Women and Care: Reflections on the Lived Experience of COVID-19 Sufferers

Introduction

COVID-19 is not just a virus claiming people’s lives. More so, it has exposed the lack of gender responsiveness in the policy measures to tackle the pandemic taken by governments worldwide. ¹ This is quite alarming since women have been at the forefront of care and response as front-line responders, health professionals, scientists, community volunteers, caregivers, and more, ² whose exposure to the virus puts them at greater risk to infection, morbidity, and death. The United Nations ³ emphasizes the need for gender data to respond to the effects of COVID-19 on women and girls. Further, it also urged the continued monitoring of health risks and other vulnerability variables that affect women as the pandemic is most likely to impact gender variables.

Men and women differ in their experience of the COVID-19 pandemic. So there is a need to apply gender-specific analysis to the crisis in order to address their individual needs appropriately. Otherwise, policy and program interventions that overlook this difference may not be practical or, worse, will cause harm to the intended beneficiaries. As Sharma et al. ⁴ aptly remarked,

Failing to integrate sex differences into COVID-19 research may lead us to neglect an important determinant of reducing the effectiveness of implementation interventions, inadvertently reinforcing sex-neutral claims, and possibly creating or increasing health inequities in care. Only by consistently investigating sex differences in a critical and reflective manner that addresses underlying inequities can we meet the requirements of scientific rigor, excellence, and maximal impact.

Studies about how women are affected by a pandemic are numerous (e.g.,^5–7). These range from how the pandemic has impacted women’s physical and mental health to the unfavorable economic and social consequences of the crisis on their lives. According to a study in Turkey, women, among other groups, are most psychologically affected by the COVID-19 pandemic. ⁸ Women may also become victims of health problems because access to reproductive health is hampered due to quarantine and travel restrictions. Since many of them work in the informal economy, loss of income is expected because of the lockdown measures (See ⁹ ).

Previous studies^10,11 show that the pandemic has increased women’s care burden. Women will have to endure additional responsibilities because of unpaid domestic duties, front-line work, and community work. ¹² As primary caregivers, not only at home but also in caregiving institutions, women, especially working mothers (and much more single mothers), are likely to bear the brunt of the pandemic because of child or elderly care. ² In the UK, for example, women were doing more unpaid care work than men during the lockdown. ¹³ This forced women to adjust their work schedule to accommodate unpaid care work,^10,11,14,15 which increased their stress level higher than men. ¹³ Also, in Spain, lockdowns made women experience more distress, anxiety, and other negative emotions. ¹⁶ This is especially true among women who spent longer hours on housework and child care.^13,16 Not only do women bear more unpaid childcare responsibilities, ² but they also put themselves at higher risk for infection ¹⁵ as they continue to serve those who fell ill. These studies supported previous claims that women remain vulnerable in disaster and crisis situations.

Recent literature on women who contracted COVID-19 is centered on the clinical impact of COVID-19 infection on pregnant women^17,18 and the lived experience of the childbearing mothers. ¹⁹ None so far has been done on the lived experience of women as caregivers – in paid and unpaid work – infected by the disease. While this study may have similar results with our previous research using the same methodology (see ²⁰ ), we highlighted in this article the experience of women as care providers which is not addressed in the previous study. Because there is a dearth of information on the lived experience of women COVID-19 sufferers, especially on women as care providers, this present study could fill the gap in the literature to aid policymakers in applying gender lens in response to the COVID-19 pandemic and in similar crisis situations. Also, it aims to show that people and their lived experience cannot be merely reported as statistical figures or treated as objects of analysis in an empirical study but must be seen as complex human phenomena that warrant a different investigation. The complexity and richness of the human experience are worth exploring using a phenomenological approach so that its deeper meaning may guide policy formulation to be responsive to the needs of the human person.

Study Background

We conducted the study during the height of the COVID-19 pandemic in Cebu City, Philippines. Cebu City is highly-urbanized and densely populated. During this period, Cebu City was a COVID-19 “hotspot” in the country, with only 14 community isolation units serving more than 10,000 individuals^21,22 with asymptomatic and mild cases. These community isolation units are public schools converted into isolation and quarantine facilities to reduce community-level transmission. In these isolation centers, basic necessities such as constant water supply, uninterrupted electricity, toilet/bath, bed and meals are provided. Assigned health workers regularly monitor the health condition of the COVID-19 patients. Even with stricter community quarantine, COVID-19 cases continued to rise in the third quarter of 2020, prompting the Department of Health to send more doctors and other resources to the city as all major hospitals were close to reaching full capacity with an estimated 4000 COVID-19 cases in a 7-day average.

