rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0044-197X-2022-66-1-5-10rfhealth-724Research ArticleОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯHEALTH CARE ORGANIZATIONCOVID-19 — пути совершенствования готовности государства к пандемииCOVID-19 — ways to improve the state preparedness for pandemiahttps://orcid.org/0000-0002-6403-0423МитрохинО. В.MitrokhinOleg V.noemail@neicon.ruhttps://orcid.org/0000-0002-9745-4265ЕрмаковаН. А.ErmakovaNina A.noemail@neicon.ruhttps://orcid.org/0000-0002-4910-0868АкимоваЕ. И.AkimovaEkaterina I.noemail@neicon.ruhttps://orcid.org/0000-0002-3817-4175СидороваЕкатерина АлексеевнаSidorovaEkaterina A.

Ассистент каф. общей гигиены, ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)», 119435, Москва.

e-mail: ekaterina_sidorovaa@mail.ru

Assistant at the Common Hygiene Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russian Federation.

e-mail: ekaterina_sidorovaa@mail.ru

ekaterina_sidorovaa@mail.ruФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)»I.M. Sechenov First Moscow State Medical University (Sechenov University)202204032022661510Copyright © Митрохин О.В., Ермакова Н.А., Акимова Е.И., Сидорова Е.А., 20222022Митрохин О.В., Ермакова Н.А., Акимова Е.И., Сидорова Е.А.Mitrokhin O.V., Ermakova N.A., Akimova E.I., Sidorova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/724Введение

Введение. Одним из наиболее значимых вопросов государственного управления стран мира в ближайшее десятилетие станет обеспечение готовности к оперативному реагированию на возможное возникновение эпидемий инфекционных заболеваний. Беспрецедентность задачи определяет возможная величина риска здоровью населения и наносимого экономического ущерба, вызванных пандемией, подобной COVID-19. 

Цель

Цель. Провести изучение готовности органов государственного управления и систем здравоохранения к пандемии, разработать предложения по их модернизации. 

Материал и методы

Материал и методы. В статье обобщён опыт органов государственного управления и общественного здравоохранения в условиях пандемии коронавирусной инфекции. Проведён экспертный анализ проблемных вопросов организации государственного управления при осуществлении профилактических и противоэпидемических мер, в ходе которого были использованы статистические материалы, публикации отечественных и зарубежных авторов. Использованы информационно-правовые базы данных, документы Всемирной организации здравоохранения, органов здравоохранения страны в условиях пандемии коронавирусной инфекции. Применены аналитические, информационные, статистические методы исследования. 

Результаты

Результаты. Исследование выявило проблемные вопросы организации государственного управления при осуществлении профилактических и противоэпидемических мер, а также оказания медицинской помощи населению. 

Заключение

Заключение. Исходя из гипотезы, что эпидемии и пандемии будут угрожать обществу в обозримом будущем, предлагаются меры по модернизации готовности оперативного реагирования государств в случае возникновения пандемии (эпидемии) на среднесрочный и долгосрочный периоды и алгоритм деятельности органов государственного управления. Доказывается необходимость реализации принципов «двойного» (с учётом эпидемий) использования помещений, зданий и сооружений и «двойного» (с учётом эпидемий) образования для специалистов в области ветеринарии и биологии, а также среднего медицинского персонала.

Introduction

Introduction. Tasks are to execute a study of the preparedness of government and health systems for a pandemic to develop proposals for their modernization. The author proceeds from the hypothesis that epidemic and pandemic diseases will threaten society in the foreseeable future, and therefore it is necessary to develop preventive strategies for states to be prepared for new threats. The article summarizes the experience of government and public health in a pandemic of coronavirus infection. 

Purpose

Purpose. To examine pandemic preparedness of public administration and health systems and develop proposals for their modernization. 

Material and methods

Material and methods. There was made an expert analysis of the problematic issues of public administration in the implementation of preventive and anti-epidemic measures using statistical materials and publications of domestic and foreign authors. The study applied information and legal databases, documents of the World Health Organization, health authorities of countries in conditions of coronavirus infection pandemic, analytical, informational, statistical methods of research. 

Results

Results. Measures are proposed to modernize states’ preparedness for possible pandemics (epidemics) for the medium and long term. 

Conclusion

Conclusion. The author has proposed an algorithm for the activities of the government in preparedness to combat a pandemic (epidemic). It is necessary to introduce the principles of “double” (including epidemics) use of premises, buildings and structures and “double” (including epidemics) education of specialists in the field of veterinary medicine and biology, as well as paramedical personnel.

