Political Leaders’ Communication Strategies during COVID-19 in Highly Infected Countries: A Scoping Review

This scoping review maps communication strategies employed by political leaders in countries that experienced high infection rates during the COVID-19 pandemic. Using the Arksey and O’Malley scoping review framework, this study systematically explored the literature from 2019 to October 2023. The process involved identifying and selecting relevant studies, charting them, and summarizing the data from the 40 articles that met the inclusion criteria. This review identified a diverse array of communication strategies, which highlight the complex nature of crisis communication. These strategies featured the use of social media, science-based policy communication, strategic narrative control, empathy, ideological influences, and storytelling. These six approaches underscore the importance of adaptability and context-specific strategies in political leadership during a health crisis. The findings demonstrate that political communication during the pandemic varied significantly and was influenced by factors such as media platform, political ideology, gender, and non-verbal cues. This review enriches our understanding of crisis communication in political contexts. It emphasizes the necessity of combining traditional and digital media and considering various sociopolitical factors. The insights gained are crucial for enhancing crisis management and public trust, and they set the stage for further research and practical application in crisis communication.


Introduction
The COVID-19 pandemic tested the capabilities and limits of political leaders worldwide.It forced them to navigate uncharted territories and make lifesaving decisions under extreme pressure.In this context, as articulated by Barry (2009), "In the next pandemic, be it now or in the future, be the virus mild or virulent, the single most important weapon against the disease will be a vaccine.The second most important will be communication" [1].Acknowledging Barry's emphasis on communication, this study focused on mapping the literature on communication strategies employed by those leaders in highly infected countries, with a goal of understanding their effectiveness during the unexpected crisis of COVID-19.
Crisis communication involves navigating myriad factors: the nature and severity of the crisis, the cultural and socio-political milieu, and the credibility and authority of the leaders themselves [2].These elements all influence the strategies adopted by the leaders to manage public perceptions and responses.An understanding of these strategies and their impacts is essential to identifying areas for improvement and to craft effective crisis communication techniques.
The pandemic prompted a surge in research exploring various aspects of crisis communication, including the roles and impacts of political leaders.Scholars and experts have examined the communication strategies employed by politicians in different countries, analyzing their effectiveness in terms of controlling the spread of the virus, maintaining public trust, and addressing society's needs during the crisis.The existing literature highlights both successes and failures, providing valuable lessons to be learned.
Widely recognized in the literature is the importance of communication in promoting public understanding and compliance.Fullwood et al. (2020) emphasized that leaders who provide simple and easy-to-follow messages are more likely to increase public understanding and compliance, a view supported by other scholars [3,4].Hu and Zhong (2023) note that effective communication not only promotes public engagement and encourages compliance, it also strengthens partnerships with the people and instills public confidence [5].Further supporting this view, scholars found that effective responder communication, especially in the delivery of practical health-focused information, results in the highest levels of compliance [6,7].They also stressed the need for intensified and diversified risk communication by policymakers and public health authorities to enhance public compliance and deter inappropriate behaviors during any future pandemic.
A study in 2021 reported the importance of intensified public health risk communication.Such communication should aim to increase information levels and facilitate compliance with public health interventions, including community quarantine [8].Additionally, other researchers noted that public cooperation and compliance with restrictions received considerable attention from government and public health officials [9].Some studies have focused on the importance of clear and consistent messaging in crisis communications.For instance, Moreland et al. (2020) argued that political leaders who spread simple and actionable messages are more likely to increase the likelihood of public understanding and compliance [10].Another researcher emphasized the importance of empathy and emotional intelligence in communication during a crisis [11].These studies suggest that leaders who demonstrate empathy and understanding are more likely to connect with the public at an emotional level, thereby facilitating a sense of solidarity and trust.
Additionally, the literature has revealed the importance of the media on political leaders' communication.The government relies on media channels to get out the message.Several studies have examined the relationship between political leaders and the media, investigating their interactions, strategies, and the impact of media coverage on public perception and behavior during a crisis [12,13].
To explore the specific strategies employed by leaders, it is essential to consider the role of communication.Political leaders have adopted various strategies to manage COVID-19-related issues and communicate country-specific priorities [14].Furthermore, the effectiveness of policy interventions depends on the credibility of political leaders and public health authorities [15].
It is also important to consider the impact of gender on the management of COVID-19.Research has examined whether having a female leader during the pandemic was associated with a lower number of COVID-19 cases and deaths per capita, after controlling for countrylevel cultural values [16].Some scholars reported a connection between female leaders and the efficient performance of nations during COVID-19, providing further insights into the role of women in leadership positions during the pandemic [17].
Overall, the literature supports the notion that by delivering clear, actionable, and practical information, leaders can enhance public engagement, strengthen collaborative partnerships, and increase compliance with public health interventions and regulations [18][19][20].
Despite extensive research on leaders' communication, there are still gaps in our understanding of the subject.The literature has provided insights into various leaders' crisis communication strategies, but there is a lack of comprehensive understanding of these strategies, particularly in the context of COVID-19.Previous studies have focused on individual aspects such as media use or rhetorical analysis, often in isolation and within limited regional contexts.Furthermore, the nature of the crisis, with its global impact and unique challenges, requires a specific investigation of how leaders adapted their communication strategies.This review aims to address this gap by mapping the diverse communication strategies employed by political leaders in highly affected countries during the recent pandemic.It encompasses a diverse range of cultures, personal liberties, and political systems.By doing so, this study not only contributes to the existing body of knowledge on political communication during health crises, it also provides a framework that can inform future strategies in similar emergencies, guide future research endeavors, and assist policymakers in developing effective crisis communication strategies.

