Política de salud pública pandémica: un gran poder conlleva una gran responsabilidad
DOI:
https://doi.org/10.5007/1677-2954.2023.e97440Resumo
En los últimos 6 meses, se ha generado una vasta cantidad de datos clínicos y epidemiológicos que describen el COVID-19 y su propagación en diversas poblaciones. Con el lujo de la riqueza, la baja densidad de población y el aislamiento geográfico, Australia y Nueva Zelanda han evitado hasta ahora las cifras de casos observadas en otros lugares, lo que ha permitido a nuestros organismos de salud pública disponer de un tiempo valioso para aprender y prepararse. La defensa de esta posición privilegiada ha visto el uso de facultades de reserva de salud pública para implementar algunas de las políticas más restrictivas en el mundo. Aquellos que ejercen estas facultades tienen una extraordinaria responsabilidad ante la comunidad. Sostenemos que nuestros organismos de salud pública y nuestros gobiernos deben hacer lo posible por mejorar la transparencia de la comunicación de los riesgos del COVID-19, las justificaciones de las intervenciones restrictivas y los objetivos globales a largo plazo de la política de salud pública. Seis meses después, ya no es aceptable que esta responsabilidad se difiera por motivos de emergencia. Sobre la base de los datos disponibles actualmente, ya es posible identificar al menos algunas políticas que probablemente se asocien a beneficios netos, otras que no son beneficiosas y otras que son injustas o, en conjunto, perjudiciales. Es una falsa dicotomía sugerir que deben aplicarse múltiples intervenciones a la vez o ninguna en absoluto, que las poblaciones deben elegir entre el "laissez faire" y el confinamiento (“lockdown”). Los organismos de salud pública tienen la responsabilidad de considerar cómo alcanzar los objetivos generales de salud pública con las estrategias menos restrictivas o que generen menos cargas y de sopesar cada intervención en función de sus méritos.
Referências
ATKINSON JA, Skinner A, Lawson K, Song Y, Hickie I. Road to Recovery: Restoring Australia’s Mental Wealth. Sydney: University of Sydney; 2020.
BONACCORSI G, Pierri F, Cinelli M,Flori A, Galeazzi A, Porcelli Fet al. Economic and social consequences of human mobility restrictions under COVID-19.Proc Natl Acad Sci2020;117:15530–5.
CLAYTON R. Premier says coronavirus hardship payments are available, as Victorians continue to work while ill.ABC News2020 Jul 22. [citado el 27 de agosto de 2020].Disponible en el URL: https://www.abc.net.au/news/2020-07-22/are-you-eligible-for-the-victorian-government-hardship-payment/12478650
COMAS-HERRERA A, Zalakaín J, Litwin C,Hsu AT, Lemmon E, Henderson Det al.Mortality Associated with COVID-19Outbreaks in Care Homes: Early International Evidence. International Long-Term Care Policy Network; 2020.
Disponible en el URL:https://superspreadingeventsdatabase.blogspot.com/p/about.html
EE N, Maccora J, Hosking D,McCallum J.Australian Grandparents Care. Canberra: National Seniors; 2020.
ELSTON DM. Occupational skin diseaseamong healthcare workers during thecoronavirus (COVID-19) epidemic.J Am Acad Dermatol 2020;82: 1085–6.
ESPOSITO S, Principi N. School closureduring the coronavirus disease 2019 (COVID-19) Pandemic.JAMA Pediatrics.2020. http://dx.doi.org/10.1001/jamapediatrics.2020.1892
FISHER JR, Tran TD, Hammargerg K,Sastry J, Nguyen H, Rowe H et al. Mental health of people in Australia in the first month of COVID-19 restrictions: a national survey. Med J Aust 2020: 1.
GUERTLER A, Moellhoff N, Schenck TL,Hagen CS, Kendziora B, Giunta RE et al. Onset of occupational hand eczema among healthcare workers during the SARS-CoV-2 pandemic–comparing a single surgical site with a COVID-19 intensive care unit. Contact Dermatitis2020;83: 108–14.
HALL B. Victoria’s contact tracing system to be bolstered after string of failures.The Age 2020 Jul 10.
HARIPERSAD YV, Kannegiesser-Bailey M, Morton K, Skeldon S, Shipton N, Edwards Ket al. Outbreak of anorexia nervosa admissions during the COVID-19 pandemic. Arch Dis Child 2020.https://doi.org/10.1136/archdischild-2020-319868
HILDENWALL H, Luthander J, Rhedin S,Hertting O, Olsson-Åkefeldt S, Melén Eet al. Paediatric COVID-19 admissions in a region with open schools during the two first months of the pandemic. Acta Paediatric 2020;109: 2152–4. https://doi.org/10.1111/apa.15432.33
SCB.Prevalence of Covid-19 in Different Occupational Groups. Stockholm: Statistics Sweden; 2020.
