Enhancing Private Sector Health System Preparedness for 21st-Century Health Threats
Donald M. Berwick, Kenneth I. Shine
Abstract
Not since the threat of global nuclear war first emerged has humankind faced the risks of potential disasters at the scale that the 21st century now brings. Climate change, international terrorism, pandemics, and cyberwarfare are only some of the ways in which injury, morbidity, and mortalitycanspreadrapidlytomillionsofpeople.Ebola,astragic as it has been, is but a small example of what could occur if,forinstance,anuclearblastwentoffinNewYork,sealevel surges flooded Florida, or the electric grid went down in a health emergency. The current coronavirus epidemic in Chinahascreatedamajorinternationalpublichealththreat, led to the full or partial quarantine of nearly 45 million people, and interrupted commerce in many cities. One is a challenge to capacity-a surge of demand for, for instance, trauma care, burn care, or treatment of an infectious agent at a scale far beyond any currently familiar level of mass casualty. Many local care systems are prepared to manage surges of demand of some size.