COVID-19: US federal accountability for entry, spread, and inequities-lessons for the future.
COVID-19: US federal accountability for entry, spread, and inequities-lessons for the future.
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DOI：
10.1007/s10654-020-00689-2
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发表时间：
2020-11
影响因子：
13.6
通讯作者：
Krieger N
中科院分区：
文献类型：
--
作者：
Hanage WP;Testa C;Chen JT;Davis L;Pechter E;Seminario P;Santillana M;Krieger N
美国是受COVID-19（由SARS-CoV-2引起的疾病）大流行的第一阶段和第二阶段影响最严重的国家之一。美国人口仅占全球人口的4%，但COVID-19死亡人数约占22%。尽管在资源和专业知识方面具有巨大优势，但目前人均死亡率超过585/百万，分别是加拿大和德国的2.4倍和5倍。当我们进入2020年秋季时，美国正在该国大部分地区持续爆发疫情。此外，在美国，大流行病的一个早期和持续的特征是对已经因种族主义和危险工作、工资不足和负担不起的住房而变得脆弱的人口的不成比例的影响，这对于头条新闻的公共卫生威胁和额外的灾难性经济影响都是如此。在这篇文章中，我们评估了联邦政府在三个具体领域的失误的影响：将病毒引入美国和建立社区传播;缺乏全国性的COVID-19工作场所标准和执行，以及向职业安全与健康管理局（OSHA）投诉的工作场所缺乏个人防护设备（PPE）我们发现这与16天后的死亡相关（ρ = 0.83）; 2020年迄今为止的超额死亡总数已经超过23万人，而COVID-19死亡率在种族/民族方面表现出严重的不平等，包括工作年龄的成年人。
The United States (US) has been among those nations most severely affected by the first—and subsequent—phases of the pandemic of COVID-19, the disease caused by SARS-CoV-2. With only 4% of the worldwide population, the US has seen about 22% of COVID-19 deaths. Despite formidable advantages in resources and expertise, presently the per capita mortality rate is over 585/million, respectively 2.4 and 5 times higher compared to Canada and Germany. As we enter Fall 2020, the US is enduring ongoing outbreaks across large regions of the country. Moreover, within the US, an early and persistent feature of the pandemic has been the disproportionate impact on populations already made vulnerable by racism and dangerous jobs, inadequate wages, and unaffordable housing, and this is true for both the headline public health threat and the additional disastrous economic impacts. In this article we assess the impact of missteps by the Federal Government in three specific areas: the introduction of the virus to the US and the establishment of community transmission; the lack of national COVID-19 workplace standards and enforcement, and lack of personal protective equipment (PPE) for workplaces as represented by complaints to the Occupational Safety and Health Administration (OSHA) which we find are correlated with deaths 16 days later (ρ = 0.83); and the total excess deaths in 2020 to date already total more than 230,000, while COVID-19 mortality rates exhibit severe—and rising—inequities in race/ethnicity, including among working age adults.
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