Despite the Philippines performing well in closing the gender gap, ²³ women are still underrepresented in government policy-making. For instance, in the composition of the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF) which is the central decision-making body of the country in the COVID-19 mitigation, there are 30 men and only two women. This gender imbalance in the IATF composition may result in the formulation of policies and measures (such as imposing lockdowns, contact tracing, testing, isolation, and treatment) that may not be responsive to the needs of women. Even if women constitute 75% of the healthcare workforce, it appears that men still have the upper hand in the “ordering” of the lives of men and women in all sectors of society affected by the pandemic.

Methods

We selected the participants through purposive sampling with these criteria: (1) a resident of Cebu City, (2) a COVID-19 survivor (later will be referred to in this study as “COVID-19 sufferer”) diagnosed with an asymptomatic or mildly asymptomatic case, (3) placed in mandatory quarantine and (4) a female care provider (whether in paid or unpaid work). The inclusion criteria were determined based on the need to examine the lived experience of the COVID-19 sufferers confined in community isolation facility which was a “new intervention” introduced by the national government to contain the community transmission of the coronavirus. In this study, eight women were quarantined in a community isolation center. At the same time, one woman underwent a home quarantine with her husband and son, who were also positive for the virus. The research participants were placed in a mandatory quarantine for 14–60 days, depending on the speed of the confirmatory test for the negative results. The nine participants came from the two communities of Cebu City with the highest number of COVID-19 cases in that period. Our research participants were women between 19 to 62 years old; the majority were COVID-19 front-line responders; others were service and support workers. Two were full-time homemakers. This research tells the lifeworld of the nine women COVID-19 sufferers during the whole trajectory of their ordeal from pre-isolation to the post-isolation period.

The participants were referred to us by the community health workers. We relied on the referrals of the community health workers because only they had access to the records of the COVID-19 positive cases and these records were confidential. Permit to conduct the face-to-face interview with the COVID-19 sufferers was granted by the Cebu City government and the concerned community following strict health protocols while conducting the interview (i.e., wearing of face mask, face shield, physical distancing). Ethical clearance was also granted by a local university, and the process of securing the informed consent from the research participants was strictly followed.

We conducted the interview inside the community center to ensure the participants’ privacy and comfort. Participants were invited to appear at the venue on a specific date. Before the interview proper, we again oriented the participants to our study’s purpose, reminding them that participation was entirely voluntary and that we were working on COVID-19 research to help the local government better manage the quarantine procedures and facilities. We did a one-on-one physical session separately, and the participants took turns in going inside the venue. With the assistance of the health workers who arranged the venue for us, we strictly adhered to the health protocols imposed by the local authorities.

We utilized the unstructured in-depth interview in the vernacular language (Cebuano). To capture what we saw and heard during our interview process, we took notes while recording the interview (after asking permission from the participants). The field notes and voice recording served as our reference in the transcription process and in describing the lived experience of the participants. The nine interview recordings were transcribed literally in Cebuano by our research staff which we verified by reading the transcripts while listening to the voice recordings.

In accessing the lived experience of the COVID-19 sufferers, our interview process was guided by Van Manen’s phenomenology of practice. By lived experience we mean the originary and pre-theoretical experience of women COVID-19 sufferers before these are conceptualized and interpreted. Van Manen’s phenomenology draws from many phenomenological models to provide varying ways of “seeing”, ²⁴ p. 22). In applying van Manen’s approach, we were conscious not to reduce phenomenology to a single method or procedure because a phenomenon could manifest itself in many different ways, “depending in each case on the kind of access we have to it”, ²⁵ p. 51). Similarly, Merleau-Ponty, ²⁶ p. xvii) reminded us that the world cannot be circumscribed by a single thought nor its meaning fully exhausted even if we are “open” to and in “communication” with it.

