Bible studies

Lessons from past public health emergencies could have saved 2020

The past 11 months could have been so different. Imagine we had clear plans in place for the last mile immunization, persuasive communications to explain its value, and strategies to distribute these life-saving drugs equitably.

For me – for all professionals in public health emergency response – the tragedy of COVID-19 is that this alternate reality was quite possible. We have worked enough on public health emergencies over the past 20 years to know that the lessons we are learning the hard way now have been learned and forgotten time and time again.

How is it possible, you will ask me, that our public health system has forgotten crucial information about pandemic management? After all, plane crashes kill far fewer people, yet National Transport Safety Office is there to learn their lessons. Similar programs exist for lower crime rate, improve education and improve the health of the population.

Corn unlike many in the developed world, the United States has no systemic means of studying and learning about public health emergencies. A three-year consensus study of the National Academies of Medicine in which I participated, led by Ned calonge, concluded that the science in this area was “seriously deficient … hampering the nation’s ability to respond to emergencies [and] save lives.

We need to address this issue immediately in the Biden administration’s latest back-up plan – before we miss our chance to learn key lessons from COVID-19 as well.

How big is the problem? Look at vaccination, the center of our hopes right now. A recent study showed that from 2008 to 2017, the federal government spent $ 16 billion to fund purely pharmaceutical research into health threats. Operation Warp Speed, the rapid surge of the vaccine from the previous administration was possible due to decades of studies caused by emergencies such as SARS, H1N1 and Ebola.

Yet the same study showed that we were spending a tiny fraction – only $ 100,000 – learning how to dispense the drugs to cure these health threats. It’s not an annual amount – it’s $ 100,000 in total over ten years. In other words, the federal government has invested over 150,000 times more to develop potential emergency drugs and vaccines than it has spent on learning how to put them in people’s arms. No one should be surprised that we are not very good at it.

Vaccine distribution is just one of the main goals of the Centers for Disease Control and Prevention preparation skills. There are 14 more, ranging from public information to lab tests. We spent an average of $ 2.8 million per year from 2008 to 2017 to study the 15 combined capacities – 0.002% of pharmaceutical research – while federal support for basic health agency readiness fell 31 percent.

Have you spent the past 11 months asking: “Why did the lab tests fail to meet the need? Why can’t contact tracing keep up? Why does no one seem to fully understand masking or social distancing? Why do racial imbalances in care continue to grow instead of shrinking? ” Well, that’s your answer. We could have learned, but we didn’t. Right now we are living and dying from the chaotic effects of this funding imbalance.

The way forward is clear. In reality, 2019 legislation has previously called for the development of “evidence-based” standards for public health preparedness – although there is no mechanism to achieve these standards. The Biden-Harris administration can fill this gap by immediately calling on the CDC to convene a multidisciplinary “lessons learned working group” with researchers, local practitioners and policymakers from across the federal government, as requested by the government. report from our national academies. This group should study health emergencies and translate their findings into practical recommendations based on equity.

How much would that cost? A paltry sum compared to the design of drugs. Some substantive calculations based on our example models and historical preparation research costs lead us to believe that about $ 22 million per year (about one percent of federal health preparedness budget) could meet the need. Long-term maintenance is the real key to success.

Can a system like this on its own overcome the toxic effects of politicize public health? Of course not; little can. But evidence always helps to win arguments, and the lack of evidence certainly allows disinformation to flourish. Building an evidence base will not win the fight against COVID deniers. But it provides much-needed ammunition to fight the current disease, as well as any public health emergencies to come. It’s the wars that really matter.

We’ve all heard or said so much “trust science” in the past year or so. But you can’t trust a science that doesn’t exist. It’s not just drugs that save lives; public health practices as well.

Whatever else happens in the aftermath of this pandemic – as we mourn and rebuild – we must establish a national system to study, catalog and learn from these public health emergencies. It’s such a small price to pay and every day we all mourn the supreme price of his absence.

Mitch Stripling is the National Director of Emergency Preparedness and Response for the Planned Parenthood Federation of America, as well as a member of the National Academies of Science, Engineering and Medicine (NASEM) Committee on Evidence-Based Practices for Preparedness. and responding to public health emergencies. . Former Deputy Commissioner in the New York Department of Health and Mental Hygiene, it has responded to more than fifteen federally declared disasters and public health emergencies.


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