MEDICAL & PUBLIC HEALTH PREPAREDNESS FOR DISASTER & EMERGENCIES AND ACTION COLLABORATIVE ON DISASTER RESEARCH RESPONSE

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• 批准号: 10704984
• 负责人: ROBERT DAY
• 金额: $ 2万
• 依托单位: NATIONAL ACADEMY OF SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-26 至 2023-09-25
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10704984
• 关键词: Academia; Academy; Acute; Address; Area; Awareness; Behavioral; Bioethics; Bioinformatics; Biological; Biological Products; Biomedical Engineering; Biomedical Research; Biotechnology; Categories; Charge; Clinical; Clinical assessments; Collaborations; Collection; Communication; Communities; Complex; Dangerousness; Data; Data Collection; Data Science; Data Set; Department of Defense; Development; Disasters; Discipline of Nursing; Disease Outbreaks; Educational workshop; Emergency Situation; Emergency response; Emerging Communicable Diseases; Engineering; Ensure; Environmental Health; Epidemiology; Ethical Issues; Ethics; Evaluation; Event; Exercise; Failure; Federal Government; Food; Fostering; Foundations; Funding; Future; Generations; Geoscience; Government; Government Agencies; Grant; Guidelines; Health; Health Sciences; Health system; Healthcare; Human; Human Subject Research; Individual; Industry; Infrastructure; Institutional Policy; Institutional Review Boards; Intelligence; International; Internet; Lead; Link; Logistics; Maintenance; Medial; Medical; Medical emergency; Medicine; Mental Health; Molecular Biology; National Institute of Allergy and Infectious Disease; National Institute of Environmental Health Sciences; Natural Disasters; Nuclear; Outcome; Paper; Persons; Phase; Play; Policies; Population; Populations at Risk; Positioning Attribute; Prevention; Primary Health Care; Principal Investigator; Private Sector; Privatization; Procedures; Process; Professional Organizations; Public Health; Public Policy; Publishing; Radiology Specialty; Readiness; Recovery; Reporting; Research; Research Personnel; Resources; Risk; Risk Reduction; Role; Safety; Science; Secure; Security; Services; Shelter facility; Strategic Planning; Structure; System; Technology; Terrorism; Time; Toxicology; Training and Education; Transportation; United States Department of Veterans Affairs; United States Dept. of Health and Human Services; United States National Academy of Sciences; United States National Institutes of Health; United States National Library of Medicine; Volunteer Organization; Water; Work; authority; base; chemical threat; clinical practice; community engagement; computerized tools; cost; design; evidence base; first responder; global health; hazard; health disparity; human subject; improved; information organization; interest; man; mass casualty; medical countermeasure; meetings; member; novel therapeutics; open data; operation; prevent; programs; psychologic; psychosocial; public health emergency; public health research; research and development; resilience; response; social; symposium; virtual

Forum for Medical & Public Health Preparedness for Disaster & Emergencies and Action Collaborative. Policy Context There are many governmental agencies and private organizations charged with ensuring the Nation’s capacity to prevent and respond to the health effects that arise from disasters, both man-made and natural. While each of these stakeholders is critical in guaranteeing adequate prevention and response, their efforts must be coordinated to ensure optimal outcomes. However, the challenge arises from the diverse set of responsibilities of the primary stakeholders, the Department of Health and Human Service (HHS) and the Department of Homeland Security (DHS), and coordinating