Goodyear-Smith Felicity, Kinder Karen, Eden Aimee R, Strydom Stefan, Bazemore Andrew, Phillips Robert, Taylor Melina, George Joe, Mannie Cristina
Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand.
Technische Universität Berlin, Berlin, Germany.
Glob Public Health. 2021 Aug-Sep;16(8-9):1304-1319. doi: 10.1080/17441692.2021.1876751. Epub 2021 Jan 24.
While the COVID-19 pandemic now affects the entire world, countries have had diverse responses. Some responded faster than others, with considerable variations in strategy. After securing border control, primary health care approaches (public health and primary care) attempt to mitigate spread through public education to reduce person-to-person contact (hygiene and physical distancing measures, lockdown procedures), triaging of cases by severity, COVID-19 testing, and contact-tracing. An international survey of primary care experts' perspectives about their country's national responseswas conducted April to early May 2020. This mixed method paper reports on whether they perceived that their country's decision-making and pandemic response was primarily driven by medical facts, economic models, or political ideals; initially intended to develop herd immunity or flatten the curve, and the level of decision-making authority (federal, state, regional). Correlations with country-level death rates and implications of political forces and processes in shaping a country's pandemic response are presented and discussed, informed by our data and by the literature. The intersection of political decision-making, public health/primary care policies and economic strategies is analysed to explore implications of COVID-19's impact on countries with different levels of social and economic development.
虽然新冠疫情目前已波及全球,但各国的应对措施各不相同。一些国家的反应比其他国家更快,策略也有很大差异。在确保边境管控之后,初级卫生保健方法(公共卫生和初级保健)试图通过公共教育来减缓传播,以减少人际接触(卫生和物理距离措施、封锁程序),根据严重程度对病例进行分诊,开展新冠病毒检测以及进行接触者追踪。2020年4月至5月初对初级保健专家关于其国家应对措施的观点进行了一项国际调查。这篇混合方法论文报告了他们是否认为本国的决策和疫情应对主要是由医学事实、经济模型或政治理想驱动的;最初是打算发展群体免疫还是平缓曲线,以及决策权力的级别(联邦、州[省]、地区)。结合我们的数据和文献,呈现并讨论了与国家层面死亡率的相关性以及政治力量和进程在塑造一个国家疫情应对措施方面的影响。分析了政治决策、公共卫生/初级保健政策和经济战略的交叉点,以探讨新冠疫情对不同社会经济发展水平国家的影响。