If we spent the cost of COVID-19 on pandemic preparations it would have lasted 500 years

COVID-19 has taken advantage of a world in disorder, causing catastrophic health, social, and economic consequences and irreparable harm to humanity. The virus has killed close to a million people and many more may die as a result of its impact on health systems, food supplies, and the economy. The financial cost will be in the trillions.

This will not be the last global health emergency. The world simply cannot afford to be unprepared again, warns the Global Preparedness Monitoring Board (GPMB) in its second report “A World in Disorder,” released today.

Last year, the GPMB warned that the world was unprepared for the very real likelihood of a deadly pandemic spreading around the globe, killing millions of people, disrupting economies, and destabilizing national security. The Board called for urgent action to break the cycle of panic and neglect that has characterized the response to global health crises in the past.

In its new report, the GPMB provides a harsh assessment of the global COVID-19 response, calling it “a collective failure to take pandemic prevention, preparedness, and response seriously and prioritize it accordingly.” In many countries, leaders have struggled to take early decisive action based on science, evidence and best practice. This lack of accountability by leaders has led to a profound and deepening deficit in trust that is hampering response efforts.

“Transparency and accountability are essential in responding to the COVID-19 pandemic,” said Elhadj As Sy, co-Chair of the GPMB. “Trust is the foundation of government-community relationships for better health but that trust dissipates when governments and leaders do not deliver on their commitments.”

Responsible leadership and good citizenship have been key determinants of COVID-19’s impact, the report finds—systems are only as effective as the people who use them.

The report also finds that, while COVID-19 has demonstrated that the world is deeply interconnected through economics, trade, information, and travel, one of the greatest challenges of the pandemic has been faltering multilateral cooperation. Leadership by the G7, G20, and multilateral organizations has been hampered by geopolitical tensions. The Board calls on leaders to renew their commitment to the multilateral system and strengthen WHO as an impartial and independent international organization. Weakening and undermining the multilateral action will have serious consequences on global health security, it warns. No-one is safe until all are safe.


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“Viruses don’t respect borders. The only way out of this devastating pandemic is along the path of collective action, which demands a strong and effective multilateral system,” said H.E. Dr. Gro Harlem Brundtland, co-chair of the GPMB. “The UN system, which includes the WHO, was created after World War II and has helped make the world a better place for billions of people. It needs to be defended, strengthened, and revitalized, not attacked and undermined.”

The report highlights how the devastating social and economic impact of pandemics, especially for the vulnerable and disadvantaged, is often underestimated and ignored. COVID-19’s long-term socioeconomic impacts are predicted to last for decades, with the World Bank’s conservative scenario estimating a US$ 10 trillion earning loss over time for the younger generation as a result of pandemic-related educational deficits.

COVID-19 has demonstrated the importance of protecting lives and livelihoods and widening our understanding of preparedness to make education, social, and economic sectors pandemic proof. “A World in Disorder” reveals that the return on investment for pandemic preparedness is immense. It would take 500 years to spend as much on preparedness as the world is currently losing due to COVID-19.

“The pandemic has shown the fragility of not only our health systems, but also our global economy. The impact of COVID-19 has been huge in the world and particularly in my region, the Americas, with a sharp increase in health, social and economic inequities,” said Jeannette Vega, GPMB member and Chief Medical Innovation and Technology Officer, La Red de Salud UC-Christus, Chile. “Let’s hope that this time we finally learn the lesson and invest in preparedness and public goods for health to avoid similar tragedies in the future.”

The report highlights the actions that must be taken to end the COVID-19 pandemic and avoid the next catastrophe—to bring order out of chaos. It calls for responsible leadership, engaged citizenship, strong and agile systems for health security, sustained investment, and robust global governance for preparedness.

“A World in Disorder” identifies the specific commitments and actions leaders and citizens must take—boldly, decisively, and immediately. These include sustainable and predictable financing for global and national health security, and a call to hold a UN Summit on Global Health Security to develop an international framework for health emergency preparedness and response.

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New study documents increasing frequency, cost, and severity of gunshot wounds

The rise in firearm violence has coincided with an increase in the severity of injuries firearms inflict as well as the cost of operations to treat those injuries; policy makers must be more aggressive in addressing violence to curb these trends, researchers report in a large national study of gunshot wounds that appears as an “article in press” on the Journal of the American College of Surgeons website ahead of print.

“Taken together, our findings suggest that gun violence has increased in numbers, at least for the sector that meets surgical criteria, and that these injuries result in a substantial financial burden in addition to the obvious psychosocial burden and other downstream effects,” said lead study author Peyman Benharash, MD, MS, with the Cardiovascular Outcomes Research Laboratories and an associate professor-in-residence of surgery and bioengineering at the David Geffen School of Medicine at the University of California Los Angeles. “We hope that our findings are able to better inform policy in terms of violence prevention as well as reimbursement to hospitals, which are often in underserved regions, that care for these patients.”