Study Design
A scoping review methodology was chosen to thoroughly understand the existing literature on leadership communication strategies during COVID-19 in highly infected countries.This approach, which is effective for exploring new research areas and providing actionable evidence, was guided by the frameworks of Arksey and O'Malley (2005) and Levac et al. (2010) [21,22].This method's inclusivity allows one to consider a broad range of literature types such as primary research studies, systematic reviews, meta-analyses, letters, guidelines, websites, and blogs [23].Our aim was to map the key concepts, sources, and types of evidence-with a focus on scholarly articles-and to identify any gaps in the research.
The selected approach emphasizes flexibility and an abductive logic of inquiry that favors a narrative-driven synthesis of findings.This approach, which is inherently interpretive, aligned well with the qualitative nature of the research topic.The review process adhered to the PRISMA protocol as outlined by Moher et al. (2015), thereby ensuring systematic and transparent reporting of findings from high-quality scientific publications [24].
The review was structured around the first five stages as recommended by Arksey and O'Malley (2005) [21] and further refined by Tricco et al. (2016) [23].These stages are (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarizing, and reporting the results.While the sixth consultation exercise stage was not conducted, it remained an available extension of this framework.Furthermore, in line with the guidance of Levac et al. (2010) [22], this review employed an interactive team approach for study selection and data extraction.It combined both a numerical summary and a qualitative thematic analysis of the extracted data, and aimed to articulate the implications of the study findings for policy and practice in crisis communication.

Search Strategy
Our research team consisted of two reviewers, who are the authors of this work.One is a PhD fellow with a medical degree and a master's in public health specializing in communication, and the other is a professor with a PhD in health leadership, policy, and management.Through a combination of in-person and virtual meetings, we formulated the overarching research question and outlined the study protocol.This protocol entailed defining the search terms, identifying the databases for the literature search, establishing inclusion and exclusion criteria, and deciding on methods for resolving any disagreements among the reviewers.In October 2023, we conducted a comprehensive search based on a structured three-step strategy.Initially, a systematic search process was carried out across three major electronic databases: Medline, Embase, and Web of Science.These were selected for their extensive coverage of relevant medical and health literature.The search targeted studies published from 2019, the onset of COVID-19, to October 2023, to encompass the most relevant and contemporary studies pertaining to the pandemic.The selection of search terms was an iterative process, refined by initial search results and consultation with experts.These terms were "leadership", "communication", "strategy", "COVID-19", "SARS-CoV-2", "pandemic", "crisis management", "public health" and "highly infected countries".These were supplemented by "collaboration", "coordination", "decision-making", "empathy", "stakeholder engagement" and "communication".
The initial database search was followed by a meticulous analysis of titles, abstracts, and index terms of the retrieved papers.Discrepancies among the reviewers were resolved through consensus meetings.Subsequently, a second search using the finalized search terms was conducted across all selected databases.Lastly, hand-searching was performed to identify any studies that may have been missed in the electronic searches.This handsearching involved scrutinizing the reference lists of the screened studies to ensure thorough coverage and to capture any additional pertinent literature.Only peer-reviewed research articles were included, ensuring the credibility of the sources used in our analysis.