коронавирусная инфекцияCOVID-19органы государственного управленияздравоохранениеэпидемиипандемияcoronavirus infectionCOVID-19government bodiesepidemicspandemicReferencesЛьвов Д.К., Альховский С.В., Колобухина Л.В., Бурцева Е.И. Этиология эпидемической вспышки COVID-19 в г. Ухань (провинция Хубэй, Китайская Народная Республика), ассоциированной с вирусом 2019-nCoV (Nidovirales, Coronaviridae, Coronavirinae, Betacoronavirus, подрод Sarbecovirus): уроки эпидемии SARS-CoV. Вопросы вирусологии. 2020; 65(1): 6-15. https://doi.org/10.36233/0507-4088-2020-65-1-6-15Lvov D.K., Al’khovskiy S.V., Kolobukhina L.V., Burtseva E.I. Etiology of epidemic outbreaks covid-19 in wuhan, hubei province, chinese people republic associated with 2019-ncov (nidovirales, coronaviridae, coronavirinae, betacoronavirus, subgenus sarbecovirus): lessons of SARS-COV outbreak. Voprosy virusologii. 2020; 65(1): 6–15. https://doi.org/10.36233/0507-4088-2020-65-1-6-15 (in Russian)El Zowalaty M.E., Järhult J.D. From SARS to COVID-19: A previously unknown SARS- related coronavirus (SARS-CoV-2) of pandemic potential infecting humans - Call for a One Health approach. One Health. 2020; 9: 100124. https://doi.org/10.1016/j.onehlt.2020.100124El Zowalaty M.E., Järhult J.D. From SARS to COVID-19: A previously unknown SARS- related coronavirus (SARS-CoV-2) of pandemic potential infecting humans – Call for a One Health approach. One Health. 2020; 9: 100124. https://doi.org/10.1016/j.onehlt.2020.100124Liu Y., Gayle A.A., Wilder-Smith A., Rocklöv J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J. Travel. Med. 2020; 27(2): taaa021. https://doi.org/10.1093/jtm/taaa021Liu Y., Gayle A.A., Wilder-Smith A., Rocklöv J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J. Travel. Med. 2020; 27(2): taaa021. https://doi.org/10.1093/jtm/taaa021Багненко С.Ф., Рассохин В.В., Беляков Н.А., Боева Е.В., Ястребова Е.Б. Коронавирусная инфекция COVID-19. Лечение и профилактика. ВИЧ-инфекция и иммуносупрессии. 2020; 12(2): 31-55. https://doi.org/10.22328/2077-9828-2020-12-2-31-56Bagnenko S.F., Rassokhin V.V., Belyakov N.A., Boeva E.V., Yastrebova E.B. Covid-19 Coronavirus infection. Treatment and prevention. VICh-infektsiya i immunosupressii. 2020; 12(2): 31–55. https://doi.org/10.22328/2077-9828-2020-12-2-31-56 (in Russian)Мелик-Гусейнов Д.В., Карякин Н.Н., Благонравова А.С., Климко В.И., Баврина А.П., Другова О.В. и др. Регрессионные модели прогнозирования количества летальных исходов при новой коронавирусной инфекции. Современные технологии в медицине. 2020; 12(2): 6-13. https://doi.org/10.17691/stm2020.12.2.01Melik-Guseynov D.V., Karyakin N.N., Blagonravova A.S., Klimko V.I., Bavrina A.P., Drugova O.V., et al. Regression models predicting the number of deaths from the new Coronavirus infection. Sovremennye tekhnologii v meditsine. 2020; 12(2): 6–13. https://doi.org/10.17691/stm2020.12.2.01 (in Russian)Belova E., Shashina E., Shcherbakov D., Zhernov Y., Sukhov V., Zabroda N., et al. Sanitary aspects of countering the spread of COVID-19 in Russia.Int. J. Environ. Res. Public Health. 2021; 18(23): 12456. https://doi.org/10.3390/ijerph182312456Belova E., Shashina E., Shcherbakov D., Zhernov Y., Sukhov V., Zabroda N., et al. Sanitary aspects of countering the spread of COVID-19 in Russia. Int. J. Environ. Res. Public Health. 2021; 18(23): 12456. https://doi.org/10.3390/ijerph182312456Reshetnikov V., Mitrokhin O., Shepetovskaya N., Belova E., Jakovljevic M. Organizational measures aiming to combat COVID-19 in the Russian Federation: the first experience. Expert. Rev. Pharmacoecon. Outcomes. Res. 2020; 20(6): 571-6. https://doi.org/10.1080/14737167.2020.1823221Reshetnikov V., Mitrokhin O., Shepetovskaya N., Belova E., Jakovljevic M. Organizational measures aiming to combat COVID-19 in the Russian Federation: the first experience. Expert. Rev. Pharmacoecon. Outcomes. Res. 2020; 20(6): 571–6. https://doi.org/10.1080/14737167.2020.1823221Есин П.