted according to PlOS One guidelines. 2. Please amend your current ethics statement to address the following concerns: a) Did participants provide their written or verbal informed consent to participate in this study? b) If consent was verbal, please explain i) why written consent was not obtained, ii) how you documented participant consent, and iii) whether the ethics committees/IRB approved this consent procedure. The ethics statement was amended as requested. 3. 3. When reporting the results of qualitative research, we suggest consulting the COREQ guidelines or other relevant checklists listed by the Equator Network, such as the SRQR, to ensure complete reporting The manuscript was checked against the COREQ guideline and complete reporting was ensured. 4. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. Reserved DOI: 10.17632/k4jp3xscg2.1 5. We note that Figure 1 in your submission contain map images which may be copyrighted. All PLOS content is published under the Creative Commons Attribution License (CC BY 4.0) Permission to use the map is included in “other” supplement. 6. We note you have included a table to which you do not refer in the text of your manuscript. Please ensure that you refer to Table 2 in your text; Table 2 was cited 7. Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables (should remain/ be uploaded) as separate "supporting information" files. Tables were added to the manuscript. 8. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Captions were added. Reviewer 1: 1. I would strongly encourage respondents to either anonymise the names of all the municipalities or describe roles in more generic terms, for example “Official in municipality”. All identifiers were replaced with generic terms (eg, officials, stakeholders, key informants) 2. a. The time period when the data were collected (i.e. interviews were conducted) is not clear The time period of the conducted interviews was added in the study procedures section. b. The research was carried out in nine municipalities, however the authors restrict their analysis to four municipalities. It would be helpful to explain the rationale for this. The rational for including 4 municipalities in this paper is to keep it short, concise, and readable (added this to the plan of analysis) c. One of the key discussion points relates to the proximity of municipalities from the capital. However, this is not described in sufficient detail in the results. It would be helpful to know, for example, whether both of the municipalities with adequate response were closer to the capital than those with inadequate response. The map may be helpful in this respect if it showed where capital was located on the map. The response of the municipalities to the capital in regard to their response is more pronounced for the 9 municipalities, with most of the proximal municipalities responded better to the pandemic due to the availability of resources and better healthcare systems. However, I removed the sentence that relates proximity to the response because on of the selected municipalities which responded well to the pandemic is not proximal to the capital (khiyam). d. Some of the statements in your discussion could have benefitted from references. For example, the entire discussion about the inequitable distribution of resources (on page 26) is not supported by existing literature. References are added Finally, here are some miscellaneous issues for the authors to consider: a. “eternally” was removed b. The ignorance of religious leaders was modified to “ignorance in health issues”. Reviewer 2: 1) I opted not to include percentages because in this qualitative study, we are not interested in quantification, rather we want to get in depth insights on the experiences of various municipalities during the pandemic. If I put percentage in the abstract, then I must add percentages to all the results. 2) (page 8) Please elaborate on "the felt presence to the virtually absent". It is difficult to understanding the meaning. Some municipalities were distinguished by the activities they undertook, thus making their presence noticed by people, while other municipalities get unnoticed because they were not active during the pandemic 3) (page 8) Please justify why SEM was used rather than other frameworks. And outline advantages and disadvantage I used SEM because it is an ideal tool to address complex public health issues, as it allows deep understanding of the dynamic interplay between personal, interpersonal, organization, community and policy levels. In other words, we can see the multi-level barriers that impeded municipalities from responding well to the pandemic and design interventions at different levels (individual, community, policy…) to overcome these barriers. However, one of the major imitations of SEM is that the programs can be expensive to implement. In addition, it requires close coordination between individuals and groups for effective implementation. 4) Methods (p1ge 11) Could you provide the IRB number? IRB number: SBS-2020-0428 5) The results and discussion sections are lengthy, making it challenging for the reader to focus on the core messages. Please try to modify/shorten the text to make it more coherent and succinct I shortened the results and discussion as much I can, but this study has a lot of themes and subthemes that cannot be omitted or overlooked. 6) Please carefully check for typos and correct grammar e.g. (page 8 SEM has been adapted The paper was spell checked and corrected. Attachments Attachment Submitted filename: Response to Reviewers (municipalities).docx https://doi.org/10.1371/journal.pone.0262048.r002
16 Dec 2021 Decision Letter - Rogis Baker, Editor EPIDEMICS AND LOCAL GOVERNMENTS IN STRUGGLING NATIONS: COVID-19 IN LEBANON PONE-D-21-23335R1 Dear Dr. Jida mulki, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Rogis Baker, Ph.D Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0262048.r003
Formally Accepted
6 Jan 2022 Acceptance Letter - Rogis Baker, Editor PONE-D-21-23335R1 Epidemics and local governments in struggling nations: COVID-19 in Lebanon Dear Dr. Al-Mulki: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Rogis Baker Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0262048.r004

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