Coronavirus disease 2019 (COVID-19) pandemic: how countries shouldbuild more resilient health systems for preparedness and response

Objective: A resilient health system plays a crucial role in pandemic preparedness and response. Althoughthe World Health Organization (WHO) has required all states parties to strengthen core capacities to respondto public health emergencies under the International Health Regulations (2005), the actions of most countriesto combating coronavirus disease 2019 (COVID-19) has showed that they are not well-prepared. This crosssectionalstudy aimed to examine the health system resilience of selected countries and analyze their strategiesand measures in response to the COVID-19 pandemic.Methods: This study selected five countries including the Iran, Japan, Republic of Korea (South Korea), the U.K.,and the U.S., based on the severity of the national epidemic, the geographical location, and the developmentlevel. Cumulative number of death cases derived from WHO COVID-19 dashboard was used to measure theseverity of the impact of the pandemic in each country;WHO State Parties Self-Assessment Annual Reporting (SPAR)Scores and Global Health Security (GHS) Index were applied to measure the national health system resilience;and research articles and press materials were summarized to identify the strategies and measures adopted bycountries during response to COVID-19. This study applied the resilient health systems framework to analyzehealth system resilience in the selected countries from five dimensions, including awareness, diversity, selfregulation,integration and adaptation.Results: The SPAR Scores and GHS Index of the four developed countries, Japan, South Korea, the U.K. and theU.S. were above the global and regional averages;the SPAR Scores of Iran were above the global average whilethe GHI Index lain below the global average. In terms of response strategies, Japan, the U.K. and the U.S. investedmore health resources in the treatment of severe patients, while South Korea and Iran had adopted a strategyof extensive testing and identification of suspected patients. In terms of specific measures, all the five countriesadopted measures such as restrictions on entry and international travel, closure of schools and industries,lockdown and quarantine. Nevertheless, the effectiveness of implementing these measures varied acrosscountries, based on the response strategies.Conclusion: Although SPAR Scores and GHS Index have evaluated the national core capacities for preparednessand response, the actions to cope with the COVID-19 pandemic has revealed the fact that most countries stilldo not build resilient health systems in response to public health emergencies. Health system strengtheningand health security efforts should be pursued in tandem, as part of the same mutually reinforcing approach todeveloping resilient health systems.

Government responses to the COVID-19 pandemic of the Gulf Cooperation Council countries:good practices and lessons for future preparedness

The COVID-19 pandemic has dramatically threatened the Gulf Cooperation Council(GCC)countries which have a large proportion of foreign workers.The governments of GCC countries have proactively implemented a com-prehensive set of policy measures,and up to our knowledge,a systematic analysis of qualitative and quantitative evidence on the government response is still lacking.We summarized the GCC countries’government response and quantitatively measured that response using four indexes—the Government Response Index,the Stringency Index,the Vaccine Index,and the Initial Response Index,to analyse their response for future pandemic preparedness.Overall,the government response of all the GCC countries to the COVID-19 pandemic has been comprehensive,stringent,and timely.Notably,the GCC countries have implemented comprehensive vaccine policies.In addition,they have worked actively to protect foreign workers to improve their access to health services and secure their essential living conditions,regardless of their immigrant status.All the GCC countries dynamically adjusted their response to the evolving COVID-19 epidemiological burden and started to relax the stringency of the control poli-cies after the Omicron wave,though the governments had different response magnitudes as measured by the four indexes.These findings have provided several important lessons for future pandemic response and preparedness for countries with similar economic,demographic,and health contexts in(1)prompt actions of containment and clo-sure policies with dynamic adjusting,(2)strengthening health system policies,(3)comprehensive vaccination policies with universal access,(4)equitable and free access to testing,diagnosis,and treatment for all,and(5)strengthening the resilience of health systems.

State fragility and the coronavirus disease 2019(COVID-19)pandemic:an ecologic analysis of data from 146 countries