the efforts among the many other governmental agencies (federal, state, and local), industry, professional societies, foundations, academia, and other interested parties. Unfortunately, venues that bring all of these stakeholders together are limited. The NAS Forum for Medical and Public Health Preparedness began to address these issues in 2008. Aligning the responsibilities and focus of each stakeholder will greatly assist in ensuring adequate protection and response. Each stakeholder offers unique assets that must be linked in to an overall strategy. It is here where the appropriate federal agencies, including the HHS, DHS, Department of Defense, Department of Transportation, and Veterans Affairs, play a vital role in developing a National strategy and logistical support and coordinating with the private sector. The Forum for Medical and Public Health Preparedness for Disasters and Emergencies (the Forum) provides a venue where the major stakeholders may sit down together and discuss the primary issues, afford organizations the opportunity to make assessments, discuss policies, and review outcomes. These areas will focus not only on the immediate responses to disasters and public health emergencies, but also the intermediate and long term needs that arise (e.g. providing adequate shelter, food and water safety, primary care, mental health) during the recovery phase and efforts to enhance preparedness, cooperation and information sharing. The activities of the federal government, volunteer organizations, the private sector, and others in the medical preparedness, resilience, and health sciences are of increasing complexity, both in terms of technology and policy. Currently, it is difficult for the nation's medical emergency response and public and mental health systems to meet the physical and psychological needs that result from all types of disasters including terrorism and natural disasters. Unfortunately, gaps continue to exist in the following areas: (1 Global Health Security, (2) Communication and Coordination, (3) Personal and Community Resilience, and (4) Critical Infrastructure Protection. Addressing the physical, psychological, and social needs that result from various acts of terrorist events or natural disasters will therefore require universal preparedness by all systems responsible for the public's health. Preparedness, response, and recovery are required for all hazards and should include all segments of the population during each phase of the event. The research and development needs of these initiatives are immense and thus require the federal government to seek and coordinate assessment from both national and international clinical practice, as well as biomedical research communities. Such coordination will require the best advice available as federal agencies seek guidance in developing its strategic plans for advancing the practice of medical preparedness. These initiatives include scientific, technical, and workforce issues in the medical and public health arenas (infrastructure, clinical, environmental, and public health, research needs, including the development of new drugs and biologics and the collection and funding of critical data collection in a timely manner); effective training, education, and communication exercises; and evaluation of preparedness. The multiple and complex ethical issues surrounding these developing fields must also be considered. Technical Context The forum will promote open discussion of existing systems and lessons learned from previous disasters and public health emergencies and identify areas for improvement. These discussions exist across four broad categories: (1) Communication and