Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Middle East Consortium on Infectious Disease Surveillance, Jerusalem, Israel.
Front Public Health. 2024 Jan 24;11:1308267. doi: 10.3389/fpubh.2023.1308267. eCollection 2023.
Reevaluating response plans is essential to ensuring consistent readiness and resilience to the COVID-19 pandemic. The "During Action Review" and Tabletop (DART) methodology provides a retrospective and prospective assessment to inform the adaptive response. Israel introduced COVID-19 vaccinations in December 2020 and was the first country to implement booster vaccination to address waning immunity and surges caused by new variants. We assessed Israel's readiness and resilience related to COVID-19 response while capturing the pre-vaccination and vaccination periods.
A DART analysis was conducted between December 2020 and August 2021 among experts involved in the management of the COVID-19 pandemic in Israel. During the retrospective stage, a role-based questionnaire and discussions were undertaken in a participant-led review of the response, focusing on epidemiology and surveillance, risk communication, and vaccines. The prospective stage included tabletop exercises to evaluate short to long-term simulated scenarios.
Participants emphasized the pivotal role of Israel globally by sharing experiences with the pandemic, and vaccination. Perceived strengths included multi-sectoral collaboration between the Ministry of Health, healthcare providers, academia, military, and others, stretching capacities, expanding laboratory workload, and establishing/maintaining surveillance. The vaccine prioritization plan and strong infrastructure, including computerized databases, enabled real-life assessment of vaccine uptake and impact. Challenges included the need to change case definitions early on and insufficient staffing. Quarantine of patients and contacts was particularly challenging among underprivileged communities. Risk communication approaches need to focus more on creating norms in behavior. Trust issues and limited cooperation were noted, especially among ethnic and religious minorities. To ensure readiness and resiliency, participants recommended establishing a nationally deployed system for bringing in and acting upon feedback from the field, especially concerning risk communication and vaccines.
Our study appraised strengths and weaknesses of the COVID-19 pandemic response in Israel and led to concrete recommendations for adjusting responses and future similar events. An efficient response comprised multi-sectoral collaboration, policy design, infrastructure, care delivery, and mitigation measures, including vaccines, while risk communication, trust issues, and limited cooperation with minority groups were perceived as areas for action and intervention.
重新评估应对计划对于确保在 COVID-19 大流行期间保持一致的准备状态和弹性至关重要。“行动中评估”（DART）和桌面演练（DART）方法提供了回顾性和前瞻性评估，为适应性应对提供信息。以色列于 2020 年 12 月推出 COVID-19 疫苗接种，并成为第一个实施加强针接种以应对免疫减弱和新变体引发的疫情反弹的国家。我们评估了以色列在 COVID-19 应对方面的准备状态和弹性，同时涵盖了疫苗接种前和接种后的时期。
在 2020 年 12 月至 2021 年 8 月期间，在以色列参与 COVID-19 大流行管理的专家之间进行了 DART 分析。在回顾性阶段，通过基于角色的问卷和讨论，参与者对疫情应对进行了主导的回顾，重点关注流行病学和监测、风险沟通以及疫苗。前瞻性阶段包括桌面演练，以评估短期到长期的模拟情景。
参与者通过分享大流行和疫苗接种经验，强调了以色列在全球范围内的关键作用。他们认为，以色列的优势包括卫生部、医疗保健提供者、学术界、军队和其他机构之间的多部门合作，扩大了能力，增加了实验室工作量，并建立/维持了监测。疫苗优先计划和强大的基础设施，包括计算机化数据库，使疫苗接种的实际评估和影响得以实现。挑战包括需要及早改变病例定义和人员配备不足。对弱势群体的患者和接触者的隔离尤其具有挑战性。风险沟通方法需要更加注重在行为中建立规范。还注意到信任问题和有限的合作，尤其是在族裔和宗教少数群体中。为了确保准备状态和弹性，参与者建议建立一个全国性的系统，用于收集和处理来自现场的反馈，特别是关于风险沟通和疫苗接种的反馈。
我们的研究评估了以色列 COVID-19 大流行应对的优势和劣势，并提出了具体建议，以调整应对措施和未来类似事件。有效的应对措施包括多部门合作、政策制定、基础设施、医疗服务提供和缓解措施，包括疫苗接种，而风险沟通、信任问题和与少数群体的有限合作被视为需要采取行动和干预的领域。