Background:Global spread and impact of the coronavirus disease 2019(COVID-19)pandemic are determined to a large extent,by resistance to the pandemic and public response of all countries in the world;while a country's resistance and response are in turn determined by its political and socio economic conditions.To inform future disease prevention and control,we analyzed global data to exam the relationship between state vulnerabilities and COVID-19 incidences and deaths.Methods:Vulnerability was measured using the Fragile States Index(FSI).FSI is created by the Fund for Peace to assess levels of fragility for individual countries.Total FSI score and scores for 12 specific indicators were used as the predictor variables.Outcome variables were national cumulative COVID-19 cases and deaths up to September 16,2020,derived from the World Health Organization.Cumulative incidence rates were computed using 2019 National population derived from the World Bank,and case fatality rates were computed as the ratio of deaths/COVID-19 cases.Countries with incomplete data were excluded,yielding a final sample of 146 countries.Multivariate regression was used to examine the association between the predictor and the outcome measures.Results:There were dramatic cross-country variations in both FSI and COVID-19 epidemiological measurements.FSI total scores were negatively associated with both COVID-19 cumulative incidence rates(β=-0.0135,P<0.001)and case fatality rates(β=-0.0147,P<0.05).Of the 12 FSI indicators,three negatively associated with COVID-19 incidences were E1(Economic Decline and Poverty),E3(Human Flight and Brain Drain),and S2(Refugees and Internally Displaced Persons);two positively associated were P1(State Legitimacy)and X1(External Intervention).With regard to association with case fatality rates,C1(Security Apparatus)was positive,and P3(Human Rights and Rule of Law)and X1 was negative.Conclusion:With FSI measures by the Fund of Peace,overall,more fragile countries are less likely to be affected by the COVID-19 pandemic,and even if affected,death rates were lower.However,poor in state legitimacy and lack of external intervention are risk for COVID-19 infection and lack of security apparatus is risky for COVID-19 death.Implications of the study findings are discussed and additional studies are needed to examine the mechanisms underpinning these relationships.

Overview of Earthquake Preparedness and Disaster Mitigation in China1

As an earthquake-prone country, China has made sustained efforts in the study of earthquakes and disaster mitigation during the past several decades, with China Seismological Bureau (CSB) as the backbone of these efforts. Working towards this purpose, a series of key projects were implemented in the “Ninth Five-Year Plan” (1995-2000) to upgrade earthquake monitoring systems and to improve the supporting infrastructure, significant results in earthquake science were achieved. In the new century, we have worked out a blueprint for earthquake preparedness and disaster mitigation in the “Tenth Five-Year Plan”, which emphases 3 systems (i.e. Seismic Monitoring & Prediction, Seismic Hazards Prevention, Emergency Response), and 10 key projects in earthquake science and technology.

Combating COVID-19: Nigerian Nurses’ Perspectives and Challenges Executive Summary

Coronavirus disease 2019 (COVID-19) is one of the worst deadly infections that is currently causing devastating effects and damages to humanity across the world. The global pandemic which outbroke in Wuhan in China has equally affected almost every country in the world. Over the past several months of the coronavirus crisis, cities went into lockdown, countries issued stay-at-home orders, and an increasing number of people had been practicing social distancing on a societal scale that has never been witnessed. However, nurses continue to provide care, comfort, and information to patients at all levels while risking their personal safety and well-being. This executive report provides an insight in Nigerian nurses’ perspectives and challenges in combating COVID-19 during the surge. Capturing nursing practice and nurses’ experiences during COVID-19 surge provide real-time guidance to mitigating challenges and improving well-being of nurses.

基于PPRR理论的精神专科医院传染病防控能力评价指标体系构建

目的构建精神专科医院传染病防控能力评价指标,为提升精神专科医院传染病防控能力建设提供参考依据。方法基于PPRR危机管理理论,综合运用文献法、半结构式访谈法、德尔菲法、层次分析法构建精神专科医院传染病防控能力评价指标体系。结果经过2轮专家函询,专家咨询积极系数均为100%,专家平均权威系数为0.88,协调系数较好,构建了一套包括4个一级指标,20个二级指标,85个三级指标的精神专科医院传染病防控能力评价指标体系,经层次法分析各级评价指标均符合一致性检验要求。结论该评价指标体系有一定的科学性和可靠性,为精神专科医院传染病防控提供了可行性标准。

应对大流行病的全球卫生融资问题研究——以国际卫生法律文书谈判为中心

预防、防范和应对大流行病的全球卫生融资一方面呈现机构激增、主体与场域多元的特征,另一方面也面临融资优先事项失衡、慈善模式、融资框架无序、治理范式失衡以及可持续供资不足的多重困境。当前,《世卫组织大流行协定》草案和《国际卫生条例(2005)》修正案就融资议题已达成框架性共识。未来,推进这一议题可供选择的路径是:以公共卫生安全与健康公平基本价值间的平衡为导向,秉持人类卫生健康共同体理念,贯彻公平原则,承认发展中国家的能力差异,统筹长期公共卫生能力建设和短期快速应急融资需求,以世界卫生组织为主导统筹两项文书下的融资协调机制,推动构建共商共治的全球卫生融资治理框架,发展可持续可预测的融资渠道。

