Keeping governments accountable: The COVID-10 assessment scorecard

A new commentary published in Nature Medicine calls for governments to recognize the urgent need to improve their outbreak preparation and response. Noting that many governments are pinning their hopes on a vaccine against COVID-19, Jeffrey Lazarus and co-authors argue that a successful vaccine could take years to develop, and tried and tested public health measure can and must be implemented now. They write, “This pandemic should be a wake-up call for countries to address the most critical shortcomings in their pandemic readiness and health-system resilience in order to prevent and to mitigate the impacts of future catastrophes.”

The authors propose six broad actions that governments should to take to improve their responses to COVID-19 and future health crises. The actions, based on the World Health Organization’s health systems framework and other national and international public health guidance, include the following: ensuring effective communication with the public, robust surveillance and contact tracing, and investment in healthcare systems.

“The Coronavirus plays no favorites and the likelihood of ongoing waves of infection, which we are already seeing, makes it imperative that we develop a system to measure the effectiveness of governmental response,” according to co-author Ayman El-Mohandes, Dean of the CUNY Graduate School of Public Health and Health Policy (CUNY SPH). “This is not an exercise in casting blame; the overall goal is to ensure universal delivery of adequate public health services.”

The authors argue there is a need to restore public faith in healthcare systems and to ensure there is credible accountability for government actions. They have designed a COVID-19 Assessment Scorecard, based on those six public-health actions, that can be used by people to rate their local or national government’s response to the crisis and assess their pandemic readiness. The scorecard includes 19 statements that can be rated 1-5 and, if used on a large scale, could be useful in guiding government actions, the authors suggest.

“There is no question that this pandemic is one of the greatest threats to human health that we have seen in our lifetimes,” says co-author Scott Ratzan, Distinguished Lecturer at CUNY SPH. “We need to manage it with systems consistent with 21st century approaches. This is just a start.”

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The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to teaching, research, and service that creates a healthier New York City and helps promote equitable, efficient, and evidence-based solutions to pressing health problems facing cities around the world.

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