Policy paper urges policymakers to build on lessons learned during the COVID-19 pandemic
Sept. 8, 2023 (ACP) — The American College of Physicians has issued recommendations that aim to ensure the United States is prepared for future pandemics, as significant gaps in the U.S. pandemic and public health emergency response system were revealed during the COVID-19 pandemic.
In a new policy paper, “Preparing for Future Pandemics and Public Health Emergencies,” published online July 25 in the Annals of Internal Medicine, ACP reflects on what the United States got right and wrong during the initial stages of the COVID-19 pandemic and outlines several key recommendations about what needs to be done to mitigate the consequences of future pandemics.
“Being in this unique point in time, where we are in close enough proximity to the events of the pandemic for it to be fresh in the mind, yet far enough from its peak to be able to review the events and actions that transpired, ACP believes that now is the opportune time to critically analyze and reflect on the U.S. COVID-19 experience and pandemic response,” said Josh Serchen, ACP associate for health policy and first author of the paper.
When the COVID-19 pandemic began, significant cracks were exposed in the public health system. “Depleted stockpiles and supply chain shocks created shortages of the tools health professionals needed to treat the most ill, as well as the personal protective equipment needed to minimize risk and be able to practice medicine safely,” Serchen explained.
To avoid this in the future, ACP calls for an adequately funded federal pandemic preparedness plan that prioritizes health equity. The boom-and-bust cycle of public health funding does not work, Serchen explained. “Typically, we will see investments in public health and the ramping-up of programs around specific public health events (i.e., the Ebola and Zika viruses, etc.) and then an immediate drop-off in funding once society deems these threats to no longer be significant,” he said.
This approach is not sustainable. “We cannot expect public health systems to be ready and capable of responding to the next emerging threat,” Serchen added.
ACP also recommends that more is done to ensure sufficient physician capacity, starting with alleviating the longstanding primary care physician shortages. “In addition to having enough physicians, their health and well-being are paramount, which requires a focus on adequate working conditions and meeting their mental and emotional health needs during periods of high stress,” Serchen said.
To that end, the policy paper affirms the importance of safety and well-being of both patients and physicians, emphasizing the need for support for medical practices during emergencies, measures to reduce infections in the workplace and universal sick leave policies.
Trust in public health and government institutions is now at an all-time low, Serchen noted, exacerbated by the spread of medical misinformation and poorly communicated guidelines and public health information. To regain the public's trust and combat misinformation, ACP is urging federal and state agencies to provide consistent and timely communication about risk and strategies to combat risk. ACP recommends this communication is powered by a national public health data infrastructure capable of real-time bidirectional data sharing among public and private-public health stakeholders.
Looking back on the initial stages of the COVID-19 pandemic, the unprecedented speed in the development of the first COVID-19 vaccines (i.e., Operation Warp Speed) was a huge win, Serchen said. “What traditionally took years was undertaken in months, leveraging prior research advances and propelled by significant government support and investment in research, development, procurement and logistics,” he said.
Going forward, ACP calls for expedited and equitable vaccine development and distribution and vaccine use in accordance with scientific recommendations. ACP is also encouraging all physicians to promote vaccine uptake among their patients.
To move the needle forward, members can advocate for modernizing data systems, promoting collaboration and data sharing across governments and sectors, and facilitating robust supply chains, according to Serchen.
This advocacy starts with urging members of Congress to work to pass legislation that reauthorizes the Pandemic and All-Hazards Preparedness Act (PAHPA), which is set to expire on Sept. 30, 2023. PAHPA serves as the primary legislative vehicle for authorizing and equipping the public health system to respond to pandemics and other threats.
In an editorial accompanying the policy paper, Dr. Ashish K. Jha, former White House COVID-19 response coordinator, agreed that the United States made progress in pandemic preparedness during the past two years and cited advances in telehealth and the advent of “test-to-treat” programs. “Now is the time to not just continue that work but accelerate it — to ensure that when the next health crisis hits, we are ready,” he wrote.
In a press release about the policy paper, ACP President Dr. Omar T. Atiq said, “We know that the COVID-19 pandemic will not be the last public health emergency that our country is faced with. We need to take action now to make sure that we are prepared for future pandemics and public health emergencies. If the recommendations we make in this paper were in place in 2020, we may have been able to mitigate some of the horrific consequences of the COVID-19 pandemic. We owe it to our patients, the public and our nation's physicians and other health care professionals to equip our country to respond.”
The position paper, “Preparing for Future Pandemics and Public Health Emergencies,” is available on the Annals of Internal Medicine website.