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Enhancing Private Sector Health System Preparedness for 21st-Century Health Threats: Foundational Principles From a National Academies Initiative.
JAMA ( IF 51.273 ) Pub Date : 2020-02-06 , DOI: 10.1001/jama.2020.1310
Donald M Berwick,Kenneth Shine

Not since the threat of global nuclear war first emerged has humankind faced the risks of potential disasters at the scale that the 21st century now brings. Climate change, international terrorism, pandemics, and cyberwarfare are only some of the ways in which injury, morbidity, and mortality can spread rapidly to millions of people. Ebola, as tragic as it has been, is but a small example of what could occur if, for instance, a nuclear blast went off in New York, sea level surges flooded Florida, or the electric grid went down in a health emergency. The current coronavirus epidemic in China has created a major international public health threat, led to the full or partial quarantine of nearly 45 million people, and interrupted commerce in many cities.1 These threats may come in 2 distinct forms. One is a challenge to capacity—a surge of demand for, for instance, trauma care, burn care, or treatment of an infectious agent at a scale far beyond any currently familiar level of mass casualty. Many local care systems are prepared to manage surges of demand of some size.2 But what if, instead of a few dozen or a few hundred affected individuals, the sudden need were to provide care for thousands or tens of thousands? A second form of threat is a disaster paired with the simultaneous destruction of basic infrastructure, such as a sustained failure of the electrical grid due to cybersabotage. How would mass casualties be managed if the power went out for many days, gasoline and water pumps no longer worked, and the communication system disappeared?
更新日期:2020-03-26

 

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