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Vulnerability and resilience of the European health care systems in the face of the Covid-19 pandemic: a framework for the comparative analysis of problematic sentinel cases

The main results in terms of inter-regional and intra-regional variations of the application of the concept of "health macro-region" are presented in the first part of the article in order to show how the European health care systems have differently coped with the COVID-19 outbreak. Given the high levels of intra-regional variation found, it seemed appropriate to also add an analysis by country in order to identify those "sentinel cases", given their alert value, which recorded the worst ratio between the infection rates (cases/population) and the lethality rates (deaths/cases). In order to explore the possible reasons behind the problematic coping with the pandemic of these "sentinel cases", a conceptual framework for the analysis of vulnerability, resilience and their governance in terms of sustainability of health care systems is developed in the second part, hoping its application could represent a useful contribution for best-practice solutions that could guide the management of future pandemics.