Cooperation; (2) Personal and Community Resilience; (3) Preparedness and Infrastructure Needs; (4) Medical and Public Health Preparedness and Response; Within these areas, topics that might be on the meeting agendas of the forum include: Global Health Security Topics within this theme focus on the ongoing efforts to accelerate progress toward a world safe and secure from emerging infectious diseases and other threats. Discussions concentrate on strengthening the U.S. health care and public health systems capacity to detect, prevent, plan for, respond to, and recover from naturally occurring outbreaks and intentional or accidental releases of dangerous substances. Communication and Cooperation: Topics within this theme focus on ensuring timely communications and effective coordination within all levels of government and between government, the private sector, and the public during large-scale disasters and incidents. Discussions concentrate on ways to improve situational awareness, threat intelligence sharing, risk communication, and collaboration among multi-sector disaster response networks including public, academic, private, governmental, and non-governmental entities, (e.g., improving coordination among disaster response networks from public, academic, private, and governmental entities and stakeholder data collection, harmonization, and management during and post disasters including acute surveillance and longitudinal exposure, health effects, clinical assessment, and evaluative data sets and information; organization and sharing of open data sets and development of computational tools to analyze the datasets (data science for discovery). Personal and Community Resilience: According to the Implementation Plan for the National Health Security Strategy (2015-2018) (http://www.phe.gov/Preparedness/planning/authority/nhss/Documents/nhss-ip.pdf), National health security is achieved when the Nation and its people are prepared for, protected from, respond effectively to, and are able to recover from incidents with potentially negative health consequences. Topics within this theme focus on issues related to the sustained ability of an individual and a community to utilize available resources to respond to, withstand, and recover from adverse situations following a catastrophic event. Discussions concentrate on ways to enhance resilience for individuals and communities through disaster risk reduction, inclusion of health in post-disaster recovery planning efforts, working with non-traditional sectors, and exploring special considerations needed to strengthen a community after a mass casualty incident. Critical Infrastructure Protection Topics within this theme focus on the ongoing efforts to secure the assets, systems, and networks, whether physical or virtual, vital to the security, public health, and safety of the nation. Discussions center on the health care and public health sector and interdependent sector vulnerabilities, consequences of cascading and prolonged failures of infrastructure, threats from chemical, biological, radiological, nuclear, and high yield explosives, and the increasing threat and consequences of cyber-attack, (e.g., investigating steps for building the next decade of disaster preparedness and simultaneously improving the public health infrastructure and addressing how existing public health systems and infrastructure can be strengthened while simultaneously moving forward to meet disaster response needs of the future). Disaster Research Response Action Collaborative The Forum will convene an Action Collaborative on Disaster Science, based on the receipt of additional supporting funds from NIH and other sponsors to: 1) foster improved