key: cord-0795519-kcfmq5fo
authors: Torri, Emanuele; Nollo, Giandomenico
title: Public Health Decision-Making in the Real World: Four Points to Reshape It After COVID-19
date: 2020-04-21
journal: Disaster medicine and public health preparedness
DOI: 10.1017/dmp.2020.108
sha: d41a584407c6481f71bdf338a6eb9e2c8fa234a5
doc_id: 795519
cord_uid: kcfmq5fo

nan

Expanding international coordination 3 and healthcare accreditation programs to guarantee reliability of hygiene practices, surveillance, and safety systems on the ground is crucial now. A special attention toward strengthening education for leadership development of public health officials and clinicians is needed to enable engagement, resilience, and trust.

Information and data sets for COVID-19 research should be in the public domain, to provide broader development of models and data supporting health authorities and agencies in public decisions. Peer observations and bottom-up inputs should be collected. Multiple scientific competence centers should be institutionalized as "scientific civil protection" for activations during emergencies to perform timely analysis and experiments tailored on policy questions.

Context-based analysis of cultural, organizational, economic, social, and ethical issues is vital given the complexity of public health. First, politicians and the public should be thoroughly educated in health technology assessment. Second, we need practical models to expedite the appraisal process and resolve technological issues in emergencies. Third, in addition to the opinion of a few experts, we could exploit the value of collective knowledge and crowdsourcing data within structured consensus mechanisms.

With limited availability of evidence and the need for broad consensus meetings, relying only on eminences or slow bureaucratic orders is not the best choice. Instead, it is essential to prompt researchers and scientists to fully review "expert evidence" 4 by basing decisional frameworks on practical insights of stakeholders and frame recommendations as actionable points disseminated through multiple channels.

While a wave of changes in culture, technology, and practice is sweeping the globe, 5 we have an unprecedented opportunity for optimizing the compromise between science and real-word decisions.

Is there a guarantee that the crisis of Covid-19 will not be repeated?

COVID-19 epidemic in middle province of northern Italy: impact, logistic & strategy in the first line hospital

Covid-19 exposes weaknesses in European response to outbreaks

Distinguishing opinion from evidence in guidelines

It will upend our way of life, in some ways forever. MIT Technology Review

The authors declare no conflict of interest.