Liu Anicca, Waldman Rachel N, Deal Bonnie, Duff Johnathan, Batycki Jacob N, Pretto Ernesto A, Saavedra Jorge, Szapocznik José
Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
School of Social Policy & Practice, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
PLoS One. 2024 Dec 2;19(12):e0314570. doi: 10.1371/journal.pone.0314570. eCollection 2024.
The COVID-19 emergency warrants reflection on how to improve future infectious disease pandemic preparedness and response (PPR). U.S. States took diverse approaches to COVID-19, with Florida's approach characterized by fewer restrictions on businesses and individuals. Despite the profound effects of the pandemic, there is a dearth of stakeholder-informed recommendations for PPR at the state level. This study aims to empirically examine stakeholder perspectives on PPR in Florida.
25 semi-structured interviews were conducted with former and current leaders from government, academia, and the private sector in Florida. Participants were asked about challenges encountered during COVID-19 and considerations for what should be done for future pandemics. Interview transcripts and notes were analyzed using qualitative content analysis (QCA).
Results were organized into four main categories (recommendations for future actions, challenges in PPR, successes and failures during the COVID-19 response), across which six sub-categories were identified: public health systems capacities; mitigation of disease transmission; roles and relationships; messaging and information dissemination; minimizing other adverse effects of a pandemic; and public health culture. Considering the neglect of existing pandemic plans and jurisdictional tensions around decision-making during COVID-19, participants proposed implementing a pandemic playbook that delineates the responsibilities of relevant agencies and processes of waiving standard procedures. While many suggested closures and restrictions to avoid the spread of disease, others questioned the extent to which such strategies should be implemented.
This study corresponds with the need for consensus-building across ideological divisions, revealing tensions among federal, state, and county-level entities, as well as across state-level agencies. Participants defined successful pandemic response as not only comprising the mitigation of disease transmission, but also the minimization of adverse social and economic effects. Participants discussed strategies for a unified, well-coordinated approach to future pandemics that balances health and economic concerns.
新冠疫情促使人们思考如何改进未来传染病大流行的防范与应对（PPR）。美国各州对新冠疫情采取了不同的应对方式，佛罗里达州的做法特点是对企业和个人的限制较少。尽管疫情影响深远，但在州层面，缺乏利益相关者提供的有关PPR的建议。本研究旨在实证考察佛罗里达州利益相关者对PPR的看法。
对佛罗里达州政府、学术界和私营部门的前任和现任领导人进行了25次半结构化访谈。参与者被问及在新冠疫情期间遇到的挑战以及对未来大流行应对措施的考虑。使用定性内容分析（QCA）对访谈记录和笔记进行了分析。
结果分为四个主要类别（对未来行动的建议、PPR中的挑战、新冠疫情应对期间的成功与失败），在此基础上确定了六个子类别：公共卫生系统能力；减轻疾病传播；角色与关系；信息传递与传播；尽量减少大流行的其他不利影响；以及公共卫生文化。考虑到在新冠疫情期间现有大流行计划被忽视以及决策过程中的管辖权紧张关系，参与者提议实施一个大流行行动手册，明确相关机构的职责和免除标准程序的流程。虽然许多人建议关闭和限制措施以避免疾病传播，但也有人质疑此类策略的实施程度。
本研究符合跨越意识形态分歧达成共识的需求，揭示了联邦、州和县级实体之间以及州级机构之间的紧张关系。参与者将成功的大流行应对定义为不仅包括减轻疾病传播，还包括尽量减少不利的社会和经济影响。参与者讨论了未来大流行应对中采取统一、协调良好的方法的策略，以平衡健康和经济问题。