流感大流行准备和应对的国际理念在中国的具体实践

世界卫生组织已经制定并不断完善关于流感大流行的准备和应对的相关指南,希望通过引导各国事先制定流感大流行准备计划,从而有效应对突如其来的流感疫情,减少流感对人类造成的损失。世界银行禽流感项目根据我国国情,将县级层面流感大流行准备和应对能力建设作为重点,创新性地开发了一系列指南和工具,并开展了大量的演练活动,积极探索将世界卫生组织的国际理念转化为中国的具体实践,为国家自上而下的应急管理体制提供经验和补充。

流行病应急响应的国际合作——联合国领导下的禽流感防疫机制透析

随着跨国公共卫生安全在全球治理中分量日益加重,流行病应急响应(Epidemic preparedness and response)的国际合作逐步被提上了全球日程。2005年,人感染高致病性禽流感在全球范围内的大规模传播,国际社会尤其是联合国领导下的相关组织如何构建防疫机制来应对这一形势成为焦点。经过多年的努力,联合国领导下的禽流感防疫机制日臻完善,该机制主要包括核心领导机构、法理基础、重要应急措施以及相关国际行为体参与4个方面。同时,该机制的有效性与局限性并存,值得引起人们的注意。

北美图书馆应对突发公共卫生事件的启示

北美图书馆在应对突发公共卫生事件中的角色定位、应急预防、应急响应等经验,可以为我国图书馆建立应急机制提供参考和借鉴。图书馆在突发公共卫生事件应对中,除了作为权威信息源为不同用户提供差异化服务,还可以发挥更多作用。图书馆应培训、保护馆员,并依托馆员开展广泛合作,采取多种形式服务社会,充分发挥生物医学类图书馆和行业协会的引领作用,建立国家灾害信息管理研究中心,开展本行业和跨行业协作,动员社会力量进行防灾减灾。

新冠疫情下美国公共卫生体系的运行:机制与评价

美国公共卫生体系包括政府机构、私营企业、非政府组织等多种实体,负责从联邦、州和地方层面向公众提供必要的公共卫生服务。新冠肺炎疫情暴发以来,美国公共卫生体系主要承担针对突发公共卫生事件的应急准备与应对职责。本文在厘清以上内容的基础上,梳理新冠肺炎疫情下美国公共卫生体系的运行机制,并参考中美两国学者对美国公共卫生体系运行情况的讨论,对新冠肺炎疫情下美国公共卫生体系的运行做出评价。

地区污名对旅行者负责任环境行为的影响研究

重大公共卫生事件往往会给旅游业的可持续发展带来冲击,甚至使得来自疫区的旅行者遭受到社会强加的地区污名。文章以资源保存理论为理论基础,以认知评价理论为整体逻辑,以新冠疫情暴发初期的湖北籍旅行者为研究对象,探讨了旅行者的地区污名对其自我概念清晰度、负面情绪以及负责任环境行为的影响,并进一步分析了自我证明动机对该链式中介模型的调节作用。通过问卷调研239名的旅行者,文章利用Mplus和SPSS软件进行了结构方程分析、Bootstrap分析以及潜调节结构模型分析,实证检验发现:(1)地区污名对负责任环境行为存在负向影响;(2)自我概念清晰度与负面情绪分别在地区污名对负责任环境行为的影响中发挥中介作用;(3)自我概念清晰度与负面情绪在地区污名对负责任环境行为的影响中起链式中介作用;(4)自我证明动机通过减弱地区污名对自我概念清晰度的负向影响进而对链式中介路径起调节作用。文章在借鉴资源保存理论的基础上,结合重大公共卫生事件中的地区污名化现象,阐释了地区污名化效应的内在逻辑及其干预措施,以期为重大卫生事件中如何优化旅行者体验和促进旅游业可持续发展提供理论依据。

疫情下新时代青年社会责任意识建构与培育途径探究

青年社会责任意识建构和培育面临的挑战在于社会交往网络虚拟化的冲击、社会发展转型下特殊战“疫”给思想意识的考验和资本逻辑的侵蚀。疫情防控是对社会责任意识的重大考验。新时代,青年社会责任意识的建构和培育作为制度优势转化为制度效能的重要体现。在疫情防控背景下,建构和培育青年社会责任意识要善于运用疫情防控实践活教材,构建高效严格的制度规范,营设积极向上的思想舆论环境,建设崇尚爱国主义、集体主义的道德环境。