In phenomenological research, rigor is achieved through a thoughtful process of (1) heuristic questioning, (2) experiential description, (4) phenomenological thematizing, and (5) “insighting,” “voking,” and interpretation, ²⁴ pp. 376–377). Heuristic questioning asks the contextual question, “What does it feel like to have COVID-19?” It is important to note that this question must be able to access the four fundamental structures of the lifeworld: lived-body, lived-space, lived-time, and lived-human relation or lived-other, ²⁷ pp. 101–102). During the interview, we provided follow-up questions to the participant to make the description reveal the four experiential structures.

In the second step, experiential description, we draw out vivid accounts from the interview transcripts. Vivid accounts are rich details of the experience as (1) one lived through it, avoiding explanations and generalizations about the experience, (2) told from the state of mind evoking feelings and moods, (3) focusing on a specific event, (4) attending to what stands out for its vividness, and (5) attending to sensory details, ²⁷ pp. 64–65). This description is intended to make the phenomenon ‘be seen from itself in the very way in which it shows itself from itself', ²⁵ p. 58). In this process, we used English in writing the experiential description while retaining the nuances of the Cebuano language. We carefully looked into what the participants had “actually” undergone and acknowledged their understanding of their experience.

After preparing the experiential description, we embarked on phenomenological thematizing. Themes are the essential structures of experience expressed in language that “captures the phenomenon one tries to understand", ²⁷ p. 79). Themes were extracted as we made sense of the sufferers’ lifeworld. Doing the phenomenological thematizing is not doing data analysis. Hycner (1999, cited in ²⁸ reminded researchers to be cautious with “data analysis” as the term (analysis) implies “breaking into parts.” What phenomenology does is understand the whole experience in relation to the parts and how these parts relate to the whole. ²⁵ Hopkins et al. ²⁹ urged researchers to be honest in their biases and assumptions and to re-examine them to address researchers’ positionality. We managed our positionality by constantly checking and reflecting on our cultural biases about Filipino women. We also ensured that our final description and interpretation reflect the “pre-reflective” experiences of these COVID-19 sufferers and not the cultural experience of a Filipino woman who went through a challenging situation. We maintained the phenomenological attitude of openness, wonder, and attentiveness to the women’s lived experience.

The last step was “insighting,” “voking,” and interpretation. Insighting draws from related literature to aid reflection, ²⁴ p. 377). In reflecting on the sufferers’ lifeworld, we presented the four structures (lived-body, lived-space, lived-time and lived-other) in a holistic and inseparable fashion, guided by the idea that the lived-body is the lived center and “ground” of experience, ³⁰ p. 105). We were careful not to impose our constructions of reality but to find the relevant texts that might shed light on our interpretation of the extracted themes. Integrated into this “insight” cultivating and writing is “voking,” which is the tactful attentiveness to the vocative nature of language, ²⁴ p. 377). Our task was to use compelling language that could bring this revelation to an experience-near level. One way to aptly name the survivors is to call them 'sufferers' instead of ‘patients.’ The latter has a clinical connotation, which is incompatible with phenomenology, while the former suggests the phenomenological experience of suffering. Suffering pertains to the physical and psychological pain, distress and hardship that a COVID-19 positive person has gone through. The last stage was interpretation. We articulated our insights to make the themes visible and invoke a richer and “fuller grasp of what it means to be in the world as women”, ²⁷ p. 12) infected by COVID-19.

Results (Themes of the Lived Experience)

The women COVID-19 sufferers’ lived experience is categorized into five themes: (1) Pain and separation; (2) Suffering and caring; (3) Stigma of discrimination; (4) Caring response; and (5) Supportive relationship. For presentation purposes, we used anecdote fragments as examples of the phenomenological experience. Fictitious names were employed for narrative effect and to protect the identity of the participants.

Discussion

The women’s lived experience has deepened our understanding of how women can get through a challenging situation. Their lived experience has also enriched our appreciation of care and responsibility in human relations. Although the lived experience is a personal event that cannot be fully approximated by describing the common underlying narratives of the women sufferers, we will just turn our gaze to the compelling insights of their lived experience that lead us to see the multi-faceted meanings of the COVID-19 pandemic. These insights have ushered us to go deeper into the situation of women in times of crisis which may have some important implications for public health policy.