Selection Criteria
To be included in the review, an article had to meet the criteria listed below.

Data Extraction
Two reviewers independently extracted data from the included studies using a predefined data extraction form.The extracted information included the first author, publication year, country of study, leadership strategy discussed, methodology, key findings, and identified areas for improvement in leadership strategy.Discrepancies were resolved through discussion and, if required, consultation with a third reviewer.A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Moher et al., 2015 [24]) statement flowchart was constructed to clearly outline how the included studies were selected.

Data Synthesis
Data were synthesized in a narrative form, guided by the objectives of the review.We grouped findings according to the identified leadership communication strategy and summarized information regarding the contexts in which the strategies were used, their impacts, and suggested areas for improvement.Tables and figures were used to categorize key aspects of the data.

Results
Our systematic scoping review, illustrated in Figure 1, commenced with an initial search yielding 2776 records.After the removal of duplicates and the application of inclusion and exclusion criteria, 167 records were selected for full-text screening.This process yielded 40 publications that met our eligibility criteria.The selected publications, which encompass a variety of methodological approaches, provide an extensive examination of leaders' communication strategies during the pandemic.These include quantitative content analysis, qualitative approaches, mixed methods, econometric analysis, survey analysis, and policy analysis.

Results
Our systematic scoping review, illustrated in Figure 1, commenced with search yielding 2776 records.After the removal of duplicates and the application sion and exclusion criteria, 167 records were selected for full-text screening.Th yielded 40 publications that met our eligibility criteria.The selected publicatio encompass a variety of methodological approaches, provide an extensive exam leaders' communication strategies during the pandemic.These include quantita tent analysis, qualitative approaches, mixed methods, econometric analysis, sur ysis, and policy analysis.The studies spanned a diverse range of countries and regions, with some countries appearing in more than one study.The United States was examined in the highest number of articles (11), constituting 21.2% of the total appearances.This was followed by the United Kingdom and Germany, with 9 (17.3%) and 7 (13.5%)appearances, respectively.Brazil, Italy, and Spain each showed up in 6 articles, accounting for 11.5% of the total for each country.At the bottom of the list were Mexico (2 articles; 3.8%) and Greece, Nigeria, India, the Philippines, and South Africa, with 1 appearance each, or 1.9%.The chronological distribution of the articles is detailed in Table A1.
This review embraces a transdisciplinary perspective to enable holistic strategies in extracting the core of various communication strategies as well as in assessing their impacts, challenges, and areas for improvement.
Based on the existing literature and guided via thematic analysis, we noted six communication strategies that could be distinguished by their unique features and objectives: (1) utilization of social media, (2) science-based policy communication, (3) strategic narrative control, (4) nonverbal communication, (5) ideologically influenced communication, and (6) metaphors and storytelling.Table A2 summarizes the strategies, areas for improvement, specific lessons learned, and opportunities for future action.Such categorization was fundamental in organizing the data to enable a coherent comparison and synthesis across the 40 articles, thereby facilitating a comprehensive understanding of these strategies within varied geopolitical contexts.

