Health technology assessment applied to emergency preparedness: a new perspective.

Emergency preparedness is a continuous quality improvement process through which roles and responsibilities are defined to effectively anticipate, respond to, and recover from the impact of emergencies. This process results in documented plans that provide a backbone structure for developing the core capacities to address health threats. Nevertheless, several barriers can impair an effective preparedness planning, as it needs a 360° perspective to address each component according to the best evidence and practice. Preparedness planning shares common principles with health technology assessment (HTA) as both encompass a multidisciplinary and multistakeholder approach, follow an iterative cycle, adopt a 360° perspective on the impact of intervention measures, and conclude with decision-making support. Our "Perspective" illustrates how each HTA domain can address different component(s) of a preparedness plan that can indeed be seen as a container of multiple HTAs, which can then be used to populate the entire plan itself. This approach can allow one to overcome preparedness barriers, providing an independent, systematic, and robust tool to address the components and ensuring a comprehensive evaluation of their value in the mitigation of the impact of emergencies.

COVID-19: Opportunity to Re-Imagine Our Response to a National Medical Crisis.

The US is facing the most significant health challenge since the 1918-1919 flu pandemic. A response commensurate with this challenge requires engaged leadership and organization across private and public sectors that span federal agencies, public and private healthcare systems, professional organizations, and industry. In the trauma and emergency care communities, we have long discussed the tension between competition in healthcare and the need for regional cooperation to respond to large-scale disasters. The response to COVID-19 has required unprecedented coordination of private and public sector entities. Given the competitive nature of the US health system, these sectors do not regularly work together despite the requirement to do so during a national emergency. This crisis has exposed how structural aspects of the present healthcare system have limited our ability to rapidly transition to a whole-nation response during a national crisis. We propose a renewed focus on the intersection of the healthcare system and national security, with the express goal of creating a public-private partnership focused on leveraging our healthcare infrastructure to support the national security interests of the US.

Living in a Multi-Risk Chaotic Condition: Pandemic, Natural Hazards and Complex Emergencies.

Humans are living in an uncertain world, with daily risks confronting them from various low to high hazard events, and the COVID-19 pandemic has created its own set of unique risks. Not only has it caused a significant number of fatalities, but in combination with other hazard sources, it may pose a considerably higher multi-risk. In this paper, three hazardous events are studied through the lens of a concurring pandemic. Several low-probability high-risk scenarios are developed by the combination of a pandemic situation with a natural hazard (e.g., earthquakes or floods) or a complex emergency situation (e.g., mass protests or military movements). The hybrid impacts of these multi-hazard situations are then qualitatively studied on the healthcare systems, and their functionality loss. The paper also discusses the impact of pandemic's (long-term) temporal effects on the type and recovery duration from these adverse events. Finally, the concept of escape from a hazard, evacuation, sheltering and their potential conflict during a pandemic and a natural hazard is briefly reviewed. The findings show the cascading effects of these multi-hazard scenarios, which are unseen nearly in all risk legislation. This paper is an attempt to urge funding agencies to provide additional grants for multi-hazard risk research.

An introduction to economic studies, health emergencies, and COVID-19.

The COVID-19 pandemic has created widespread harm and disruption. Countries have implemented unprecedented measures to protect the lives and livelihoods of their inhabitants. The scope and composition of these responses are shaped, in part, by research and analysis about the estimated economic impacts of the COVID-19 Pandemic and proposed responses to it. This analysis outlines basic features and principles involved in economic studies, specifically economic impact studies and economic evaluations, which have formed a significant part of the ever-increasing evidence base about COVID-19. This analysis introduces economic studies in this context, highlighting what they can do, their limitations, and key steps involved in conducting them. It highlights examples of economic analysis focused on COVID-19 and on health emergencies and disasters more broadly. Knowing how economic studies are conducted, and their limitations, will help introduce how their findings can be a useful, usable, and used part of efforts to tackle this global health crisis.