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呼吁将“One Health”理念纳入医学教育:COVID-19 大流行如何凸显了整合人类、动物和环境卫生的必要性。

A Call for One Health in Medical Education: How the COVID-19 Pandemic Underscores the Need to Integrate Human, Animal, and Environmental Health.

机构信息

M.P. Dykstra is a first-year internal medicine resident, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

E.J. Baitchman is vice president of animal health and conservation, Zoo New England, Boston, Massachusetts, and lecturer on pathology, Department of Pathology, Harvard Medical School, Boston, Massachusetts.

出版信息

Acad Med. 2021 Jul 1;96(7):951-953. doi: 10.1097/ACM.0000000000004072.

Abstract

During the early stages of the COVID-19 pandemic in 2020, the first author, then a fourth-year student at Harvard Medical School, was enrolled in a One Health clinical experience at Zoo New England where he was introduced to a transdisciplinary approach to integrate human, animal, and ecosystem health. Seeing the vast impact of the pandemic and knowing its roots as a zoonotic disease, he realized this approach was critical to his medical education and for preparation against future novel infectious diseases. Zoonotic diseases have been emerging into human populations with increasing frequency, leading to public health emergencies such as Ebola, avian influenza, and SARS. The SARS-CoV-2 narrative, starting in bats and then mutating through an intermediate host into humans, is another striking example of the interconnectedness between human, animal, and ecosystem health that underlies these infections. Preventing future pandemics will require a transdisciplinary One Health approach, and physicians should be prepared to participate in these discussions while advocating for One Health initiatives for the benefit of their current and future patients. Integration of One Health education into medical school curricula will also prepare future physicians for other complex and urgently important health issues such as climate change, antimicrobial resistance, and the impact of biodiversity loss. As the consequences of the COVID-19 pandemic persist, education in One Health must become a priority; it is essential to break down the conventional disciplinary silos of human medicine, veterinary medicine, environmental health, public health, and the social sciences, so that future health crises can be prevented and mitigated collaboratively.

摘要

在 2020 年 COVID-19 大流行的早期阶段,当时还是哈佛医学院四年级学生的第一作者,参加了在新英格兰动物园进行的一项 One Health 临床体验,在那里他接触到了一种跨学科方法,将人类、动物和生态系统健康整合在一起。看到大流行的巨大影响,并了解到它作为一种人畜共患病的根源,他意识到这种方法对他的医学教育和为应对未来新型传染病的准备至关重要。人畜共患病以越来越高的频率进入人类群体,导致了埃博拉、禽流感和 SARS 等公共卫生紧急情况。SARS-CoV-2 的叙述始于蝙蝠,然后通过中间宿主突变进入人类,这是一个突出的例子,说明了人类、动物和生态系统健康之间的相互联系,这些感染正是基于这种相互联系。预防未来的大流行将需要采用跨学科的 One Health 方法,医生应该准备参与这些讨论,同时倡导 One Health 计划,以造福他们当前和未来的患者。将 One Health 教育纳入医学院课程也将为未来的医生应对气候变化、抗微生物药物耐药性以及生物多样性丧失的影响等其他复杂和紧迫的重要健康问题做好准备。随着 COVID-19 大流行的持续,One Health 教育必须成为优先事项;打破人类医学、兽医学、环境卫生、公共卫生和社会科学的传统学科壁垒至关重要,以便能够共同预防和缓解未来的健康危机。

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