National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands.
BMJ Open. 2023 Feb 10;13(2):e062960. doi: 10.1136/bmjopen-2022-062960.
Points of entry (POE) have an important role in timely national response to infectious diseases threats. However, a guiding framework is lacking for the transition from generic preparedness into optimally specified response for an imminent infectious disease threat, a step called 'operational readiness'.
We aim to contribute to the conceptual closure of this preparedness-response gap for infectious disease control at POE by providing content to the operational readiness concept.
We first explored the NATO Combat Readiness (NCR) concept for its applicability on infectious disease control at POE, as the military discipline faces the same need of being flexible in preparing for unknown threats. Concepts of the NCR that support the transition into response to a specific threat were integrated into the operational readiness concept. To explore the added value of the concept in practice, we conducted and analysed semistructured interviews of professionals at European POE (n=24) responsible for the early COVID-19 response.
Based on the NCR, operational readiness builds on the fact that activating the response capabilities and capacities to a specific threat requires time. For professionals at POE, the transition from generic preparedness into the COVID-19 response led to challenges in specifying response plans, dealing with an overload of information, while experiencing shortages of public health staff. These challenges could be covered within operational readiness by defining the time and the specific staging needed to upgrade response capabilities and capacities.
We conclude that a guiding framework for operational readiness seems appropriate in relation to the many activities and challenges POE have had to face during the COVID-19 response. Operational readiness is mainly defined by the time dimension required to deploy the response to a specific threat. However, integrating this conceptual framework into practice requires structural and sustainable investments in outbreak preparedness.
入境点（POE）在及时应对传染病威胁方面发挥着重要作用。然而，在从通用准备过渡到针对即将到来的传染病威胁的最佳特定反应（称为“业务准备就绪”）方面，缺乏指导框架。
我们旨在通过为业务准备就绪概念提供内容，为 POE 传染病控制方面的这种准备-反应差距的概念封闭做出贡献。
我们首先探索了北约作战准备就绪（NCR）概念在 POE 传染病控制方面的适用性，因为军事学科面临着为未知威胁做好灵活准备的同样需求。支持过渡到针对特定威胁的反应的 NCR 概念被整合到业务准备就绪概念中。为了探索该概念在实践中的附加值，我们对负责早期 COVID-19 应对的欧洲 POE（n=24）的专业人员进行了半结构化访谈并进行了分析。
基于 NCR，业务准备就绪基于这样一个事实，即激活针对特定威胁的反应能力和能力需要时间。对于 POE 的专业人员来说，从通用准备过渡到 COVID-19 反应导致了在指定反应计划方面的挑战，应对信息过载，同时公共卫生人员短缺。通过定义升级反应能力和能力所需的时间和特定阶段，可以在业务准备就绪范围内涵盖这些挑战。
我们的结论是，在 POE 在 COVID-19 应对期间必须面对的许多活动和挑战方面，业务准备就绪似乎是一个合适的指导框架。业务准备就绪主要由部署针对特定威胁的反应所需的时间维度来定义。然而，将这一概念框架纳入实践需要对疫情准备进行结构性和可持续的投资。
