The government response of the GCC countries to the COVID-19 pandemic has been comprehensive, stringent, and timely. They have all implemented a complete set of policies to respond to the epidemiological and economic consequences of the pandemic. Policies that aim to reduce transmission and mortality include containment and closure policies, health system policies, and vaccination policies. Specifically, the containment and closure policies restrict people’s mobility, while health system policies and vaccination policies aim to use a public health approach to control the pandemic. Economic policies have also been developed to relieve the financial loss to individuals, households, and enterprises caused by the pandemic. The stringency of the response has been kept high, especially at the beginning of the outbreak. All the governments began to act around late January 2020, when there were fewer than 100 local cases per GCC country. To ensure effectively-coordinated efforts in the future to tackle epidemics and strengthen public health efforts, the GCC countries established the new Gulf CDC in Riyadh, Saudi Arabia, in January 2021. The mission of the Center is envisioned to foster harmonization, build knowledge, and generate evidence to enable the prevention of communicable and non-communicable diseases, mitigation of public health emergencies, and promotion of healthy communities across the GCC region [38].

The GCC countries have adjusted the government response dynamically based on the epidemiological burden, the virological characteristics of the SARS-CoV-2 variants, and the availability of vaccines. Similarly, these governments kept the stringency of lockdown-style policies at a very high level, especially when the pandemic started. However, they began to relax these policies when cases went down, especially after the vaccines became available in late 2020. When the Gamma and Delta variants began to circulate, the GCC countries intensified their health systems and vaccination policies while keeping the stringency of the containment and closure policies at a moderately high level. After the Omicron variant started to hit the GCC countries, the governments stepped up their vaccination policies as their primary response while relaxing other policies to restore the economy. Boosting economics became the top priority after the pandemic death rates were well under control.

Large proportion of foreign workers was a challenge for COVID-19 control in GCC countries, and governments have developed and implemented tailored policies to address this. Compared with nationals, foreign workers usually have lower socioeconomic status, worse living and health conditions, and are prone to SARS-CoV-2 infections [16]. Singapore has the same demographic situation and the uncontrolled spread of SARS-CoV-2 among foreign workers, who lived in high-density accommodations, contributed to the surge of cases in April and May 2020 [39]. The governments of GCC countries have learned this lesson and worked actively to formulate and implement effective policies for the foreign workers to improve their access to health services and secure their essential living conditions, regardless of their immigrant status. This aligned with the recommendations put forth by the International Labour Organization and World Health Organization during the early phase of the pandemic [40, 41]. The governments have provided free testing, diagnosis, and treatment for these workers. Furthermore, they extended work and residency permits for workers who could not return to their home countries due to travel controls. In addition, some governments also provided sheltered places for undocumented workers during the pandemic.

The GCC countries have proactively and effectively implemented comprehensive vaccination policies targeting vulnerable and high-risk populations. The vaccination policies conducted in these countries primarily cover (1) developing a country prioritization plan to deliver the vaccines to populations with different risks of infection and developing severe symptoms; (2) ensuring the availability of vaccines among the population regardless of their prioritization order; (3) provision of sufficient funding for each recipient category in the prioritization plan to be freely vaccinated; (4) stating compulsory requirements to facilitate vaccination, such as restricting indoor activities and travel among the unvaccinated. Prominently, these countries have kept the vaccination campaign momentum after the surge of cases caused by the Omicron variant, especially the UAE, Saudi Arabia, and Oman. Notably, the share of people who received at least two doses of vaccines had reached 96.2 percent in the UAE by the end of March 2022, which was the highest rate worldwide [42]. Globally, Singapore and Portugal were the second and third most vaccinated countries, at 90.3 percent and 86.8 percent; respectively, and during the same period [42].

Several important causes shape the effective government response of the GCC countries. First, previous experience in dealing with the MERS-CoV had helped the region to strengthen its preparedness and response efforts, facilitating a faster and more effective response against the COVID-19 pandemic when it was initiated [18]. Measures such as lockdowns of major cities, school closures, and suspension of flights were implemented quickly, as those Asian countries or regions—such as China (Mainland, Hong Kong and Taiwan) and Singapore, which had previous experience in controlling SARS—did [6, 43,44,45]. Second, the region has used its available financial resources to develop a set of socioeconomic policies and tools for effective responses. Sufficient funding has been used to support the implementation of all the control and economic policies, which is especially important regarding securing vaccines and improving coverage. A recent study further demonstrates that higher GDP per capita can significantly predict lower cumulative rates of SARS-CoV-2 infection, based on data from 177 countries [46]. In addition, the carefully-designed and comprehensive vaccination policies and robust implementation, as mentioned above, are other critical factors in reducing death rates.

The study findings have provided several important lessons for other pandemic responses and preparedness, not only for GCC countries but also for other countries with similar economic, demographic, and health system contexts. First, it is essential to promptly activate and implement containment and closure policies under the government’s strong leadership to restrict people’s mobility at the very beginning of the pandemic or epidemic. It is essential to reduce interpersonal transmission when there is limited knowledge about a new virus. Second, the stringency of the containment and closure policies needs to be dynamically adjusted based on the epidemiological burden, the virological features of different virus variants, and the availability of vaccines and medicines. Strengthening health system policies, such as testing and contact tracing, is the key to maintaining the gains achieved when it is time to relax the stringency of lockdown-style policies and to prepare for opening up. Third, it is essential to proactively implement comprehensive vaccination policies to improve coverage when vaccines are available and provide sufficient funding to ensure free access to vaccines. Fourth, it is crucial to ensure equitable and free access to testing, diagnosis, and treatment for all residents, regardless of their nationality and immigration status. Particular attention should be paid to vulnerable or marginalized populations, such as migrant workers and others with lower socioeconomic status living in poor and high-density accommodations. Fifth, strengthening the resilience of health systems—especially in governance, financing, human resources, and service delivery [47]—should be integrated as part of routine work to enhance pandemic response capacity. The four elements of resilience in highly effective country responses to COVID-19, as outlined in a recent study among 28 countries, are (1) activating comprehensive responses, (2) adapting health system capacity, (3) preserving health system functions and resources, and (4) reducing vulnerability [48]. Countries can use these elements to guide and monitor the system resilience strengthening throughout the process.