Caring Amidst Vulnerabilities

The concept of care is pivotal to our understanding of the research participants' lived experience. Care refers to “a species activity that includes everything that we do to maintain, continue, and repair our world so that we can live in it as well as possible (Fisher & Tronto, 1990:40 as cited in, ³¹ p. 12). As Noddings ³² describes, caring involves a “displacement” of ordinary self-interest into unselfish concern for another person. This unselfish concern is best exemplified in the experience of the mothers who bear the pain of isolation. The mothers’ profound worry for the welfare of their minor children stems from engrossment or mental attentiveness, ³² which is implied in the act of caring. The act of caring involves thinking for the other and means doing something. ³² The mothers’ inability to give care to their children while in isolation causes them mental anguish, which exacerbates their vulnerability. However, even with increased vulnerability, these mothers were able to care for others in the facility.

Another instance of caring amidst vulnerability is visible in the lived-space and lived-other of the research participants. Before the COVID-19 sufferers were placed in the community isolation facility, they were forced to self-quarantine in their abode for four to 14 days. Their lived-space is a source of pain as they become the target of discrimination in the neighborhood. What is more painful is that they lived in the community, which they called home – their lived-space – and yet they feel alienated because of discrimination. The people’s dread of COVID-19, coined “coronaphobia,” brought social discrimination against those who contracted the disease and excessive fear or perceived risk of acquiring the infection. ³³ The family of Maria was emotionally harmed when the authorities cordoned their house with plastic cellophane. Also, Ana’s family suffered blatant discrimination when a drunk man threw bottles at their house. Similarly, Thelma and her family were deeply hurt by their neighbors’ stern warning, “Stay away from them. They have the virus.”

To the women COVID-19 sufferers, the neighbors' discriminating words and actions are more potent than the virus. ²⁰ When attitudes such as those exemplified by the discriminators are left unchecked, harm is done to the sufferers. According to Petersen, ³⁴ p. 53), harm is caused by the “lack of care,” while Kittay, ³⁵ p. 53) describes it as the “consequence of the failures in responsibility and responsiveness.”

Amidst the neighbors’ hurtful words and actions, Thelma and Ana continued to care. Thelma pacified her son, who was about to confront their neighbors, with her comforting words. Ana spoke with the drunk man in a firm and careful manner. She also expressed an invitation for him to become adaptive and more understanding to those who contracted the virus. In situations where potential conflict could erupt, these women display calm composure and understanding towards their discriminators. In these examples, women may have been emotionally harmed and weakened brought about by the pains of separation and discrimination, yet they remain steadfast in caring.

Resilience and Relationality vis-à-vis Caring

Resilience, in the context of crisis, is the ability to adapt to a challenging situation and “bounce back after stress”. ³⁶ Our research participants displayed unwavering resilience when they battled against COVID-19. We also observed that this resilience is not divorced from relationality – i.e., the sense of connectedness with their fellow COVID-19 sufferers and with their God. Relationality is a common attribute in women. ³⁷ In care ethics, relationality sees the self as having no “separate, essential core” and just emerges upon its encounter with others (Hekman, 1995, as cited in, ³¹ p. 14).

The mothers’ deep concern for their children left at home demonstrates relationality. They were able to expand the sphere of this relationality to include other COVID-19 sufferers, which strengthened their resilience. The mothers were able to bear the pain of isolation when they extended their care to their fellow COVID-19 sufferers. This suggests that care is not only confined to the home, i.e., those who are ‘near’ and ‘dear’ to us, but can also be given to strangers upon our interaction with them. Through this interaction with a “stranger,” relationality is developed, which preconditions the act of caring. For Noddings, ³² p. 4), relationality is both “human encounter” and “affective response,” which are basic facts of human existence. In other words, to be a “self” means to care for the other.

Relationality is strengthened by empathy. Two front-line responders shared how they took care of the elderly in the facility. Lolita and Teresa were moved to help the elderly COVID-19 sufferers because of pity. This is an act of empathy which, according to Michael Slote, ³⁸ p. 13) is associated with “feelings of another (involuntarily) aroused in ourselves, as when we see another person in pain” or in need. As already shown, care needs not to be confined to family members. It can also be extended to include nonfamily members like the elderly in the quarantine facility. More so, empathy involves not projecting oneself into the other but being receptive to the needs and feelings of other COVID-19 sufferers. It entails “feeling with the other,” which Noddings, ³² pp. 30 – 32) characterizes as a feminine way of relating with others. This contrasts with the masculine notion of empathy as projection, which connotes the imposition of one’s views and values on another. Women’s pity and compassion flow from their receptiveness to the suffering of the elderly. This exemplifies ethics that puts the human other above the self. ³⁹ Therefore, it is clear to us that these women COVID-19 sufferers place the welfare of their children and the elderly sufferers above themselves and their illness.

