Summary 

•  Though the US dealt with major outbreaks in the past 20 years, the American Public Health Emergency Preparedness and Response system was unable to generate a sufficient coordinated response for COVID-19. 
• The American Public Health Emergency Preparedness and Response system needs an analysis in the present time to evaluate the effects of public health policies and their implementation to build better reforms for the future emergencies.  
• A robust approach for the public health emergency response system should be to focus on establishing a separate National Board on Pandemic Preparedness, build an action plan to mitigate ongoing opioid crisis and increase public health funding for US government to plan and prepare for future emergencies. 

Background 

         The public health emergencies across U.S. have been of infectious origin or due to climate change in the recent times (Robinson & Battenfield, 2020). COVID-19, a contagious disease and a rapidly evolving pandemic, has affected people across the world in many ways and taught this world lessons in almost all fields. Starting from the year 2001, the 9/11 Terrorist attack awakened the Public Health Response system in America for the first time and the Public Health Security and Bioterrorism Preparedness, and Response Act were brought into action (Fraser, Barishansky, & Blumenstock, 2021). After Severe Acute Respiratory Syndrome (SARS) in the year 2003, there was a global spread of H5N1 – Avian Influenza that gave rise to Pandemic and All Hazards Preparedness Act (PAHPA). The deficiencies in the response system were identified when major outbreaks hit the US, officials realized there was less investment in public health system and its improvement. 

            On the other hand, the most challenging pandemic – H1N1 Influenza has been a major victory in knowing the federal investments made in public health system and the nations response during these times (Fraser, Barishansky, & Blumenstock, 2021). The Ebola Virus (2014) and Zika Virus (2015) outbreaks both lasted for a year but warned the American health system that there are going to be epidemics and pandemics in the future and therefore prepare for the most major and long-lasting outbreaks (Fraser, Barishansky, & Blumenstock, 2021).

Research documents that emergencies such as H1N1 influenza and Ebola virus caused significant threats to the public and needed to be investigated before a major pandemic hit (Myers, 2016). Knowing this the public health emergency response team seemed unprepared for the COVID-19 pandemic. There is much work left for the US to be prepared for future emergencies and at the same time recovering from the COVID-19 pandemic as new variants keep emerging. It is vital to bring in a different approach to public health emergency response system in the United States for policymakers to identify and address the needs of the population during an emergency crisis. 

        The Public Health Service Act, section 319 gives the secretary of Health and Human Services the right to declare a public health emergency in collaboration with public health officials. Additionally, the National Emergency Act, Public Health Service Act, Pandemic and All-Hazards Preparedness Act, The Public Readiness and Emergency Preparedness Act, together permit the federal government to declare a state of public health emergency (Hodge, 2021). Public health emergency preparedness and responsiveness gained immense importance in the year 2020 when COVID-19 pandemic hit (Hodge, 2021). 

Addressing Issues 

             A new reform entailing significant changes in public health response management will better outcomes for the twenty-first century. There was a delayed and fragmented national response at the beginning of the COVID-19 pandemic. The federal government, public health agencies on the state and local level failed to address the COVID-19 virus, the spread of infection, COVID-19 tests, vaccination updates in a timely manner. The lack of workforce, inadequate federal funding for public health emergencies and inability of teamwork.  

• National Pandemic Response Team 

            The impact of public health laws affects the discipline of our lives, some of them have been structured and constructed thoughtfully in the past two years (Xiong, Hu, & Wang, 2021). What needs to be changed is the evaluation of pandemic responses among the laws or policies made in future and establish a National Board on pandemic preparedness (Xiong, Hu, & Wang, 2021). The ability of the policymakers to make better policies right now will determine the public health emergency preparedness, response, and capability of the public health system to handle natural disasters in the years to come (Xiong, Hu, & Wang, 2021) 

• Ongoing Opioid Crisis  

        The opioid crisis has been a nationwide public health emergency since the year 2017 and research suggests that the opioid treatment programs have been significantly impacted because of the COVID-19 pandemic (Tracy, Wachtel, & Friedman, 2021). Doctor-patient interaction, requirement of physical space for certain treatments/ programs, screening procedures, and telemedicine are a few of the challenges faced during the pandemic (Tracy, Wachtel, & Friedman, 2021). There is an urgent need for policymakers to pivot increased access to evidence based care for substance use disorders, pain and harm reduction measures. 

