Assuntos
COVID-19/prevenção & controle , Planejamento em Desastres/organização & administração , Saúde Global/normas , Recursos em Saúde/organização & administração , Pandemias/prevenção & controle , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Tomada de Decisões/ética , Feminino , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Cooperação Internacional , Liderança , Masculino , Pandemias/economia , Pesquisa Qualitativa , SARS-CoV-2/genética , Classe Social , Participação Social/psicologiaAssuntos
COVID-19/prevenção & controle , Planejamento em Desastres/organização & administração , Pandemias/prevenção & controle , Saúde Pública/normas , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Comunicação , Participação da Comunidade , Atenção à Saúde/organização & administração , Surtos de Doenças/prevenção & controle , Feminino , Mão de Obra em Saúde/organização & administração , Direitos Humanos/ética , Humanos , Objetivos Organizacionais , Vigilância da População/métodos , Sistemas de Apoio Psicossocial , SARS-CoV-2/genética , Minorias Sexuais e de Gênero/psicologiaRESUMO
Understanding the spread of SARS-CoV-2, how and when evidence emerged, and the timing of local, national, regional, and global responses is essential to establish how an outbreak became a pandemic and to prepare for future health threats. With that aim, the Independent Panel for Pandemic Preparedness and Response has developed a chronology of events, actions, and recommendations, from December, 2019, when the first cases of COVID-19 were identified in China, to the end of March, 2020, by which time the outbreak had spread extensively worldwide and had been characterised as a pandemic. Datapoints are based on two literature reviews, WHO documents and correspondence, submissions to the Panel, and an expert verification process. The retrospective analysis of the chronology shows a dedicated initial response by WHO and some national governments, but also aspects of the response that could have been quicker, including outbreak notifications under the International Health Regulations (IHR), presumption and confirmation of human-to-human transmission of SARS-CoV-2, declaration of a Public Health Emergency of International Concern, and, most importantly, the public health response of many national governments. The chronology also shows that some countries, largely those with previous experience with similar outbreaks, reacted quickly, even ahead of WHO alerts, and were more successful in initially containing the virus. Mapping actions against IHR obligations, the chronology shows where efficiency and accountability could be improved at local, national, and international levels to more quickly alert and contain health threats in the future. In particular, these improvements include necessary reforms to international law and governance for pandemic preparedness and response, including the IHR and a potential framework convention on pandemic preparedness and response.
Assuntos
COVID-19/epidemiologia , Pandemias , Animais , COVID-19/transmissão , China/epidemiologia , Surtos de Doenças , Saúde Global/legislação & jurisprudência , Humanos , Disseminação de Informação , Cooperação Internacional , Regulamento Sanitário Internacional , Medição de Risco , SARS-CoV-2/isolamento & purificação , Fatores de Tempo , Organização Mundial da Saúde , Zoonoses/virologiaRESUMO
Health systems resilience is key to learning lessons from country responses to crises such as coronavirus disease 2019 (COVID-19). In this perspective, we review COVID-19 responses in 28 countries using a new health systems resilience framework. Through a combination of literature review, national government submissions and interviews with experts, we conducted a comparative analysis of national responses. We report on domains addressing governance and financing, health workforce, medical products and technologies, public health functions, health service delivery and community engagement to prevent and mitigate the spread of COVID-19. We then synthesize four salient elements that underlie highly effective national responses and offer recommendations toward strengthening health systems resilience globally.