Carole R. Baskin, DVM, MSc, is Director, Communicable Disease Control Services; Mark Barry, MBA, MIB, is Director, Fiscal Services; Rachel E. Cohen, MPH, is a Public Health Coordinator, Health Promotions & Public Health Research; Colleen Condren, MSW, MPA, is a Change Management Officer; Sarah Crosley, MA, is a Public Health Coordinator; Carrie D. Dickhans is Director, Environmental Services; Kate Donaldson, MPH, is Assistant Division Director, Division of Health Promotion and Public Health Research; Sharon Gardner, MBA, is Director, Human Resources; Ken J. A. Griffin, MA, was Chief Operating Officer, Public Health & Primary Care Integration; Arletta Place is Director, Administrative Services; and Emily D. Doucette, MD, MSPH, FAAFP, and Spring Schmidt are Acting Co-Directors; all at St. Louis County Department of Public Health, Berkeley, MO. Ken J. A. Griffin is now Chief Operating Officer, Howard Brown Health, Chicago, IL.
Health Secur. 2021 Jul-Aug;19(4):364-369. doi: 10.1089/hs.2020.0149. Epub 2021 Apr 1.
The COVID-19 pandemic has stretched limited public health resources beyond measures, particularly at the local level. What started as an interesting report of pneumonia of unknown etiology in late December 2019 in Wuhan, China, bloomed into an international crisis by mid-January 2020. However, it was not until late January, when the first case was reported in the United States, that a new reality took shape for US public health agencies. After all, severe acute respiratory syndrome never made it to this country, and the only 2 cases of Middle East respiratory syndrome here were imported and never spread. Local public health agencies are notoriously short-staffed and underfunded. Therefore, when a crisis looms, personnel from a multitude of areas within the agencies are called upon to help out. Under its innovative and forward-thinking leadership, the St. Louis County Department of Health internally implemented the Incident Command System, a component of the National Incident Management System. While reassignment of individuals to new responsibilities under a new and temporary reporting structure did not always go perfectly, Incident Command System kept its promise to be adaptable to a fast-evolving situation, to clearly outline needed areas of responsibility, and to provide scaffolding that kept the Department of Health functional in chaotic times. It was able to be implemented quickly within hours of the first confirmed COVID-19 case in St. Louis County and enhanced the quality and timeliness of the public health response. This experience is being shared to provide a model of how organizations with limited personnel can use the Incident Command System to reorganize and meet unexpected challenges with increased success.
新冠疫情已经使有限的公共卫生资源不堪重负，尤其是在地方层面。2019 年 12 月下旬，中国武汉首次报告了病因不明的肺炎，起初这只是一个有趣的报告，但到 2020 年 1 月中旬已演变成一场国际危机。然而，直到 1 月下旬美国报告首例病例时，美国公共卫生机构才面临一个新局面。毕竟，严重急性呼吸综合征从未传入这个国家，而这里仅有的 2 例中东呼吸综合征病例都是输入性的，从未传播过。地方公共卫生机构的人员通常配备不足且资金不足。因此，当危机来临时，需要从机构内的多个领域调用人员来提供帮助。在其创新和前瞻性领导下，圣路易斯县卫生局在内部实施了事件指挥系统，这是国家事件管理系统的一个组成部分。虽然在新的临时报告结构下重新分配个人的新职责并不总是尽善尽美，但事件指挥系统承诺能够适应快速变化的情况，明确所需的责任领域，并提供支撑，使卫生局在混乱时期保持运转。该系统能够在圣路易斯县首例确诊的新冠疫情病例发生后的数小时内迅速实施，并提高了公共卫生应对的质量和及时性。分享这一经验是为了提供一个模型，说明人员有限的组织如何使用事件指挥系统进行重组，以更高的成功率应对意外挑战。
