揺らぎを公衆衛生の備えに織り込む

──日本における新型コロナウイルス感染症への2020年の対応から──

抄録

　This paper describes unsteady and inconsistent policymaking against COVID-19 in Japan. It also tries to draw lessons from its initial experiences to develop epidemic preparations against radically new infectious diseases. After briefly reviewing concepts of public health, and legal and administrative pandemic preparations in Japan, it points out two shortcomings in Japanese responses against COVID-19 in 2020: insufficient consideration on scale of responses necessary for massive epidemic and reluctancy to face lack of sufficient knowledge or incompetency in providing evidence-informed policy at the beginning of epidemic. The paper focuses on the latter point and argues that we need to weave unsteadiness into public health preparedness against radically new infectious diseases by introducing the following four planned actions: recognition of intrinsic uncertainty in policy making at the initial period of such epidemics, preparation for effective and rapid development of scientific knowledge to convert uncertainty into measurable risks, scientifically competent organization for collecting, synthesizing, and distributing new knowledge, and development of human resources for such activities.