processes and platforms for developing and implementing needed time-critical data collection and research in response to disasters (“Science Preparedness”); 2) identify evidence-based mechanisms and opportunities for conducting and sharing information gathered from public health research during disasters; 3) engage cross-sector stakeholders in development, refinement, and promotion of disaster research opportunities and best practices; 4) provide a venue to support the development and maintenance of a rapid response mechanism for the National Academies to continue to meet sponsor needs for convening, idea generation and information sharing during the initial stages of a public health emergency. Activities of the Action Collaborative may include1) outlining and defining processes for conducting research (particularly research involving human subjects and at-risk populations) quickly following a disaster to avoid missing critical data; 2) ensuring community engagement and IRB/ethical considerations in disaster research. 3) defining processes for expanding and enhancing a coordinated network of disaster researchers; 3) assembling data collection, research, and best practice resources (or any other substantive products for the first year); 4) exploring appropriate venues to support the development and maintenance of a rapid response mechanisms for the National Academies and other platforms or forums to continue to meet sponsor needs for convening, generating ideas, and sharing information during the initial, as well as later stages of a public health emergency. Since 2008, the forum has held numerous meetings and workshops and published a number of documents regarding the issues listed above. Task Description: The National Academies of Science, Engineering and Medicine (NAS)) established a Forum on Medical Preparedness for Disasters and Emergencies (the “Forum”) in 2008. Forums are designed to provide its members with a venue for exchanging information and presenting individual views, and allow a structured opportunity for dialogue and discussion while scrutinizing critical and possibly contentious scientific and policy issues. Representatives from government, industry, academia, and other interested parties are expected to serve on the Forum, which will convene two to three times a year to confer on subject areas of mutual interest and concern. At its meetings, the Forum identifies and discusses emerging scientific research and policy required to improve the Nation's medical preparedness and resilience to acts of terrorism and/or natural disasters, as well as issues in the coordination of federal, state, local, public, and private medical preparedness and resilience activities. The Forum sponsors workshops as an additional mechanism for informing forum meetings and discussions. The Forum may also commission individually-authored papers. Forum discussions or workshops or other formats of meetings, may lead to proposals for specific studies by units of The National Academies resulting in institutional reports. Such studies, if undertaken, will be conducted independently and at arm’s length from the Forum and in accordance with all institutional policies and procedures governing such study activities. All activities of the Forum will be conducted in accordance with institutional guidelines described in "Roundtables: Policy and Procedures." In addition, with funding from NIH and possibly other sponsors, will support a Disaster Research Action Collaborative as an additional activity of the Forum. For the past several years, NIH and others have sponsored a Standing Committee on Medial and Public Health Research during Large-Scale Emergency Events. After