А. Сценарий развития мирового рынка в условиях коронавирусного кризиса. Известия высших учебных заведений. Прикладная нелинейная динамика. 2020; 28(2): 158-67. https://doi.org/10.18500/0869-6632-2020-28-2-158-167Esin P.A. World market development scenario in the context of the Coronavirus crisis. Prikladnaya nelineynaya dinamika. 2020; 28(2): 158–67. https://doi.org/10.18500/0869-6632-2020-28-2-158-167 (in Russian)Li H., Liu S.M., Yu X.H., Tang S.L., Tang C.K. Coronavirus disease 2019 (COVID-19): current status and future perspectives.Int. J. Antimicrob. Agents. 2020; 55(5): 105951. https://doi.org/10.1016/j.ijantimicag.2020.105951Li H., Liu S.M., Yu X.H., Tang S.L., Tang C.K. Coronavirus disease 2019 (COVID-19): current status and future perspectives. Int. J. Antimicrob. Agents. 2020; 55(5): 105951. https://doi.org/10.1016/j.ijantimicag.2020.105951Panovska-Griffiths J., Grieco L., van Leeuwen E., Baguelin M., Pebody R., Utley M. Are we prepared for the next influenza pandemic? Lessons from modelling different preparedness policies against four pandemic scenarios. J. Theor. Biol. 2019; 481: 223-32. https://doi.org/10.1016/j.jtbi.2019.05.003Panovska-Griffiths J., Grieco L., van Leeuwen E., Baguelin M., Pebody R., Utley M. Are we prepared for the next influenza pandemic? Lessons from modelling different preparedness policies against four pandemic scenarios. J. Theor. Biol. 2019; 481: 223–32. https://doi.org/10.1016/j.jtbi.2019.05.003Legido-Quigley H., Asgari N., Teo Y.Y., Leung G.M., Oshitani H., Fukuda K., et al. Are high-performing health systems resilient against the COVID-19 epidemic? Lancet. 2020; 395(10227): 848-50. https://doi.org/10.1016/s0140-6736(20)30551-1Legido-Quigley H., Asgari N., Teo Y.Y., Leung G.M., Oshitani H., Fukuda K., et al. Are high-performing health systems resilient against the COVID-19 epidemic? Lancet. 2020; 395(10227): 848–50. https://doi.org/10.1016/s0140-6736(20)30551-1Panovska-Griffiths J., Grieco L., van Leeuwen E., Grove P., Utley M. A method for evaluating the cost-benefit of different preparedness planning policies against pandemic influenza. Methods X. 2020; 7: 100870. https://doi.org/10.1016/j.mex.2020.100870Panovska-Griffiths J., Grieco L., van Leeuwen E., Grove P., Utley M. A method for evaluating the cost-benefit of different preparedness planning policies against pandemic influenza. Methods X. 2020; 7: 100870. https://doi.org/10.1016/j.mex.2020.100870Oppenheim B., Gallivan M., Madhav N.K., Brown N., Serhiyenko V., Wolfe N.D., et al. Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index. BMJ Glob. Health. 2019; 4(1): e001157. https://doi.org/10.1136/bmjgh-2018-001157Oppenheim B., Gallivan M., Madhav N.K., Brown N., Serhiyenko V., Wolfe N.D., et al. Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index. BMJ Glob. Health. 2019; 4(1): e001157. https://doi.org/10.1136/bmjgh-2018-001157Sands P., Mundaca-Shah C., Dzau V.J. The neglected dimension of global security - a framework for countering infectious-disease crises. N. Engl. J. Med. 2016; 374(13): 1281-7. https://doi.org/10.1056/nejmsr1600236Sands P., Mundaca-Shah C., Dzau V.J. The neglected dimension of global security – a framework for countering infectious-disease crises. N. Engl. J. Med. 2016; 374(13): 1281–7. https://doi.org/10.1056/nejmsr1600236Kandel N., Chungong S., Omaar A., Xing J. Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries. Lancet. 2020; 395(10229): 1047-53. https://doi.org/10.1016/s0140-6736(20)30553-5Kandel N., Chungong S., Omaar A., Xing J. Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries. Lancet. 2020; 395(10229): 1047–53. https://doi.org/10.1016/s0140-6736(20)30553-5Улумбекова Г.