American College of Physicians, Washington, DC (J.S., K.C.).
Atlantic Health System, Hinsdale, Illinois (S.M.).
Ann Intern Med. 2023 Sep;176(9):1240-1244. doi: 10.7326/M23-0768. Epub 2023 Jul 25.
The onset of the COVID-19 pandemic revealed significant gaps in the United States' pandemic and public health emergency response system. At the federal level, government responses were undercut by a lack of centralized coordination, inadequately defined responsibilities, and an under-resourced national stockpile. Contradictory and unclear guidance throughout the early months of the pandemic, along with inconsistent funding to public health agencies, also created notable variance in state and local responses. The lack of a coordinated response added pressure to an already overwhelmed health care system, which was forced to resort to rationing care and personal protective equipment, creating moral distress and trauma for health care workers and their patients. Despite these severe shortcomings, the COVID-19 pandemic also highlighted successful policies and approaches, such as Operation Warp Speed, which led to the fastest development and distribution of a vaccine in history. In this position paper, the American College of Physicians (ACP) offers several policy recommendations for enhancing federal, state, and local preparedness for future pandemic and public health emergencies. This policy paper builds on various statements produced by ACP throughout the COVID-19 pandemic, including on the ethical distribution of vaccinations and resources, conditions to resume economic and social activity, and efforts to protect the health and well-being of medical professionals, among others.
新冠疫情大流行的爆发暴露出美国大流行和公共卫生应急反应系统的重大缺陷。在联邦层面，由于缺乏集中协调、职责界定不明确以及国家储备资源不足，政府的应对措施受到了削弱。在疫情早期，各种相互矛盾且不明确的指导意见，以及向公共卫生机构提供的资金不一致，也导致了州和地方应对措施的显著差异。缺乏协调一致的应对措施给已经不堪重负的医疗系统增加了压力，迫使医疗系统不得不对医疗服务和个人防护设备进行配给，这给医疗工作者及其患者带来了道德困境和创伤。尽管存在这些严重的缺陷，但新冠疫情也突显了一些成功的政策和方法，如“ warp speed 行动”（Operation Warp Speed），该行动促成了史上最快的疫苗研发和分发。在这份政策文件中，美国医师学会（ACP）为加强联邦、州和地方应对未来大流行和公共卫生紧急事件的准备工作提出了若干政策建议。本政策文件以 ACP 在新冠疫情期间发布的各种声明为基础，包括疫苗和资源的公平分配、恢复经济和社会活动的条件以及保护医疗专业人员健康和福祉的努力等。
