I write this article in a sad days where the Coronavirus pandemic is again causing a growth in cases of contamination, hospitalization and deaths around the world. We are slowly returning to where we were a few months ago. On the part of governments, increasingly drastic measures are being taken to curb this growth. We do not yet know which measures are the most effective because in the end there are multiple factors that determine the success or failure of the measures taken. One of them being the cultural factor and patterns of behavior. In fact, we don’t know what’s going to happen next week.
The perfect storm
We are facing the perfect storm, health crisis, social crisis and political crisis, not forgetting the humanitarian crisis suffered by millions of refugees, countries at war or in terrorist conflicts. UN agencies fear that the socio-economic consequences of the coronavirus pandemic will push tens of millions of people into extreme poverty and also trigger the number of malnourished, from the nearly 690 million currently estimated to be more than 820 million with which could close 2020 if no action is taken.
As we cannot talk about everything in an article, we focus on what needs to be changed in health systems, especially public health. Society wants a health care system focused on people but supported by institutions instead of one that is centred on institutions that people are forced to navigate. It should be one in which people are not worried about how changes in their life—pandemic-related or otherwise—could affect their ability to care for their families. It should be one in which clinicians’ relationships with patients and communities are at the core. And it should be one in which the people who have been ignored, left behind, and mistreated are central, maybe for the first time.
Humanity is suffering
With the pandemic there are a number of layers of suffering. The first is that of people who are contaminated by the virus whatever the impact on them, the second is that of relatives who anxiously live the vicissitudes of the sick person, especially when their pathological picture requires their entry into an Intensive Care Unit, and in some cases their death. the third is that of people who in one way or another become jobless and cannot cope with their family’s day-to-day costs, suddenly becoming poor people who needing help, whatever their previous financial situation. The fourth is anxiety and sometimes depression of citizens who have nothing to do with the above but who live worried about the future and who are somehow candidates to be part of the layers described above. In fact no one can escape the effects of this pandemic.
Now is the time to take stock
With the experience of this pandemic and its consequences, health systems need to be transformed rapidly with a number of actions in areas where decisions are need to improve and increase investment.
The WHO has recently identified three clear areas where success or failure as to how Governments managed the pandemic depends on: investment (in public health resources), communication (transparency in public messaging) and engagement with civil society (working with local/regional groups and acknowledging their local knowledge and expertise).
In any case, it is clear that public and private health systems have to rethink the health service models that to date seemed robust and efficient.
Within the ‘New Normal’ we need to scan the horizon, collect information and try and make sense of what lessons are to be learned, to improve the resilience of health systems:
Protecting primary care
The pandemic has demonstrated the importance of primary care services and as such we have learned that primary care must be strengthened and valued.
Technology
New technologies, especially digital technologies, have shown their importance and impact. For years there has been talk of telemedicine and now today it will become an essential tool. The new technologies facilitate an equitable access to care, health information and privacy, to highlight the Artificial intelligence as a necessary tool in healthcare.
Care for frail and older people
We have achieved an increase in people’s longevity over recent decades, but not always accompanied by active and healthy aging. New programs for aging from childhood and a new model of care for the elderly must be implemented.
The education challenge and behaviour change
We know from scientific evidence that behaviour, healthy habits, and health education have a significant impact on human health. To date they have been issues of little relevance to health systems. They should be part of the training curriculum at all levels. Lifelong health training should be a priority.
Mental health
Behind the Covid-19 pandemic is the mental health pandemic. Alarms regarding the increase in mental illness had already sounded in the past. Now with the impact of the Coronavirus, its increase could be exponential. A new model of care for people with mental health problems is urgent.
Global collaboration
Although it seems that globalization is in crisis, paradoxically it is when we need a great collaboration at the level of countries and regions of the globe to overcome the Coronavirus pandemic and implement new models of health delivery. The role of WHO must be strengthened, there must be promotion of scientific alliances and the sharing of best practices in the reform of health systems
These and other changes will not be easy to make. Governments will have to prioritize and provide the necessary financing, which is not easy when we are on the brink of a global economic recession. The hope is that humans have always been able to overcome extremely complex situations. And above all, never in our history has there been so much talent and goodwill in our societies. Yes we can!!!
Sources and bibliography
Infographic: The Shadow Pandemic – Violence Against Women and Girls and COVID-19
How the pandemic might play out in 2021 and beyond
https://www.nature.com/articles/d41586-020-02278-5
Multimorbidity. Technical Series on Safer Primary Care.WHO:
What are the top healthcare challenges to overcome in the near future according to industry leaders?https://healthcaretransformers.com/healthcare-business/future-healthcare-challenges-solutions/embed/#?secret=zp5aBJjW7r
Health Care Policy After the COVID-19 Pandemic. Victor R. Fuchs, PhD
https://jamanetwork.com/journals/jama/fullarticle/2767352
What Are The 4 Biggest Challenges Facing the Healthcare Sector?