As soon as the Republic of Georgia’s National Center for Disease Control and Public Health (NCDC) sounded an alarm about a cluster of unusual pneumonia cases in Wuhan, China, Prime Minister Giorgi Gakharia’s government set its pandemic response into motion.  It was early January 2020, and there was still no hard evidence that the infection had spread across borders, but the country’s health leaders were wary. As outbreaks of the virus, identified as COVID-19, began to appear in other countries, the government quickly created a multisectoral coordination council chaired by the prime minister and then adopted a number of emergency response measures. Working with a network of local public health centers, the NCDC launched a communications blitz, with scientists and physicians at the forefront. The public health campaign encouraged compliance with stringent—and unpopular—lockdown measures. Through the first half of 2020, the weekly number of new cases remained low, even as infections surged in many high-income industrial countries. But it was too early for a victory lap. Pressure grew to open up resort centers during July and August in an economy heavily dependent on tourism. During September, October, and November the number of new cases per day climbed sharply, driven mainly by expansion of the outbreak in Adjara, a vacation destination. Compared to most European countries, the incidence of disease remained low, however, and the number of new infections later plummeted, approaching initial levels by March 2021. This case study highlights how a small, middle-income country with a privatized and decentralized health-care system initially succeeded in its pandemic response, struggled with sharp reversals, and then brought the infection rate close to earlier levels prior to vaccine distribution.

Tyler McBrien drafted this case study based on interviews conducted with Nona Tsotseria, MD, PhD, in January and February 2021. Case published June 2021. This case study was supported by the United Nations Development Programme Crisis Bureau as part of a series on center-of-government coordination of the pandemic response.

The views expressed in this publication are those of the author(s) and do not necessarily represent those of the United Nations, including UNDP, or the UN Member States.

In the early 1990s, scientists discovered that the city of Seattle faced far severer seismic hazards than previously known. Their findings showed that a devastating earthquake would occur—perhaps tomorrow, perhaps next year, or maybe not for decades. In any event, the coastal city—the largest in the Pacific Northwest region of North America—was gravely unprepared. The uncertainties surrounding the timing and extent of such a disaster worked against the case for immediate, significant, and unified government action. Beset by more-pressing priorities, elected officials were reluctant to commit significant tax dollars, extensive amounts of time, and substantial political capital to the issue. Municipal emergency managers and community organizers took on much of the responsibility and tried to address important aspects of how to respond to the population’s immediate needs amid the devastation a massive earthquake would cause. They worked especially hard to build networks of organizations and people that would strengthen the city’s preparedness and resilience. Still, organized efforts directed toward two other elements of preparedness—mitigation and recovery—lagged. Seattle’s effort to grapple with those problems spotlighted a bigger question: How should a society prepare for a high-consequence disaster of uncertain timing?

Gordon LaForge drafted this case study based on interviews conducted in Seattle, in July and August 2019. Case published October 2019.