JAMROZIK E, Selgelid MJ. COVID-19 human challenge studies: ethical issues. Lancet Infect Dis 2020;20: e198–203.
KEHOE J. More cancer deaths from COVID-19 lockdown. Australian Financial Review 2020 Aug 12.
LADHANI SN, Chow JY, Janarthanan R,Fok J, Crawley-Boevey E, Vusirikala Aet al. Increased risk of SARS-CoV-2 infection in staff working across different care homes: enchanced Covid-19 outbreak investigations in Londoncare homes. J Infect2020;81: 621–4.
LANGE PW, Gazzard M, Walker S, Hilton JJ, Haycock S, Wagstaff JFR et al. Where are our patients? Retrospective cohort study of acute medical unit admissions during and prior to the COVID-19 pandemic.Intern Med J2020;50: 1132–4.
LECLERC QJ, Fuller NM, Knight LE,Funk S, Knight GM, Group CC-W.What settings have been linked to SARS-CoV-2 transmission clusters? Wellcome Open Res.2020;5: 83.
LECLERC QJea. SARS-CoV-2Superspreading Events Database 2020 [citado el 27 de agosto de 2020].
MAFHAM MM, Spata E, Goldacre R,Gair D, Curnow P, Bray Met al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England.Lancet 2020;396: 381–9.
MARTIN CA, Jenkins DR, Minhas JS,Gray LJ, Tang J, Williams Cet al. Socio-demographic heterogeneity in the prevalence of COVID-19 during lockdown is associated with ethnicity and household size: results from an observational cohort study. E Clinical Medicine 2020;25: 100466.
NGUYEN LH, Drew DA, Graham MS,Joshi AD, Guo C-G, Ma Wet al. Risk of COVID-19 among front-line health-careworkers and the general community: a prospective cohort study. Lancet PublicHealth2020;5: E475–83. [citado el 27 de agosto de 2020]. https://doi.org/10.1101/2020.04.29.20084111
NICOLL A, Ciancio B, Chavarrias VL,Mølbak K, Pebody R, Pedzinski Bet al. Influenza-related deaths-available methods for estimating numbers and detecting patterns for seasonal and pandemic influenza in Europe. EuroSurveill. 2012;17: 20162.
PARK YJ, Choe YJ, Park O, Park SY,Kim Y-M, Kim Jet al. Contact tracing during coronavirus disease outbreak, South Korea, 2020. [citado el 27 de agosto de 2020].Emerg Infect Dis2020;26: 2465–8.https://doi.org/10.3201/eid2610.201315.
PATRICK DM, Petric M, Skowronski DM,Guasparini R, Booth TF, Krajden Met al. An outbreak of human coronavirus OC43 infection and serological cross-reactivity with SARS coronavirus.Can J Infect Dis Med Microbiol 2006;17: 330–6.
PIERCE M, Hope H, Ford T, Hatch S,Hotopf M, John Aet al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. Lancet Psychiatry 2020;7: 883–92.
QIAN H, Miao T, Li L, Zheng X, Luo D,Li Y. Indoor transmission of SARS-CoV-2.medRxiv2020. https://doi.org/10.1101/2020.04.04.20053058
SALJE H, Kiem CT, Lefrancq N,Courtejoie N, Bosetti P, Paireau J, et al. Estimating the burden of SARS-CoV-2 in France.medRxiv2020;369:208–211.
SIMONSEN L, Clarke MJ, Schonberger LB, Arden NH, Cox NJ, Fukuda K. Pandemic versus epidemic influenza mortality: a pattern of changing age distribution. J Infect Dis 1998;178: 53–60.
STALL NM, Jones A, Brown KA,Rochon PA, Costa AP. For-profit long-term care homes and the risk of COVID-19 outbreaks and resident deaths.CMAJ 2020;192: E946–E55.
VERITY R, Okell LC, Dorigatti I,Winskill P, Whittaker C, Imai Net al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis2020;20: 669–77.
VINER RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield Cet al. School Closures And management practices during coronavirus outbreaks including COVID-19: a rapid systematic review.Lancet ChildAdolesc Health2020;4: 397–404.
WEILL JA, Stigler M, Deschenes O,Springborn MR. Social distancing responses to COVID-19 emergency declarations strongly differentiated by income. Proc Natl Acad Sci2020;117:19658–60.
WEINBERGER DM, Chen J, Cohen T,Crawford FW, Mostashari F, Olson D.et al. Estimation of Excess Deaths Associated With the COVID-19Pandemic in the United States, Marchto May 2020.JAMA Internal Medicine.2020;180: 1336–44.
http://dx.doi.org/10.1001/jamainternmed.2020.3391.
WILLIAMSON EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE et al. Open SAFELY: factors associated with COVID-19 death in 17 million patients.Nature2020;584:430–6.
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