discussion with the sponsors and NASEM, it was decided to move from the Standing Committee to an Action Collaborative under the Forum. The Action Collaborative will work on outlining and defining processes and procedures for conducting research following disasters as described above. Expertise The Forum’s membership includes over 30 individuals, chosen for their professional and policymaking perspectives, as well as their scientific or public policy credentials. Expertise includes government technical program management; medical operations in support of homeland security; biotechnology/bioengineering; strategic planning; threat assessment; toxicology; environmental health and geosciences; bioinformatics; national public health and emergency management and response; epidemiology; molecular biology; state/local public health; health care; risk communication; first responders; bioethics; nursing; pharmacotherapeutics, medical countermeasure planning and response, workforce education and training, health disparities and community engagement, data science and bioethics. Representatives of federal research and regulatory agencies are appointed by virtue of the positions they hold. Additional experts are invited to participate in particular discussions on an ad hoc basis. Each sponsor sends a primary representative and is welcome to also send “alternate” members. Currently Ms. Stacey J. Arnesen, NLM (Florence Chang, alternate) Barbara Mulach, NIAID, and Dr. Aubrey Miller, NIEHS, serve as NIH representatives to the forum. The Action Collaborative will include members, chosen for their professional expertise in developing, conducting, and promoting disaster-related research as well as their general scientific and/or disaster medicine/public health/emergency management credentials. Expertise may include grant management (e.g., as a Principal Investigator), emergency management, homeland security, environmental health and geosciences, toxicology, behavioral/psychosocial/mental health, data science/ bioinformatics, health care, public health, public policy, risk communications, health disparities and community engagement, and human subjects research/bioethics. Work plan The type of work that a forum, such as the Forum on Medical and Public Health Preparedness for Disasters and Emergencies, with mixed Federal, academic, not-for-profit, and industry for-profit participation can engage in include: meetings and workshops on topics of interest to Forum members; symposia held for the purpose of informing Forum members more widely about medical and public health preparedness, response, and resilience consistent with Forum interests and discussions. The Forum can also serve as a locus for informing each of its members of the views and plans of other members about approaches to problems and work on holding public events. Specific activities will be organized according to the following tasks: 1. Forum Meetings. Forum Meetings will be held two or three times a year. They will be open or closed as needed and attended by NAS staff and Forum members. 2. Workshops or Other Activities Sponsored by the Forum. The Forum will consider the use of several mechanisms to convene experts on topics in which it needs to be informed. Examples of activities include workshops and active collaborations. The Projected Costs shown at the end of the proposal includes funding for these activities. 3. Individually authored summary documents or proceedings of the Forum's workshops and symposia may be published by NAP or posted on the internet.

