key: cord-1046214-q326wynw
authors: nan
title: From the Editor
date: 2022-02-24
journal: J Ambul Care Manage
DOI: 10.1097/jac.0000000000000413
sha: 6005ff156a0baa685c3a8ffd41ed0a4f164b1b61
doc_id: 1046214
cord_uid: q326wynw

nan

We will continue to confront the implications of the COVID pandemic for years to come. In the meantime, The Journal of Ambulatory Care Management will publish contributions to our understanding of how to best reorganize our ambulatory response to this health care crisis. With pediatric vaccine access now approved by the Centers for Disease Control and Prevention and widely available, Dr Boogard and colleagues highlight issues of vaccine program implementation. Dr Fifolt et al examine how COVID has successfully forced many health professionals adjust how they manage their professionals. Quoting from their article: "Team-based, interprofessional nature of patient care was one of the primary reasons the clinics continued to function at a high level during the pandemic." Yet, these accomplishments are necessary but hardly sufficient if we are to finally address the fundamental "wound" (Selllers, 2022) that COVID has inflicted on the United States and the rest of the world. At the end of this FTE, I make a proposal that begins to address the need to not only rebuild our public health system but truly focus on population health. The next 2 articles (Quigley and Elder) analyze different aspects of ambulatory care and underserved populations.

In 2022, we will highlight changes in ambulatory care practices both in the United States and overseas. We are interested in submissions on this topic. Impact of COVID is of interest but by no means required. The final 3 articles by Chaney, Razai, and Smithline together with their colleagues provide an outstanding to this series.

The author has disclosed that he has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. (Anthes, 2022) highlights the challenge the United States face in its COVID response: "I'm confident in our ability to detect the variant," Dr Fauver said, "What I'm not confident in is our ability to do anything about it . . . . One thing that we've lacked continuously through the pandemic is a goal. We still don't have that. Certainly, we don't have that for Omicron" (Emily Gurley).

Fragility, a term used in the "peace through health" field, describes countries that are emerging from conflict. The United States, assessed in 2018 to be the country most able to deal with a disaster, has tragically performed the worst of any industrialized country. There are 2 components of this fragility: the political polarization around the COVID pandemic, and the dramatic disproportional impact of the pandemic on lower socioeconomic strata. These 2 factors continue and in fact have become exacerbated despite many American strengths.

Copyright © 2022 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.

Health care is a significant economic driver in the United States. A bipartisan group of senior elected officials needs to lead the pandemic response. Without this active leadership, economic interests will continue to struggle with each other, resulting in a lackluster or failed public health response. Grant-making and encouragement of localities are not sufficient.

What should the "goal" or model be? We need a state-wide public health system that elected officials lead in a bipartisan manner and places CHWs at the center of the wheel. Such a model provides ample opportunity for variation in implementation (Goldfield et al., 2020) . Numerous CHW-led models exist.

The price of failure is severe. Without public trust, American fragility and resultant polarization in American society will not only continue but also worsen. This will only exacerbate the pandemic and our socioeconomic disparities. Our economic growth will be stymied. Without effective public health at the time of a pandemic, public trust cannot be reestablished.

Editor

Omicron is a dress rehearsal for the next pandemic. The New York Times

COVID-19 crisis creates opportunities for community-centered population health: Community health workers at the center

But the nation's public health system remains fractured