The study authors note that gun violence overall carries an annual cost to the U.S. health care system of $170 billion, with $16 billion for operations alone. The researchers used the National Inpatient Sample (NIS) to identify all hospital admissions for gunshot wounds (GSW) from 2005 through 2016. The researchers did not look at all adult GSW victims admitted to the hospital, estimated at 322,599, but only at the 262,098 victims who required at least one major operation.

Dr. Benharash explained the rationale for the study. “We’re now seeing a lot more on the impact of gun violence,” he said. “In the past, gun violence was never really discussed in the open; it was thought to only affect a certain population. However, now we know that it affects everyone. In the hopes of trying to reduce it at a systemic level from top to bottom, we’re reporting, as surgeons, how gun violence in the patients that we treat has changed over the last decade.”

The costs for hospitalizations, measured as median costs adjusted for gross domestic product, increased more than 27 percent over the 12-year study period, from $15,100 to $19,200 (p<0.001). The amount of time these patients spent in the hospital—a major cost driver—also increased from an average of 7.1 days to 12.6 days (p<0.001). The percentage of fatalities declined, from 8.6 percent in 2005 to 7.6 percent in 2016, despite an annual increase in overall admissions for GSW-related operations, from 19,832 in 2005 to 23,480 in 2016. The severity of these injuries, based on billing codes, increased slightly over that period, with predicted survival decreasing from 81 to 79 percent (P<0.001). The authors used a non-parametric test for trends to judge the significance of temporal changes in their analysis.

The cost analysis categorized operations by type and three different cost ranges: low, medium and high, with average costs of $7,400, $17,200, and $58,800, respectively. “We found that compared with those who were not operated on, patients having head-neck, vascular, and gastrointestinal operations had increased odds of being in the high-cost tertile,” Dr. Benharash said. “Being in the Western United States was also a predictor [of being in the high-cost tertile], as was being of Black race and having insurance by Medicaid. So there are certainly disparities that are socioeconomic in origin as well.”

For example, the study found that while 3.4 percent of all patients had operations for head and neck injuries, these operations were disproportionately represented in the low- and high-cost ranges, accounting for only 0.81 percent of the former but 7.1 percent of the latter. “Gunshot wounds to the neck, for example, can be very costly because they can affect many delicate structures as compared with lower extremities, and these patients often require extensive hospitalization and a greater number of procedures,” Dr. Benharash said.

The finding that costs in the West were higher is also important, Dr. Benharash noted, because it’s in line with what other studies have reported with other specialties. “It’s very important for policy makers and health services researchers to evaluate the disparities in cost,” he said.

The improved survival of GSW patients is a function of improvements in trauma transport from the field, better prehospital resuscitation, and improved techniques, patient management and adjunct therapies once they get to the hospital, Dr. Benharash said. “It appears that patients are reaching surgery more often because of reduced mortality before they get to the hospital,” he said.

The study also attributed these improvements in survival to efforts by the American College of Surgeon’s Committee on Trauma, including the Advanced Trauma Life Support curriculum and Stop the Bleed campaign. The latter trains the public in techniques to stop life-threatening bleeding in everyday emergencies.

But those improvements don’t obviate the need for addressing the underlying problem, Dr. Benharash noted. “It’s very important to put it in perspective that this entity is quite economically burdensome,” he said. “If you’re looking at prevention vs. treating a gunshot wound from an economic standpoint, it would make sense to invest in anti-violence interventions that can reduce assaults that are often preventable.”

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Preventive and without symptoms: Corona-Tests will be considerably expanded

Tests for the Coronavirus may in the future be considerably expanded – and even without signs of the disease, and especially in sensitive areas. The one on Tuesday will come into force regulation of the Federal Minister of health, Jens Spahn sets.

“We want to nip the Virus in the Bud,” said the CDU politician. “The homes is only possible with preventive series of tests in hospitals and nursing and if we all contact persons from Infected test.” On money this not to fail. “It is much more expensive to test enough to test too much,” said Spahn.

Specifically, should now be, in principle, tested all patients admitted in the hospital. In addition, health boards or Doctors can Tests for people without symptoms Vera. The cost of 50 euros per Test, the Statutory health insurance (GKV) takes over. Is possible to comprehensive testing for close contacts to become Infected, for example, also be so that, if the proposed voluntary Corona-Warning App for Smartphones report a such contact. Width Tests are also outbreaks at the Corona-in day-care centres or schools as well as regular series of tests in hospitals and nursing homes.

The rules on costs will apply retroactively to 14. May, also for private patients and people without health insurance. So far, there are Tests on the cash costs of the rule only when a specific infection is suspected, so in people with symptoms.