Women are socialized in a home environment characterized by caretaking and nurturing (Gilligan, 1982/1993) which presupposes relationality. The women’s relationality is observed in how they resolve conflict. For example, two of our research participants, Ana and Maria, exemplify women’s proclivity to nonviolent means in dealing with conflicts. To recall, Ana, in trying to neutralize aggression from a drunk man who threw bottles at their house, talked to him using emotional appeal. She told him, “I hope we can just help each other and not cause further harm.” Maria, at the isolation center, was able to soothe the aggression of her fellow sufferers who planned to escape from the center by appealing to their sensibilities and concern for others. This is what Williams (1972, as cited in, ³⁴ p. 59) suggests to extend one’s capacity for “other-concern” by appealing to their “confined sympathies.” Careful not to implicate essentialism into this contention, we only want to emphasize that the relational character of women makes them effective communicators, especially in managing conflict situations.

The women sufferers’ relationality is key to surviving the crisis. Their sense of self can be seen as relational, and this motivates them to connect with others. As Miller (1976, as cited in ⁴⁰ p. 169) says, “women stay with, build on, and develop in a context of attachment and affiliation with others,” that “women’s sense of self becomes very much organized around being able to make, and then to maintain affiliations and relationships.” The women participants’ ability to draw strength from one another stems from how they relate to the other. For example, the mothers’ deep sense of responsibility for their children’s welfare made them survive the COVID-19 ordeal. In the same vein, relationality strengthens the social bond and interdependence between the research participants and the rest of the COVID-19 sufferers in the isolation facility. For example, the sufferers participated actively in routine social activities like the morning exercises. Moreover, the women’s strong religious faith, as manifested by the experiences of Thelma and Lolita, bolstered their resilience in overcoming their ordeal. Resilience, when supported and sustained by faith, enables an individual to survive a crisis, ⁴¹ p. 121).

Another example of drawing strength is shown between Sheila’s family and their good neighbor, whom they depended on running errands for their daily needs. According to Kittay, ³⁵ p. 52), “the ability of a being to give and receive care is a source of dignity for humans.” The human other can be a reason for us not to give up on life amidst suffering. As Frankl ⁴² reminds us,

Being human always points, and is directed, to something, or someone, other than oneself—be it a meaning to fulfil or another human being to encounter. The more one forgets himself—by giving himself to a cause to serve or another person to love—the more human he is, and the more he actualizes himself. (p. 133)

The women participants were still able to give care to their fellow COVID-19 sufferers in the center despite their battle. As they provided care to others in need, they also felt fulfilled in this act of caring. This is what Noddings ³² called the reciprocity of the act of caring and of receiving care. The need to depend on another is an essential human experience. There is nothing wrong with receiving care or relying on another. The caring relation is completed when the one being cared-for responds with respect and obedience to the one caring, ³² p. 75).

Care Ethics and Public Health Policy

Public health, as used in this study, is a public good that the government needs to manage and regulate to ensure the health of its population as a whole. A public health system bereft of care ethics may perpetuate the subtle inequalities and continue to harm women, children, the elderly, and the other vulnerable sectors in society. Without caring practices that sustain society, liberty, equality, and the good life may not be achieved, ⁴³ p. 5). The experience of Sheila and her family, who were the first to use the isolation facility, speaks of the lack of care in the implementation of the guidelines. Sheila said they were not provided with water, hygiene supplies, and other essential provisions during their first week in the isolation center, contrary to what they expected. This uncaring environment of the isolation facility compounded the anxiety of the COVID-19 sufferers and their feeling of uncertainty. Another example of this lack of care is the incident of cordoning the house with plastic cellophane to contain the spread of the virus. Even with the consent from the affected family, the local authorities should have exercised “care” in handling the situation. Without “care” measures to manage the pandemic becomes “authoritarian” and “cruel” which can further harm those we want to protect. As Daniel Engster ⁴³ indicates, caring should be mainstreamed in public policy formulations and institutional processes for efficient care work.