新冠肺炎病例散发出现时对输血科工作的影响与应对

目的 分析新冠肺炎(COVID-19)防控对输血科工作的影响与应对。方法 收集2021年10月~11月及2018年同期2个时间段西京医院门(急)诊量和住院收容量,输血科输血相容性3项试验的工作量,以及所有临床用血科室的各种成分血使用量等数据,做统计学分析。结果 西京医院2021年10月~11月及2018年同期的门急诊量(人)和住院收容量(人)分别为8 359±3 615 vs 1 0151±3 225、280±157.1 vs 340.4±110.2,血型检测、不规则抗体筛查和交叉配血例数分别为272.0±132.4 vs 341.6±110.4、78.26±42.22 vs 98.51±43.53、237.2±99 vs 475.7±155.6,所有临床用血科室的成分血使用重量(U)为457.9±50.32 vs 579.4±62.51、各成分血使用量也均下降(均为P<0.05)。COVID-19疫情及其防控对门急诊量和住院收容量的影响最快,如本地宣布确诊新发COVID-19病例d2就开始持续下降;输血科血型检测、不规则抗体筛查和交叉配血工作量的下降分别从d2、d3和d5开始且持续时间依次略有缩短;临床红细胞和血浆使用量的下降均从d7开始并持续到本地宣布此轮COVID-19清零的d6左右,血小板和冷沉淀使用量的下降分别开始d8和d10,分别持续到清零后的d2和d6。结论 COVID-19疫情及其防控严重影响输血科的工作常态化开展。对此输血科应及时调整原有的工作模式、人员配置以及各成分血库存量比,以维护临床医疗救护患者生命安全工作的正常开展。

新型冠状病毒肺炎疫情的全球流行现状和其对中国的影响及政策建议

当前全球六大洲、114个国家、领土或地区受到新型冠状病毒肺炎疫情不同程度的影响,WHO已宣布本次疫情构成"全球大流行"。为进一步加强对全球新型冠状病毒肺炎疫情的防控,应对全球疫情升级对中国的挑战,本研究着重回答3个问题:新型冠状病毒肺炎全球流行现状及各国防疫情况;全球疫情对中国影响;中国应对全球疫情的短期预案和中长期策略建议。

中国五省(区)市疾病预防控制机构流感大流行应对能力现状研究

目的了解浙江、新疆、山东、贵州、武汉五省(区)市疾病预防控制机构的流感大流行应对能力现状,研究针对性干预措施。方法对五省(区)市的59家疾病预防控制中心进行问卷调查,数据进行描述流行病学分析。结果调查的各级疾控中心均成立了应急处置组织体系,制定了流感大流行应急预案并开展演练和培训;75.00%的省级、55.56%的市级和51.35%的县级疾控中心认为储备的消毒药品不能满足重大突发公共卫生事件的处置需求;省、市级疾控中心均具备流感病毒检测能力,但县级疾控中心仅浙江省有69.57%可以开展检测。结论五省(区)市疾控机构具备了应对流感大流行的基本专业技术能力,但仍存在人才队伍数量不足、应急物资储备机制不完善、监测系统建设东西部发展不均衡、基层流感病毒检测能力薄弱等问题,亟需加强和改进。

世界卫生组织和中国在流感大流行应对准备计划方面的发展及现状

历史上流感的每次大流行都给人类带来灾难，其中以1918年“西班牙流感”大流行最为严重。近100年来，随着对流感病毒了解的不断深入，以及检测技术的长足发展和监测手段的逐步丰富，人类面对流感大流行并非如前般无所适从。为努力延缓和降低其危害，人们希望通过不断完善应对准备工作，以期实现早期预警或尽早发现具备大流行潜能的流感病毒，以及在大流行期间，通过实施应对准备计划中相应的防控措施，延缓高峰出现和控制疫情流行，从而达到降低影响的目的。本文回顾了百年来WHO和中国的流感大流行应对准备工作的策略、重点及其随时间的演变与发展进程，以温故而知新，为今后不断完善流感大流行应对准备工作提供参考。

流感、禽流感和流感大流行：我们准备好了吗？

2017-2018年冬春季我国流感疫情高发，引起了社会和公众的极大关注。2018年正值1918年“西班牙流感”大流行100周年，本期“流感大流行100周年”栏目的系列文章，系统地展示了全球和我国历次流感大流行的影响、特点和应对情况，回顾了我国在监测、预防控制策略、疫苗接种、治疗等方面的进展和经验，也提出了季节性流感防治、人感染禽流感防控和大流行应对工作的不足和挑战，对进一步提高公众和专业机构对流感大流行和流感防控的认识，加强我国流感大流行应对工作有积极意义。

新型冠状病毒肺炎疫情由应急处置转入应急处置和常态化防控相结合的思考

从新型冠状病毒肺炎(新冠肺炎)蔓延的范围和速度看,新冠肺炎疫情是复杂而凶险的。由于新冠肺炎的传染源将会长期存在、传播途径难以彻底切断以及易感人群众多等因素,决定了新冠肺炎疫情可能长时间存在。因此,预防控制工作将是长期艰巨的任务,需要坚持应急处置和常态化防控相结合的原则,统筹推进疫情防控和经济社会发展。