Friedman Samuel R, Perlman David C, Paraskevis Dimitrios, Feldman Justin
NYU Grossman School of Medicine, New York, NY 10016, USA.
Infectious Diseases, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Pathogens. 2023 Aug 8;12(8):1023. doi: 10.3390/pathogens12081023.
The AIDS and COVID-19 pandemics demonstrated that nations at similar economic development levels varied widely in their capacity to protect the health of their residents. For AIDS, Britain and Australia brought gay representatives into official counsels and adopted harm reduction far more rapidly than the United States or Spain, and East African countries responded more effectively than South Africa or the Democratic Republic of the Congo. National responses to COVID-19 varied widely, with New Zealand, China, and Vietnam more effective than Italy, Brazil, or the United States. Further, as phylogenetic research has demonstrated, these pandemics spread from one country to another, with those that responded poorly acting as sources for mutations and potentially sources of transmission to countries with more effective responses. Many observers expressed surprise at the poor responses of the United States to COVID-19, but in retrospect the cutbacks in public health funding at state and national levels made it clear that this was a predictable weakness even in addition to the political vacillations that crippled the US and Brazilian responses. In a time of global sociopolitical and climate instability, it is important to measure and conduct research into spatial and time variations in 1. public health and medical funding, 2. social influence networks, social cohesion and trust, and stigmatization, 3. income inequality, 4. social conflict, and 5. other factors that affect responsiveness to pandemics.
艾滋病和新冠疫情表明,经济发展水平相近的国家在保护本国居民健康的能力方面存在很大差异。就艾滋病而言,英国和澳大利亚比美国或西班牙更快地将同性恋代表纳入官方咨询机构并采取减少伤害措施,东非国家的应对也比南非或刚果民主共和国更有效。各国对新冠疫情的应对差异很大,新西兰、中国和越南比意大利、巴西或美国更有效。此外,系统发育研究表明,这些疫情从一个国家传播到另一个国家,应对不力的国家成为变异的源头,并可能成为传播到应对更有效的国家的传染源。许多观察家对美国对新冠疫情的糟糕应对表示惊讶,但回顾起来,州和国家层面公共卫生资金的削减表明,即使除了削弱美国和巴西应对措施的政治摇摆之外,这也是一个可预见的弱点。在全球社会政治和气候不稳定的时代,衡量并研究以下方面在空间和时间上的变化非常重要:1. 公共卫生和医疗资金;2. 社会影响网络、社会凝聚力和信任以及污名化;3. 收入不平等;4. 社会冲突;5. 以及其他影响对疫情应对能力的因素。