Care reasoning is noticed in the experience of Maria when she pacified her fellow COVID-19 sufferers who planned to escape from the isolation center. Studies show that women typically engage in accommodative, compromising ⁴⁴ and indirect, smoothing strategies to diffuse conflict (Ting-Toomey, 1988, as cited in. ⁴⁴ These attributes of women are forms of care reasoning that help resolve disputes, ³⁴ p. 59). Care reasoning implies attentiveness. “Attentiveness needs to encompass not only a personal attentiveness to the particular situation of others but also recognition of the social and cultural circumstances and factors that affect the experience and nature of need”, ⁴⁵ p. 20). This means that caring is not only limited to close relations as in the case of Maria and her fellow COVID-19 sufferers but can also be extended to the “unknown” others in the community who might be infected with the virus should the sufferers escape from the isolation center. This notion of care extended to the “unknown” others in the community finds support in Benedict Anderson’s ⁴⁶ concept of “imagined communities” where people perceive themselves as part of the group. It is in this “imagined community” that relationality inheres, which is presupposed in the act of caring. Maria’s care reasoning is inclusive because it considers the various situations of people affected by the pandemic.

In applying attentiveness to public policy, the local authorities may not go into the overkill of binding Maria’s house with plastic cellophane. Instead, they will have to work on providing proper care and support to those who fell ill and disseminate accurate information about the virus to appease the community’s anxiety. For example, the local government authorities may organize and train gender-balanced pandemic response teams, which will serve as support groups to the infected individuals; while others may work on information, communication and education (IEC) materials to counter the misinformation and myths about the disease. It is important to note that people may be susceptible to wrong information propagated by social media, which are prevalent in the local communities. A public policy inspired by an ethics of care protects not only a particular group of individuals but all those affected and who might be affected, considering their social roles, identities, special needs, religion, values, and other social variables.

The women participants made us realize there are still many areas of our institutional policies that need to be “care-fully” assessed to eliminate current and subtle forms of gender inequality. Although as a general policy, these community isolation centers are supposedly “family-oriented” and “gender-sensitive,” this is not observable in practice. There is an urgent need to address the needs of women with different social roles and contexts as part of the measures in the COVID-19 mitigation. For example, a strong social support mechanism to help isolated mothers not to worry about care work for their minor children can be integrated into public health crisis management. Also, looking at the special needs of women should be considered before implementing any government intervention to avoid worsening their vulnerability. Another responsive measure in isolating the sick members of the community is to strengthen the social networks and support systems reflective of people’s values.

Conclusion

Our reflections re-present the taken-for-granted caring and nurturing character of women who, despite the great risk in their lives, do not stop caring for others. The lived experience of women COVID-19 sufferers is reflective of the female virtue of altruism, strong devotion, and self-denial which is often associated with care, ³⁴ p. 59). Even if they are vulnerable, suffering, and in need of care, women never stop caring for their children, family members, and others in need. Their resilience and readiness to self-sacrifice are even made more manifest even in times of deep crisis. This is not to reinforce the social and cultural constructs that women are predetermined to assume the caring and nurturing role. We are only showing the strength of their character in challenging situations. The women sufferers’ have taught us how to respond to the needs of others in times of crisis. If we do not want to lose hope in our battle against any crisis, our policy measures should not only be responsive to women’s needs but also reflect the caring character of women. ⁴⁷ The relational aspect of care is seemingly missing in the existing rational-based COVID-19 policies and practices which tend to be “authoritarian” and “cruel.” When societies are so designed in a very rational way that embodies patriarchal values and practices, there is a propensity to downplay the real condition of women. This is a form of structural violence that “infects relationships between institutions and individuals and is characterized precisely by lack of care between unequal parties”, ³⁴ p. 53). Eliminating subtle inequalities might need zooming in on our gender lens to see the real condition of women. We may need ethics of care to serve as the framework of which all practices are examined, ³² p. 265). Thus, ethics of care has a role to play in building and maintaining better societies, ⁴⁸ p. 52; Held, 1993/2006 and Tronto, 1993 cited in. ⁴⁹ And if we truly want to put people at the center of development, we might need to “care-fully” look into people’s lived experience to revisit our existing policies and practices. Thus, we recommend for further study the lived experience of the implementers or the local authorities to understand how they perceive their duties and responsibilities as public officials. In this way, a deeper understanding of the stakeholders’ lifeworld may provide a richer information for a better management of the pandemic.