Leicester Biomedical Research Centre, Leicester, UK, honorary specialist registrar, University Hospitals of Leicester NHS Trust, Leicester, UK, and visiting academic, Li Ka Shing Institute of Health Information and Discovery, University of Oxford, Oxford, UK.
University of Leicester, Leicester, UK and consultant in virology, University Hospitals of Leicester NHS Trust, Leicester, UK
Clin Med (Lond). 2023 Sep;23(5):527-530. doi: 10.7861/clinmed.2023-0283. Epub 2023 Sep 29.
In June 2023, the UK began official hearings for its independent investigation into pandemic preparedness. Thus far, the inquiry has been told that planning has been wholly inadequate and that a future outbreak is inevitable. We present here four key problems that contributed to significant morbidity and mortality during the Coronavirus 2019 (COVID-19) pandemic over the past 3 years in the UK - and which will contribute to excess morbidity and mortality in the next outbreak. First, there was misunderstanding about what procedures were deemed as aerosol generating. Aerosol transmission has always been a component of respiratory viruses; however, no specific aerosol-generating procedures are required to transmit any respiratory pathogens over long distances. Second, policy-makers were too binary in their answers to the public in terms of questions about severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). This meant that, as evidence evolved and different conclusions were drawn, the public lost faith in both the UK Government and science. Third, public health guidance did not take into account that certain groups would be impacted differentially by public health guidelines and instead used a one-size-fits-all approach to non-pharmaceutical interventions. Finally, there was worsening of existing inequalities, especially in ethnic minority groups, that resulted in excessive numbers within certain cohorts becoming infected.
2023 年 6 月，英国开始对其大流行病防范情况进行独立调查。迄今为止，调查已经得知，规划是完全不足的，未来的爆发是不可避免的。我们在此提出四个主要问题，这些问题导致了过去 3 年英国 2019 年冠状病毒病（COVID-19）大流行期间的高发病率和死亡率，并且将在下一次爆发中导致更高的发病率和死亡率。首先，对于被认为是产生气溶胶的程序存在误解。气溶胶传播一直是呼吸道病毒的一个组成部分；然而，没有特定的产生气溶胶的程序需要在长距离内传播任何呼吸道病原体。其次，决策者在回答公众关于严重急性呼吸系统综合症冠状病毒 2（SARS-CoV-2）的问题时过于二分法。这意味着，随着证据的发展和不同的结论被得出，公众对英国政府和科学界都失去了信心。第三，公共卫生指南没有考虑到某些群体将因公共卫生指南而受到不同的影响，而是对非药物干预措施采用一刀切的方法。最后，现有的不平等现象恶化，特别是在少数族裔群体中，导致某些群体中过多的人感染。