Э., Гиноян А.Б., Петрачков И.В. Эпидемия COVID-19 и ответ здравоохранения в разных странах. Демографическое обозрение. 2020; 7(2): 121-42. https://doi.org/10.17323/demreview.v7i2.11140Ulumbekova G.E., Ginoyan A.B., Petrachkov I.V. Healthcare responses to COVID-19 in different countries. Demograficheskoe obozrenie. 2020; 7(2): 121–42. https://doi.org/10.17323/demreview.v7i2.11140 (in Russian)Самородская И.В., Ларина В.Н., Назимкин К.Е., Ларин В.Г. Организационные и клинические проблемы диагностики COVID-19 на амбулаторном этапе. Врач. 2020; 31(5): 23-9. https://doi.org/10.29296/25877305-2020-05-05Samorodskaya I.V., Larina V.N., Nazimkin K.E., Larin V.G. Organizational and clinical problems of outpatient COVID-19 diagnostics. Vrach. 2020; 31(5): 23–9. https://doi.org/10.29296/25877305-2020-05-05 (in Russian)Gupta V., Kraemer J.D., Katz R., Jha A.K., Kerry V.B., Sane J., et al. Analysis of results from the Joint External Evaluation: examining its strength and assessing for trends among participating countries. J. Glob. Health. 2018; 8(2): 020416. https://doi.org/10.7189/jogh.08.020416Gupta V., Kraemer J.D., Katz R., Jha A.K., Kerry V.B., Sane J., et al. Analysis of results from the Joint External Evaluation: examining its strength and assessing for trends among participating countries. J. Glob. Health. 2018; 8(2): 020416. https://doi.org/10.7189/jogh.08.020416Simsek M., Kantarci B. Artificial intelligence-empowered mobilization of assessments in COVID-19-like pandemics: a case study for early flattening of the curve.Int. J. Environ. Res. Public. Health. 2020; 17(10): 3437. https://doi.org/10.3390/ijerph17103437Simsek M., Kantarci B. Artificial intelligence-empowered mobilization of assessments in COVID-19-like pandemics: a case study for early flattening of the curve. Int. J. Environ. Res. Public. Health. 2020; 17(10): 3437. https://doi.org/10.3390/ijerph17103437Lai C.C., Wang C.Y., Wang Y.H., Hsueh S.C., Ko W.C., Hsueh P.R. Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status.Int. J. Antimicrob. Agents. 2020; 55(4): 105946. https://doi.org/10.1016/j.ijantimicag.2020.105946Lai C.C., Wang C.Y., Wang Y.H., Hsueh S.C., Ko W.C., Hsueh P.R. Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status. Int. J. Antimicrob. Agents. 2020; 55(4): 105946. https://doi.org/10.1016/j.ijantimicag.2020.105946Силаев Б.В., Вечорко В.И., Проценко Д.Н., Аверков О.В., Халикова Е.Ю. Минимальная потребность в реанимационных койках и дыхательном оборудовании в учреждениях, перепрофилированных под лечение новой коронавирусной инфекции COVID-19. Вестник интенсивной терапии им. А.И. Салтанова. 2020; (2): 34-40. https://doi.org/10.21320/1818-474X-2020-2-34-40Silaev B.V., Vechorko V.I., Protsenko D.N., Averkov O.V., Khalikova E.Yu. Minimum requirements for rescuit beds and respiratory equipment in institutions refined for treatment of the new coronavirus infection COVID-19. Article. Vestnik intensivnoy terapii im. A.I. Saltanova. 2020; (2): 34–40. https://doi.org/10.21320/1818-474X-2020-2-34-40 (in Russian)Улумбекова Г.Э. Предложения по реформе здравоохранения РФ после завершения пика пандемии C0VID-19. ОРГЗДРАВ: новости, мнения, обучения. Вестник ВШОУЗ. 2020; 6(2): 9-26. https://doi.org/10.24411/2411-8621-2020-12001Ulumbekova G.E. Proposals for health care reform in the Russian federation after reaching the COVID-19 pandemic peak. Vestnik VShOUZ. 2020; 6(2): 9–26. https://doi.org/10.24411/2411-8621-2020-12001 (in Russian)Пшеничная Н.Ю., Веселова Е.И., Семенова Л.А., Иванова С.С., Журавлев А.С. COVID-19 - Новая глобальная угроза человечеству. Эпидемиология и инфекционные болезни: актуальные вопросы. 2020; (1): 6-13. https://doi.org/10.18565/epidem.2020.10.1.6-13Pshenichnaya N.Yu., Veselova E.I., Semenova L.A., Ivanova S.S., Zhuravlev A.S COVID-19 is a new global threat to humanity. Epidemiologiya i infektsionnye bolezni: aktual’nye voprosy. 