The Johns Hopkins Center for Health Security, 621 East Pratt Street, Pier IV Building, Suite 210, Baltimore, MD, 21202, USA.
Soc Sci Med. 2022 Jan;292:114554. doi: 10.1016/j.socscimed.2021.114554. Epub 2021 Nov 6.
Since the emergence of the SARS-CoV-2 virus in late 2019, the world has been in a state of high alert and reactivity. Once the acute stage of the infectious disease crisis does abate, however, few if any communities will have a detailed roadmap to guide recovery - that is, the process of becoming whole again and working to reduce similar, future risk. In both research and policy contexts where data are absent or difficult to obtain, expert judgment can help fill the void. Between November 2019 and February 2020, we conducted an expert elicitation process, asking fourteen key informants - with specializations in infectious diseases, disaster recovery, community resilience, public health, emergency management, and policymaking - to identify the design principles, priority issues, and field experiences that should inform development of an epidemic recovery model. Participants argued that recovery from epidemics is distinct from natural disasters due to epidemics' potential to produce effects over large areas for extended periods of time and ability to generate high levels of fear, anticipatory anxiety, and antisocial behavior. Furthermore, epidemic recovery is a complex, nonlinear process involving many domains - political, economic, sociocultural, infrastructural, and human health. As such, an adequate model of post-epidemic recovery should extend beyond strictly medical matters, specify units of interest (e.g., individual, family, institution, sector, community), capture differing trajectories of recovery given social determinants of health, and be fit for use depending upon user group (e.g., policymakers, responders, researchers). This formative study commences a longer-term effort to generate indicators for a holistic, transformative epidemic recovery at the community level.
自 2019 年底 SARS-CoV-2 病毒出现以来，世界一直处于高度警惕和反应状态。然而，一旦传染病危机的急性阶段缓解，很少有社区会有详细的路线图来指导恢复——也就是说，重新恢复完整并努力减少类似的、未来的风险的过程。在研究和政策背景下，数据缺失或难以获取，专家判断可以帮助填补空白。在 2019 年 11 月至 2020 年 2 月期间，我们进行了一次专家征集过程，询问了 14 名关键信息提供者——他们在传染病、灾难恢复、社区弹性、公共卫生、应急管理和政策制定方面具有专业知识——以确定设计原则、优先事项和现场经验，这些都应该为传染病恢复模型的制定提供信息。参与者认为，传染病的恢复与自然灾害不同，因为传染病有可能在很长一段时间内对大片地区产生影响，并产生高水平的恐惧、预期焦虑和反社会行为。此外，传染病恢复是一个复杂的、非线性的过程，涉及许多领域——政治、经济、社会文化、基础设施和人类健康。因此，一个充分的传染病后恢复模型不应仅限于医学问题，应指定感兴趣的单位（例如，个人、家庭、机构、部门、社区），根据健康的社会决定因素捕捉不同的恢复轨迹，并根据用户群体（例如，政策制定者、应对者、研究人员）进行调整。这项基础研究开始了一项更长期的努力，以在社区层面上生成一个全面的、变革性的传染病恢复指标。