Utilization of Social Media
One of the most popular communication strategies identified in our review was the use of social media.This strategy was featured in four studies conducted across various countries.Each offered unique insights into the use and impact of social media in crisis communication.
In particular, the use of social media platforms for direct public interaction and dissemination of crisis-related information was highlighted in the United States and Spain [25].The Spanish government closely adhered to the health ministry's recommendations on its social media profiles; it disseminated accurate and guideline-consistent information.Conversely, in the USA, while official accounts such as the White House and CDC complied with these guidelines, President Trump's account displayed a more political bent that often contradicted public health messages.This dichotomy highlights the potential for misinformation and the influence of ideologies on communications.The study underscored the effectiveness of these platforms in engaging the public, while also noting the challenges in managing the balance between providing too much or too little information.A significant concern was the potential for misinformation.Nonetheless, the ability of social media to disseminate accurate information while countering misinformation was emphasized.
From India, a Twitter analysis examined 12,128 tweets from 29 local politicians [26].The findings revealed that more than half of the tweets shared fact-based information and approximately 90% conveyed positive or neutral information.This study demonstrated the use of Twitter for direct communication, sentiment analysis to gauge public opinion, and dissemination of fact-based and reassuring information.However, the challenge of verifying the authenticity of follower accounts and records was noted.
A study in Italy examined the impact of government and press communication on public apprehension during the COVID-19 crisis [27].After analyzing more than 200,000 tweets, the study found that specific types of government and media messages were positively correlated with public fear levels, particularly discussions on individual vulnerability and external control.This study emphasized the use of social media for government communication, the importance of monitoring public emotional responses through hashtag campaigns, and the necessity of quelling panic through specific messaging strategies.
A contrasting result was obtained by scholars who analyzed government Twitter communications during the first surge of COVID in Brazil [28].This study reported that the Brazilian authorities underestimated the magnitude of the pandemic, which was reflected in their social media guidance, situational information, and even misinformation.The lack of coordination in communication among different levels of government was seen as a contributing factor in the public's willingness (or lack thereof) to follow measures to reduce the spread of COVID.
Collectively, the studies illustrate the positive and negative impacts of social media in political leaders' communication during the crisis.Together, the findings underscore the importance of providing accurate information and managing public sentiment during a health crisis.

Science-Based Policy Communication
This strategy was evident across various countries, with each adopting its own approach.In the United Kingdom, the government relied on a small group of specialist advisors, particularly the Scientific Advisory Group for Emergencies (SAGE) [29].The government used a phased response, one that initially focused on behavioral modification, and later shifted to direct regulation and lockdown.Although intended to manage the pandemic in the long term and avoid a second peak, this approach faced criticism for its slow response and failure to consider a wider range of scientific opinions.Another study looked into leaders in the UK, Italy, and the European Commission and analyzed how they utilized science in their speeches during the pandemic [14].The researchers identified three main narratives: national pride, ethics, and integration.Each was prevalent in the communication of the different leaders.The study highlighted the use of science to build national identity and pride, emphasized social responsibility, and underscored the role of science in the economy, social development, and political identity.
A study from the Philippines examined the government's policy responses and the role of scientific advice in managing the pandemic [30].The study stressed the importance of scientific advice in shaping policy decisions and underlined the challenges in implementing effective measures during the pandemic.In South Africa, a study analyzed President Ramaphosa's communication approaches during the crisis [31].Unlike other presidents, Ramaphosa relied on scientific advice and a diplomatic approach, which bolstered public trust.However, the study pointed out the challenges in this approach, including potential elitism and little community input, which may have contributed to a lack of compliance with public health measures.
These studies illustrate the importance of relying on scientific advice for policy communication.They also draw attention to the challenges in managing public perception, ensuring inclusivity, and addressing the socioeconomic realities of different populations.