灾难和紧急情况的医疗和公共卫生准备及行动协作论坛。 政策背景 许多政府机构和私人组织负责确保国家有能力预防和应对人为和自然灾害对健康造成的影响，虽然这些利益相关者中的每一个在保证充分的预防和应对方面都至关重要，但他们的努力却至关重要。然而，主要利益相关者、卫生与公共服务部 (HHS) 和国土安全部 (DHS) 的不同职责以及协调各部门之间的努力带来了挑战。许多其他政府机构（联邦、州和地方）、行业、专业协会、基金会、学术界和其他相关方。不幸的是，将所有这些利益相关者聚集在一起的场所有限。NAS 医疗和公共卫生准备论坛开始讨论这些问题。 2008年的问题。 协调每个利益相关者的职责和重点将极大地有助于确保适当的保护和响应，每个利益相关者都提供必须与总体战略联系起来的独特资产，包括美国卫生与公众服务部、国土安全部、卫生部。国防部、交通部和退伍军人事务部在制定国家战略和后勤支持以及与私营部门协调方面发挥着至关重要的作用，灾害和紧急情况医疗和公共卫生准备论坛（论坛）提供了一个场所。主要利益相关者可以坐下来讨论主要问题，为组织提供进行评估、讨论政策和审查结果的机会。这些领域不仅关注对灾害和公共卫生紧急情况的立即反应，而且还关注中间反应。恢复阶段出现的长期需求（例如提供足够的住所、食品和水安全、初级保健、心理健康）以及加强准备、合作和信息共享的努力。 联邦政府、志愿者组织、私营部门和其他方面在医疗准备、复原力和健康科学方面的活动在技术和政策方面都变得越来越复杂，目前，国家的医疗应急响应变得困难。不幸的是，以下领域仍然存在差距：(1 全球卫生安全，(2) 沟通和协调， (3) 个人与社区弹性，以及 (4) 关键基础设施保护。 因此，要满足各种恐怖事件或自然灾害行为所带来的身体、心理和社会需求，就需要负责公众健康的所有系统都做好准备、应对和恢复工作，并应包括所有方面。这些举措的每个阶段的人口的研究和开发需求是巨大的，因此需要联邦政府寻求和协调国家和国际临床实践以及生物医学研究界的评估。联邦机构寻求的最佳建议这些举措包括医疗和公共卫生领域（基础设施、临床、环境和公共卫生、研究需求，包括开发新的药物）的科学、技术和劳动力问题。还必须考虑围绕这些发展领域的多重复杂的道德问题。 技术背景 该论坛将促进对现有系统以及从以往灾难和公共卫生紧急情况中汲取的经验教训进行公开讨论，并确定需要改进的领域：(1) 沟通与合作；(2) 个人和社区复原力；(3) ) 准备和基础设施需求； (4) 医疗和公共卫生准备和响应；在这些领域内，论坛会议议程上可能包括： 全球卫生安全 该主题的主题重点是为加快建设一个免受新出现的传染病和其他威胁的安全的世界而不断努力，讨论重点是加强美国医疗保健和公共卫生系统检测、预防、规划、应对、应对的能力。并从自然发生的爆发以及危险物质的故意或意外释放中恢复。 沟通与合作： 该主题内的主题重点是确保及时沟通和有效 各级政府内部以及政府、私营部门和私营部门之间的协调 公众在大规模灾难和事件期间的讨论集中在如何应对。 提高态势感知、威胁情报共享、风险沟通和 多部门救灾网络之间的合作，包括公共、学术、 私营、政府和非政府实体（例如，改善之间的协调） 来自公共、学术、私人和政府实体的灾难响应网络 灾害期间和灾后利益相关者数据收集、协调和管理 包括急性监测和纵向暴露、健康影响、临床评估、 评估数据集和信息；组织和共享开放数据集以及开发用于分析数据集的计算工具（用于发现的数据科学）。 个人和社区的复原力： 根据《国家卫生安全战略实施计划（2015-2018年）》（http://www.phe.gov/Preparedness/planning/authority/nhss/Documents/nhss-ip.pdf），实现国家卫生安全国家及其人民已做好准备、受到保护、有效应对可能对健康造成负面影响的事件并能够从中恢复。 该主题内的主题重点关注与个人和社区利用现有资源应对、抵御不利影响并从中恢复的持续能力相关的问题 讨论集中在灾难性事件发生后的情况上。 通过减少灾害风险、包容健康来增强个人和社区的复原力 在灾后恢复规划工作中，与非传统部门合作，以及 探索在大规模伤亡后加强社区所需的特殊考虑 事件。 关键基础设施保护 该主题中的主题重点关注为确保资产、系统和安全而进行的持续努力。 网络，无论是物理的还是虚拟的，对安全、公共健康和安全至关重要 讨论的重点是医疗保健和公共卫生部门以及相互依存的问题。 部门脆弱性、基础设施连锁和长期故障的后果， 来自化学、生物、放射性、核和高当量爆炸物的威胁，以及 网络攻击的威胁和后果日益严重（例如，调查构建网络攻击的步骤 下一个十年的备灾并同时改善公共卫生 基础设施并解决现有公共卫生系统和基础设施的问题 加强的同时，满足各国的救灾需求 未来）。 灾害研究响应行动协作 论坛将在收到 NIH 和其他赞助商提供的额外支持资金的基础上召开灾害科学行动合作会议，以：1）促进改进流程和平台，以开发和实施应对灾害所需的时间关键的数据收集和研究（ “科学准备”）； 2) 确定在灾害期间开展和共享从公共卫生研究中收集的信息的循证机制和机会； 3) 让跨部门利益相关者参与灾害研究机会和最佳实践的开发、完善和推广； 4) 提供一个场所来支持国家科学院快速反应机制的开发和维护，以继续满足发起人在突发公共卫生事件初始阶段的召集、想法产生和信息共享的需求。 行动协作组织的活动可能包括：1) 概述和定义灾难发生后迅速开展研究（特别是涉及人类受试者和高危人群的研究）的流程，以避免丢失关键数据；2) 确保灾害研究中的社区参与和 IRB/道德考虑3) 确定扩大和加强灾害研究人员协调网络的流程； 3) 整合数据收集、研究和最佳实践资源（或第一年的任何其他实质性产品）；为国家科学院和其他平台或论坛开发和维护快速反应机制，以继续满足赞助商在突发公共卫生事件的初始和后期阶段召集、产生想法和共享信息的需求。 自2008年以来，论坛针对上述问题举办了多次会议和研讨会，并发布了许多文件。 任务描述： 美国国家科学、工程和医学院 (NAS) 于 2008 年建立了灾害和紧急情况医疗准备论坛（“论坛”）。论坛旨在为其成员提供交流信息和发表个人观点的场所，并为对话和讨论提供结构化的机会，同时审查关键的和可能有争议的科学和政策问题。预计来自政府、工业界、学术界和其他利益相关方的代表将在论坛上任职。每年召开两到三次会议，讨论共同感兴趣和关心的主题领域。 在会议上，论坛确定并讨论了改善国家医疗准备和应对恐怖主义和/或自然灾害的能力所需的新兴科学研究和政策，以及协调联邦、州、地方、公共和政府部门的问题。论坛主办研讨会，作为为论坛会议和讨论提供信息的额外机制。 论坛讨论或研讨会或其他形式的会议可能会导致国家科学院各单位提出具体研究建议，从而形成机构报告，此类研究如果进行，将独立进行，与论坛保持一定距离，并符合所有要求。管理此类研究活动的机构政策和程序。 论坛的所有活动将按照“圆桌会议：政策和程序”中描述的机构准则进行。 此外，在 NIH 和可能的其他赞助商的资助下，将支持灾害研究行动合作作为论坛的一项额外活动。扩大紧急事件规模。与赞助商和 NASEM 讨论后，决定从常务委员会转移到论坛下的行动协作组织。 行动合作组织将致力于概述和定义上述灾害后开展研究的流程和程序。 专业知识 该论坛的成员包括 30 多名成员，他们的专业知识和公共政策经验包括支持国土安全的医疗行动；毒理学；生物信息学；流行病学；国家/地方公共卫生；护理；药物治疗、医疗对策规划和响应、劳动力教育和培训、健康差异和社区参与、数据科学和生物伦理学等联邦研究和监管机构的代表根据其所担任的职务任命。临时的。 每个申办者均派出一名主要代表，并欢迎派出“候补”成员。目前，Stacey J. Arnesen 女士（NLM）（Florence Chang，候补）、Barbara Mulach（NIAID）和 Aubrey Miller 博士（NIEHS）担任 NIH 代表。论坛。 行动合作组织将包括根据其在开发、开展和促进灾害相关研究方面的专业知识以及一般科学和/或灾害医学/公共卫生/应急管理资格而选出的成员。专业知识可能包括赠款管理（例如，作为首席研究员）、应急管理、国土安全、环境健康和地球科学、毒理学、行为/心理社会/心理健康、数据科学/生物信息学、医疗保健、公共卫生、公共政策、风险沟通、健康差异和社区参与和人类受试者研究/生物伦理学。 工作计划 联邦、学术、非营利和行业营利性混合参与的论坛（例如灾难和紧急情况的医疗和公共卫生准备论坛）可以从事的工作类型包括：论坛成员感兴趣的主题；举办研讨会的目的是让论坛成员更广泛地了解医疗和公共卫生的准备情况、应对措施，并与论坛的兴趣和讨论保持一致。的意见和其他成员关于解决问题的方法和举办公共活动的工作的计划。 具体活动将按照以下任务组织开展： 1. 论坛会议。论坛会议每年举行两到三次，会议将根据需要举行，由 NAS 工作人员和论坛成员参加。 2. 论坛赞助的研讨会或其他活动 论坛将考虑使用多种机制召集专家讨论需要了解的主题。活动的例子包括研讨会和积极合作。该提案包括为这些活动提供资金。 3. 个人撰写的论坛讲习班和专题讨论会的摘要文件或会议记录可由国家行动计划出版或在互联网上发布。