• Public Health Funding 

           The aim for the government should be to build a foundational public health infrastructure around emergencies thereby prioritizing community needs and preparing the public for personal preparedness (Fraser, Barishansky, & Blumenstock, 2021). Public Health funding is essential to prevent infectious disease outbreaks and have a disease-free nation. The National Health Security lies in the hands of policymakers who aim to focus on improving coordination with healthcare, public health professionals, federal officials, and private sectors (Fraser, Barishansky, & Blumenstock, 2021). The evolution of public health emergencies can be used as a guidance to build policies supporting health and economic aspects seen especially during the COVID-19 pandemic (Arthi, V., & Parman, 2021). 

Conclusion 

The themes described above accentuate the public health laws, the federal response to the pandemic and its effect on the health care system till now. Though there was limited information on any other pandemic as important as COVID-19, but the findings identified the inconsistent responses of the public health system during emergencies. The review studies the public health laws, analyzes the gaps in their implementation and provides a solution to better advance the public health emergency response system in future generations.

This research advises the policymakers to focus on the evidence-based approaches to public health emergencies till now and identifies specific response systems. A collective approach to all the current and future public health emergencies needs a framework of organized public health action plan and implementation of new policies with modified coverages in health and all sectors that will help us see a better outcome in future emergencies.

References 

Arthi, V., & Parman, J. (2021). Disease, downturns, and wellbeing: Economic history and the long-run impacts of COVID-19. Explorations in Economic History, 79, N.PAG. https://doi.org/10.1016/j.eeh.2020.101381 

Brown, H. L. (2021). Emergency Care EMTALA Alterations During the COVID-19 Pandemic in the United States. JEN: Journal of Emergency Nursing, 47(2), 321–325. https://doi.org/10.1016/j.jen.2020.11.009 

Chandra, S., Christensen, J., Chandra, M., & Paneth, N. (2021). Pandemic Reemergence and Four Waves of Excess Mortality Coinciding With the 1918 Influenza Pandemic in Michigan: Insights for COVID-19. American Journal of Public Health, 111(3), 430–437. https://doi.org/10.2105/AJPH.2020.305969 

Dolan, B., & Rutherford, G. (2020). How History of Medicine Helps Us Understand COVID-19 Challenges. Public Health Reports, 135(6), 717–720. https://doi.org/10.1177/0033354920961132 

Fraser, M.R., Barishansky, R.M., & Blumenstock, J.S. (2021). Twenty Years after 9/11: The Public Health Preparedness We Need Now. American Journal of Public Health. https://doi.org/10.2105/AJPH.2021.306459 

Hodge, J. G., Jr. (2021). National Legal Paradigms for Public Health Emergency Responses. American University Law Review, 71(1), 65. http://dx.doi.org/10.2139/ssrn.3827288 

Myers, N. (2016). Policy Making to Build Relationships: A Grounded Theory Analysis of Interviews and Documents Relating to H1n1, Ebola, and the U.S. Public Health Preparedness Network. Journal of Health and Human Services Administration, 39(3), 313–356. https://eds-s-ebscohost-com.ezproxymcp.flo.org/eds/pdfviewer/pdfviewer?vid=7&sid=2ef89e99-e295-48e5-81e5-13f309793adb%40redis 

Robinson, D., & Battenfield, A. (2020). The Worst Outbreaks in U.S. History. Healthline. https://www.healthline.com/health/worst-disease-outbreaks-history 

Tracy, K., Wachtel, L., & Friedman, T. (2021). The impact of COVID-19 on opioid treatment program (OTP) services: Where do we go from here? Journal of Substance Abuse Treatment, 131, 108394. https://doi.org/10.1016/j.jsat.2021.108394 

Xiong, L., Hu, P., & Wang, H. (2021). Establishment of epidemic early warning index system and optimization of infectious disease model: Analysis on monitoring data of public health emergencies. International Journal of Disaster Risk Reduction, 65. https://doi-org.ezproxymcp.flo.org/10.1016/j.ijdrr.2021.102547