2020; (1): 6–13. https://doi.org/10.18565/epidem.2020.10.1.6-13 (in Russian)Moore D., Gamage B., Bryce E., Copes R., Yassi A., BC Interdisciplinary Respiratory Protection Study Group. Protecting health care workers from SARS and other respiratory pathogens: organizational and individual factors that affect adherence to infection control guidelines. Am. J. Infect. Control. 2005; 33(2): 88-96. https://doi.org/10.1016/j.ajic.2004.11.003Moore D., Gamage B., Bryce E., Copes R., Yassi A., BC Interdisciplinary Respiratory Protection Study Group. Protecting health care workers from SARS and other respiratory pathogens: organizational and individual factors that affect adherence to infection control guidelines. Am. J. Infect. Control. 2005; 33(2): 88–96. https://doi.org/10.1016/j.ajic.2004.11.003Савилов Е.Д., Брико Н.И., Колесников С.И. Эпидемиологические аспекты экологических проблем современности. Гигиена и санитария. 2020; 99(2): 134-9. https://doi.org/10.33029/0016-9900-2020-99-2-134-139Savilov E.D., Briko N.I., Kolesnikov S.I. Epidemiological aspects of environmental problems of the present. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2020; 99(2): 134–9. https://doi.org/10.33029/0016-9900-2020-99-2-134-139 (in Russian)Emanuel E.J., Persad G., Upshur R., Thome B., Parker M., Glickman A., et al. Fair allocation of scarce medical resources in the time of Covid-19. N. Engl. J. Med. 2020; 382(21): 2049-55. https://doi.org/10.1056/nejmsb2005114Emanuel E.J., Persad G., Upshur R., Thome B., Parker M., Glickman A., et al. Fair allocation of scarce medical resources in the time of Covid-19. N. Engl. J. Med. 2020; 382(21): 2049–55. https://doi.org/10.1056/nejmsb2005114Ferioli M., Cisternino C., Leo V., Pisani L., Palange P., Nava S. Protecting healthcare workers from SARS-CoV-2 infection: practical indications. Eur. Respir. Rev. 2020; 29(155): 200068. https://doi.org/10.1183/16000617.0068-2020Ferioli M., Cisternino C., Leo V., Pisani L., Palange P., Nava S. Protecting healthcare workers from SARS-CoV-2 infection: practical indications. Eur. Respir. Rev. 2020; 29(155): 200068. https://doi.org/10.1183/16000617.0068-2020Шашина Е.А., Исютина-Федоткова Т.С., Макарова В.В., Груздева О.А., Митрохин О.В. Подходы к анализу эффективности средств защиты органов дыхания как мер снижения риска нарушения здоровья во время пандемии COVID-19. Анализ риска здоровью. 2021; (1): 151-8. https://doi.org/10.21668/health.risk/2021.1.16Shashina E.A., Isyutina-Fedotkova T.S., Makarova V.V., Gruzdeva O.A., Mitrokhin O.V. Approaches to analyzing efficiency of respiratory protective equipment as a way to reduce health risks during COVID-19 pandemic. Analiz riska zdorov’yu. 2021; (1): 151–8. https://doi.org/10.21668/health.risk/2021.1.16 (in Russian)Lee I.K., Wang C.C., Lin M.C., Kung C.T., Lan K.C., Lee C.T. Effective strategies to prevent coronavirus disease-2019 (COVID-19) outbreak in hospital. J. Hosp. Infect. 2020; 105(1): 102-3. https://doi.org/10.1016/j.jhin.2020.02.022Lee I.K., Wang C.C., Lin M.C., Kung C.T., Lan K.C., Lee C.T. Effective strategies to prevent coronavirus disease-2019 (COVID-19) outbreak in hospital. J. Hosp. Infect. 2020; 105(1): 102–3. https://doi.org/10.1016/j.jhin.2020.02.022Chen C., Zhao B. Makeshift hospitals for COVID-19 patients: where health-care workers and patients need sufficient ventilation for more protection. J. Hosp. Infect. 2020; 105(1): 98-9. https://doi.org/10.1016/j.jhin.2020.03.008Chen C., Zhao B. Makeshift hospitals for COVID-19 patients: where health-care workers and patients need sufficient ventilation for more protection. J. Hosp. Infect. 2020; 105(1): 98–9. https://doi.org/10.1016/j.jhin.2020.03.008

The authors declare that there are no conflicts of interest present.