To Have and Have Not

Global health must view current pandemic reports as works in progress. Recommendations should be issued, organized and available for future outbreaks.

To start the recommendation organization, we could observe WHO's outstanding COVID update: 

Four areas can grow from this well-thought out, rapidly disseminated work. Four movements should be:

⦾ Establishing a summarized table of performance indicators for COVID readiness, for easy consumption.

⦾ Specifying recommendations by indicator; current indicators are not captioned with specific points.

* The five indicators for future roadmapping could be accompanied by a couple of actionable items. What resources are available to progress for the proportion of priority countries and territories with an active risk communication/commnity engagement mechanism, proportion with an Incident Management Support Team/IPC training, proportion with identified core set of essential services, proportion that has had an immunization campaign affected and proportion with multisectoral mental health and psychosocial support working group? 

* The current indicator without advanced success could be strengthened: "Proportion of countries and territories that have a COVID-19 clinical referral system". This indicated has no detailed management. Is this indicator specific enough to address "Infection prevention and control, case management and continuity of essential health services" and is it the correct one to address the IPC issues?  

 ⦾ Approaching indicators comprehensively, for future edits.

The current indicator for infection prevention and control does not speak to compliance, adherence or social impact. The US has exceptional IP efforts in hospital and healthcare, and the US pandemic mismanagement has created an out of control situation in which travel is restricted and the economy is impacted. Perhaps tying the infection prevention and control indicator to compliance and successful implementation measures will see greater global success with the next pandemic. 

 Having an indicator that isn't tied to success fails us.

        ⦾ Focusing on compliance. 

Compliance to infection prevention recommendations, policies and social protocols is critical to note. The US's exceptional difficulty with broad, standardized protocol follow through is notable.

* Adherence to recommendations and compliance to current policies could be acknowledged, particularly for future pandemic planning. 

* Enforcement strategies should be documented. Poor approaches and successful approaches in enforcement could be detailed with future pandemic management in mind. 

* Metrics around enforcement and compliance should be available. The heavy-handed approach of banning US travelers during US pandemic failures could be accompanied by health and economic impacts. In these measures, countries can visualize, hear and consume the impacts of successful enforcement and unsuccessful management. Herd immunity assessments as welcomed as a start, yet these can be confusing for the public (particularly when vaccine herd immunity is also in public conversation). 

* Pragmatic analyses could assist in policy implementation and enforcement.  

The use of performance indicators in ongoing assessments for COVID preparedness is a work in progress. Standardizing the right metrics assists in future pandemic planning and preparedness. Fortunately, the world has a flexible, dedicated global health group.