Strategic Narrative Control
One striking communication strategy was noted in Spain, Italy, Germany, and Mexico [27,32,33].The Spanish government's communications can be described as a blend of conventional information and a subtle use of warlike language.This approach featured a narrative that played up the pandemic's severity.Such a strategy appeared to be a deliberate choice to impose social control and compliance through a somewhat alarmist narrative, aligning with broader crisis management efforts.
The study from Italy looked into how government and press releases affected public anxiety [33].The authors emphasized the significance of using empathetic and targeted messaging strategies to address public concerns.
The Mexican government disseminated information primarily through press conferences.The article described a blend of rational and emotional messaging while also pointing out the difficulty in balancing technical content with relatable, engaging communication [27].
Collectively, these studies explain the application of narrative control and public engagement in governmental communication during COVID.They emphasize the importance of empathetic communication and the effectiveness of both traditional and digital communication channels.Challenges in this strategy include aligning communications with public needs and perceptions.There is, therefore, a need for a wide variety of communication approaches to manage public perception and response during a health crisis.

Nonverbal Communication
This strategy was often employed in Spain and several other Western democracies.In Spain, the televised speeches of President Pedro Sánchez revealed a notable control in his body language and vocal expressions coupled with excessive repetition in body movements [34].There was a significant disconnect between his verbal communication and nonverbal cues (both kinesic and paralinguistic), which undermined the credibility of his words.The study highlights a strategic but inconsistent integration of nonverbal elements with his verbal messages, especially across different phases of the pandemic.
Another pivotal study, "Gender Effect on Political Leaders' Nonverbal Communicative Structure during the COVID-19 Crisis", analyzed the televised appearances of 10 heads of state (five males and five females) from various democratic Western countries.Four of these countries-the US, UK, Italy, and Germany-were included in this review's scope [35].The study revealed significant differences in nonverbal communication structures between men and women.Men displayed more assertive, controlling, and rational nonverbal behaviors, whereas women tended to show empathetic, cooperative, and emotionally communicative nonverbal cues.Interestingly, according to the study, countries led by women had fewer severe COVID-19 cases, suggesting a possible link between leadership styles and pandemic outcomes.The study raised concerns about the risk of reinforcing gender stereotypes through nonverbal communicative structure and how gendered communication might influence public perception and crisis management effectiveness differently.
In summary, these studies determined the critical role of nonverbal communication and the implications of this strategy in public perception, crisis management, and health outcomes.These findings reinforce the importance of considering verbal and nonverbal communication in evaluating political leadership during a health crisis.

Ideologically Influenced Communication
Numerous studies have underscored ideologically influenced communication as a key strategy among political leaders during the pandemic, with a focus on South America, particularly Brazil, alongside notable instances in the United States and Mexico [36][37][38][39][40].This body of research, particularly those articles covering Brazil, has been pivotal in revealing the influence of ideologies on public communication in times of crisis.
Significant among these is a work that explored Brazilian President Bolsonaro's communications [37].The author found a distinctive "populist-crisis" mode characterized by messages about the people and opposing elites, leading to further social divisions and misinformation.
A study by Stuart Davis and co-authors (2023) [39] linked President Bolsonaro's response to the pandemic with elements of right-wing populism and epidemiological denialism, leading to public mistrust in health institutions.Similarly, a critique by Elize Massard da Fonseca and colleagues (2021) [40] examined Bolsonaro's denialism and prioritization of economic interests over health considerations, which led to tensions between various levels of government.Damasio Duval Rodrigues Neto (2021) [41] also critiqued the Brazilian government's response, particularly its handling of the pandemic and the promotion of free market legislation.
In the United States, scholars revealed patterns of "follow the leader" politics and "responsive representation" [38].In Mexico, Erika Lourdes González-Rosas and her coauthors (2022) [42] delved into President López Obrador's utilization of Twitter to reveal a lack of effective communication regarding the health emergency.
These studies all demonstrate the role that politics played in shaping communication during the COVID-19 pandemic.The ideologies of the leaders profoundly influenced their messages, leading to public mistrust, crisis mismanagement, and the potential for misinformation.These insights highlight the dangers of mixing politics with public health.

