Background: The coronavirus disease 2019 (COVID-19) pandemic revealed how mental health, especially among frontline and non-medical frontline workers, who has often been overlooked in pandemic policies and approaches. Global health frameworks such as the World Health Organization (WHO) Pandemic Agreement and International Labour Organization (ILO) guidelines have begun to incorporate mental health into Occupational Safety and Health (OSH) agendas, while limited study focus on people such as frontline worker’s mental health in large-scale international events in an exclusive pandemic setting. The objective of this study is to investigate how mental health has been reflected in pandemic policy frameworks and to explore how non-medical frontline workers lived experiences and feedback can inform more inclusive pandemic governance.
Methods: This study develops a conceptual framework linking policy design, frontline discretion, and mental health outcomes, drawing upon Policy Feedback Theory (PFT), Street-Level Bureaucracy (SLB), and Event System Theory (EST). Based on this model, a mixed-method survey was designed to assess the perceptions, stress, coping mechanisms, and policy feedback of non-frontline workers (NFWs) who supported COVID-19 countermeasures at the Tokyo 2020 and Beijing 2022 Olympic and Paralympic Games.
Results: Preliminary findings from policy document analysis show that mental health and well-being concerns were largely absent from earlier pandemic strategies related to mass gatherings (MGs). Semiconductor interviews suggest that non-medical frontline workers experienced significant emotional strain, such as anxiety, fatigue, and isolation, especially under restrictive “bubble” policies. These psychological challenges were often unaddressed in official protocols, and in some cases, led to declining morale or reduced willingness to comply with infection control measures.
Conclusions: This study reveals a growing but uneven recognition of mental health in pandemic governance and MGs. While recent policy frameworks begin to address mental health and well-being, the past experiences and feedback of non-medical frontline staff remain underrepresented. By identifying these gaps and capturing perspectives from Olympic contexts, this research offers insights to inform more inclusive and equitable planning for future mass-gathering and pandemic governance as well.
