Weber David Jay, Malani Anurag N, Shenoy Erica S, Banach David B, Batshon Lynne Jones, Branch-Elliman Westyn, Dumyati Ghinwa, Haessler Sarah, Hsu Vincent P, Jump Robin L P, Mathew Trini A, Murthy Rekha K, Pergam Steven A
Division of Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA.
Trinity Health Michigan, Ann Arbor, MI, USA.
Infect Control Hosp Epidemiol. 2024 Jul;45(7):813-817. doi: 10.1017/ice.2024.67. Epub 2024 Jun 5.
The COVID-19 has had major direct (e.g., deaths) and indirect (e.g., social inequities) effects in the United States. While the public health response to the epidemic featured some important successes (e.g., universal masking ,and rapid development and approval of vaccines and therapeutics), there were systemic failures (e.g., inadequate public health infrastructure) that overshadowed these successes. Key deficiency in the U.S. response were shortages of personal protective equipment (PPE) and supply chain deficiencies. Recommendations are provided for mitigating supply shortages and supply chain failures in healthcare settings in future pandemics. Some key recommendations for preventing shortages of essential components of infection control and prevention include increasing the stockpile of PPE in the U.S. National Strategic Stockpile, increased transparency of the Stockpile, invoking the Defense Production Act at an early stage, and rapid review and authorization by FDA/EPA/OSHA of non-U.S. approved products. Recommendations are also provided for mitigating shortages of diagnostic testing, medications and medical equipment.
新冠疫情在美国产生了重大的直接影响(如死亡)和间接影响(如社会不平等)。尽管针对该疫情的公共卫生应对措施取得了一些重要成功(如普遍佩戴口罩,以及疫苗和治疗方法的快速研发与批准),但也存在一些系统性失败(如公共卫生基础设施不足),这些失败掩盖了这些成功。美国应对措施的关键缺陷是个人防护装备(PPE)短缺和供应链缺陷。文中针对未来大流行期间缓解医疗机构中的供应短缺和供应链故障提出了建议。预防感染控制和预防基本要素短缺的一些关键建议包括增加美国国家战略储备中的个人防护装备库存、提高储备的透明度、尽早援引《国防生产法》,以及美国食品药品监督管理局/美国环境保护局/美国职业安全与健康管理局对非美国批准产品进行快速审查和授权。文中还针对缓解诊断检测、药物和医疗设备短缺提出了建议。