Consideration on improving public health emergency management ability of current medical health system

Abstract

COVID-19 is a Public Health Emergency of International Concern (PHEIC). Direct economic loss is expected to be much more than that of SARS outbreak in 2003. The risk factors of COVID-19 epidemic at the early stage included the misjudgment of the epidemic, delay in reporting this emerging infectious disease, nosocomial infection-caused transmission of the virus into local communities, and weak public health interventions. The infection rate (or the incidence) reflects the prophylactic effect in population. Case fatality reflects the therapeutic effect of clinical intervention. There were sufficient medical resources at the national top levels accumulated in Wuhan. Furthermore, medical professionals and sufficient medical supplies from other provinces have been assigned to join in the fighting against the epidemic in Wuhan. However, the case fatality in Wuhan has been kept the highest in China, indicating that clinical treatment for this virus-caused emerging infectious disease, whose pathogenesis remains to be elucidated, with limited effect in controlling this epidemic. The unusual, extremely costly public health interventions including the temporarily city quarantine and transportation ban issued by the central government are crucial in controlling this epidemic. The control of epidemic indicates the importance of public health measures but also reflected its insufficient capacity in China. Recently, profit-seeking mechanism run in Chinese health service system disorganized the balance of clinical service and public health service patterns in China, promoting the vicious circle of "attaching importance to clinical treatment and despising disease prophylaxis" , damaging the infrastructure of public health capacity, thus contributing to the formation of the inevitability in various fortuities of public health emergency. To strength the capacity of our medical service system to respond to public health emergency efficiently, two key issues should be considered. First, public health service, which should be fixed as the health section of the governments' public services by the law, must be greatly improved to meet the increasing health needs of the publics. Second, the vicious circle of profit-seeking-caused "attaching importance to clinical treatment and despising disease prophylaxis" should be immediately broken to optimize the national health service system in China by increasing the investment in public health service.