Metaphors and Storytelling
The employment of metaphors and storytelling during the pandemic forms the crux of a comprehensive study conducted in Greece [43].Gkalitsiou and Kotsopoulos meticulously documented how metaphors and stories were not just rhetorical flourishes but became propaganda tools that were increasingly utilized as the crisis intensified.The authors categorized the types of metaphors and narratives employed, shedding light on their use to bolster communication effectiveness, convey pivotal messages, and influence public perception.
The study found some inherent challenges of this approach.A significant concern is the propensity for metaphors and stories to simplify complex realities.The study also draws a line between rhetorical efficacy and factual integrity, highlighting instances where metaphorical language could obscure or distort factual content.While acknowledging a story's capacity to engage and sway audiences, the study cautions against their indiscriminate use.This research contributes significantly to the discourse on political communication, particularly in crisis contexts.It emphasizes the importance of audience interpretation and the specificities of the crisis in determining the impact of such rhetorical strategies.

Discussion
This scoping review offers an extensive mapping of the communication strategies deployed by political leaders during the COVID-19 pandemic in the highly infected countries, highlighting both congruence with and divergence from established theories in political crisis communication.Notably, the strategic employment of social media in nations such as the USA, Spain, India, and Brazil aligns with Chadwick's hybrid media system theory, which emphasizes the integration of traditional and digital platforms in political discourse [44].However, challenges like misinformation and the sway of political ideology on communication methods mark a significant departure from traditional models, which often regard social media as straightforward tools for factual dissemination.
Further, the examples of the UK and South Africa resonate with Bucchi's model of public engagement in science communication, underscoring the significance of scientific input in policymaking [45].And yet, complaints of slow responses and potential elitism in these approaches suggest a more intricate interaction between science and policy than often presumed.
Our analysis also uncovered cases of strategic narrative control, empathy, and public engagement in such nations as Germany and Mexico, reflecting Entman's framing theory [46].This strategic narrative shaping, along with traditional communication methods and empathetic language, illustrates a complex dynamic in crisis communication, challenging existing models that often overlook the intricacies of empathetic and authoritative communication across varied cultural contexts.
Our review also explored the role of nonverbal communication and gender differences, especially in Western democracies.By doing so, our review supplements theories on nonverbal cues in political discourse and challenges gender stereotypes in leadership, as posited by Ekman [47] and Eagly and Carli [48].This calls for a more inclusive approach to gender dynamics in political communication.
The influence of ideologies on strategic communication in, inter alia, South America and the USA aligns with Corner and Pels' concept of political communication as an ideological tool [49].Its impact on public trust and crisis management echoes Bennett and Iyengar's concerns about polarization in crisis communication, challenging views of strategic communication as a neutral conduit [50].
The use of metaphors and storytelling, particularly in Greece, bears out Lakoff and Johnson's metaphor theory in politics, highlighting the challenges of maintaining rhetorical effectiveness without compromising factual accuracy [51].This necessitates the use of refined theories that address the pitfalls of employing metaphors in crisis communication.
The review also identifies unexpected and occasionally contradictory findings, such as the effectiveness of traditional communication methods versus the growing reliance on digital platforms.For instance, Angela Merkel's use of direct and clear information through televised speeches offers a stark contrast to the prevalent advocacy of social media in crisis communication.This suggests the context-dependent efficacy of communication strategies, influenced by cultural norms, public expectations, and the nature of the crisis.
Additionally, this review highlights the significance of gender on nonverbal communication strategies, challenging traditional notions in political communication literature.This finding suggests a possible link between communication style and crisis outcomes, necessitating cautious interpretation to avoid reinforcing gender stereotypes.
Contradictory findings in the utilization of social media illustrate the complex landscape of digital communication in crises, where benefits such as reach and immediacy are offset by risks of misinformation and political manipulation.This underscores the need for research to develop balanced strategies that capitalize on social media's strengths while mitigating its drawbacks.
While this study focused on political leaders, it is important to recognize the influence of religious leaders on public discourse.This aspect, extensively explored by Norberto Gonzalez Gaitano [52], highlights the diverse sources of leadership and their communication strategies, adding an important dimension to the broader narrative of leadership during public health emergencies.
The practical implications of these findings are useful for political leaders and communication strategists.An effective approach to crisis communication requires a strategy that seamlessly integrates traditional and digital platforms, is tailored to specific cultural and political contexts, and considers factors such as gender and nonverbal cues.This underscores the importance of developing adaptive communication strategies that can respond to the changing needs of diverse audiences and evolving circumstances.
Equipping political leaders with a toolbox of communication skills, including mastery of nonverbal cues and empathetic language, could enhance their ability to connect with and reassure the public.Moreover, establishing robust frameworks to counteract misinformation, coupled with efforts to promote media literacy among the public, are essential steps in augmenting the efficacy of crisis communication.Such strategies not only empower leaders in conveying their messages more effectively, they also enable the public to evaluate and respond to the information they are bombarded with.This nuanced approach is pivotal in navigating the complexities of modern political discourse and ensuring that public messaging during health crises is both trustworthy and useful.
Future research should explore the adaptability of communication strategies across different cultural and political sceneries and in response to the turbulent media and technological landscape.The digital era has ushered in transformative changes in communication, presenting both opportunities and pitfalls for leaders.Understanding how to tailor communication strategies to diverse contexts will further enrich our mastery of crisis communication.Additionally, future studies should explore how leaders can balance the dissemination of accurate, science-based information with real audience engagement, especially on digital platforms.The rise of social media has revolutionized the way leaders communicate during crises, but the challenge remains to maintain informational integrity while ensuring robust audience engagement.
Moreover, there is a need to move beyond stereotypes to understand how gender dynamics influence the efficacy of crisis communication.
Longitudinal studies are also necessary to evaluate the long-term effects of various communication strategies on public trust, policy compliance, and crisis resolution.Understanding these long-term impacts will guide policymakers and practitioners in choosing the most effective approaches to crisis communication.

