American College of Physicians Makes 13 Pandemic Preparedness Recommendations

The COVID-19 pandemic exposed several weaknesses in public health emergency preparedness such as insufficient centralized coordination at the federal level.

The frequency of pandemics on the scale of the COVID-19 pandemic is likely to increase and preparedness planning needs to improve, according to a position paper from the American College of Physicians (ACP).

The COVID-19 pandemic exposed several weaknesses in public health emergency preparedness, the position paper says. At the federal level, those weaknesses included insufficient centralized coordination, inadequately defined responsibilities, and an under-resourced national stockpile of supplies such as personal protective equipment. Other weaknesses included the failure to have a widespread testing and tracing system to contain the outbreak.

The ACP position paper, which was published today in Annals of Internal Medicine, makes 13 recommendations to improve public health emergency preparedness.

1. The federal government should have a comprehensive pandemic preparedness and response plan that is evidence-based and includes input from qualified professionals. Congress should provide adequate funding for pandemic preparedness.

2. Health equity should be a top priority for policy makers and public health officials in pandemic planning to diminish health disparities.

3. Federal and state agencies should have consistent and timely communication about risk and evidence-based strategies to address a pandemic as recommended in the ACP's earlier position paper, "Modernizing the United States' Public Health Infrastructure." Physicians have a key role to play in communicating evidence-based prevention and treatment strategies, and they should contribute to pandemic communications at the federal, state, tribal, and local levels. Efforts must be made to dispel misinformation and to boost trust in the healthcare system.

4. There should be a congressionally funded national public health data infrastructure that can support real-time data sharing between public and private public health stakeholders.

5. Efforts should be undertaken to secure and improve the healthcare supply chain. There should be funding to have sufficient personal protective equipment and other essential supplies in the Strategic National Stockpile.

6. Public policy should promote first-responder capacity and training as well as surge capacity at healthcare facilities. Education and training is needed to bolster the healthcare workforce, including physicians, nurses, and public health practitioners. Federal, state, and private agencies involved in licensing or work visas should be prepared to use volunteer physicians and other healthcare workers to meet labor demand during public health emergencies.

7. There should be a reserve of healthcare workers including physicians and public health professionals in healthcare settings to counsel, diagnose, treat, and monitor patients during a public health emergency.

8. Safety and well-being should be promoted during public health emergencies. Government agencies and medical institutions should partner to craft emergency preparedness plans that foster patient health, safety, and welfare. Government agencies and medical institutions should protect the safety and well-being of healthcare workers during a public health emergency.

9. Public and private payers should provide financial support to healthcare providers during public health emergencies, particularly in underserved communities. This financial support is essential because of increased costs and decreased revenues during pandemics.

10. Efforts should be made to decrease infection in workplaces, especially for essential workers. There should be federal mandates for workplace protections for essential workers during public health emergencies.

11. There should be universal access to sick leave with paid time off to allow workers to address personal or family illnesses, injury, or other medical conditions.

12. There should be public-private partnerships to speed vaccine development and distribution during a pandemic. Clinical trials should include all populations such as racial minorities and children.

13. Vaccines should be used based on recommendations from the Centers for Disease Control and Prevention as well as the agency's Advisory Committee on Immunization Practices. Vaccines should be distributed equitably, with priority place on high-risk people such as healthcare workers. Physicians should promote vaccination among their patients.

There is an urgent need to improve pandemic preparedness, the co-authors of the ACP position paper wrote. "As our global society continues to be ever more interconnected, and climate change is worsening, evidence suggests that more frequent and severe pandemics are on the horizon. Now is the time to take action and make preparations before the next pandemic happens. Policymakers must learn from the experience of the U.S. with COVID-19—both the good and the bad—and draw from it to inform a robust, comprehensive, and unified national pandemic preparedness plan."

Related: How to Improve Emergency Preparedness for Pandemics