Conclusions
This scoping review has systematically outlined the variety of communication strategies utilized by political leaders during the COVID-19 crisis.It uncovered the nuanced interplay of social media, science-based policy communication, narrative control, empathy, public engagement, and both traditional and digital platforms.This analysis not only deepens our understanding of health crisis communication in a political context but also reveals the strengths and limitations inherent in these diverse approaches.
A takeaway from this study is that giving clear, calm, and honest messages in the midst of a deadly pandemic is no easy job.The varied strategies adopted by leaders around the globe affirm that effective communication in times of crisis cannot be restricted to a single methodology.Rather, it necessitates a bespoke approach, finely tuned to the distinct cultural, societal, and political fabrics of each audience.This insight calls for political leaders to be aware of their audience's cultural sensitivities, values, and preferences when crafting their communication strategies.
The influence of ideologies on communication, particularly in regions like South America, underscores the intertwining of political bias with public trust and the efficacy of crisis management.Leaders need to transcend their biases and ensure that their communication strategies align with the broader interests of the public.
Furthermore, this study highlights the role of gender differences in nonverbal political messaging.These differences call for a sophisticated approach to engaging with diverse audiences, enhancing the leaders' capacity to project empathy, establish trust, and effectively convey their messages during crises.
Additionally, the enduring relevance of traditional media, exemplified by Angela Merkel's televised addresses in Germany, shows that, notwithstanding the popularity of social media, traditional channels remain vital in reaching broad audiences and maintaining credibility.Leaders are thus encouraged to leverage a multi-platform approach that capitalizes on the unique strengths of different communication channels.
This review also recognizes its own limitations.Its focus on leaders' strategies and the selection of English language publications potentially neglects the broader spectrum of crisis communication stakeholders and non-English research.Moreover, the evolving nature of the COVID-19 pandemic suggests that more recent developments in crisis communication may have been missed.The diverse methodologies of the analyzed studies also introduced variances in quality and depth, impacting the uniformity and robustness of the conclusions drawn.Furthermore, the search conducted on Web of Science, Embase, and Medline, though extensive, did not encompass the entirety of available literature.While these databases offer a broad coverage of peer-reviewed journals and have an international reach, they do not include all available evidence.

Table A2 .
Summary of communication strategies, associated positive outcomes, challenges, and areas for improvement.