It’s certain that the Covid-19 crisis will significantly change the healthcare system itself. It will serve as a catalyst in developing more effective, efficient and, above all, more humane medicines.
New Delhi: The deep impact of Covid-19 has been a frontal attack on humanity, which has left the world in a suspended state of animation, surrounded with fear, grief and untold uncertainty, changing lives for many, forever. We have seen how, individual health, personal development, social solidarity, and businesses are all intertwined. At the same time, a new type of reflection has set in about how our collective experience during this pandemic will and should change our world in the future.
It’s certain that the Covid-19 crisis will significantly change the healthcare system itself. It will serve as a catalyst in developing more effective, efficient and, above all, more humane medicines.
Here are the key reasons and episodes learnt from this crisis:
1. The RNA virus has shifted our mental DNA set button to enhance critical infrastructure and public healthcare.
The Covid-19 pandemic reminds us that healthcare is part of a country’s critical infrastructure. Expenditure for healthcare will come to be viewed as an investment in a country’s prosperity and competitiveness, and no longer as an annoying expense cost factor. Consequently, development of the healthcare system will become a central issue on the long-term agenda for each country’s growth, along with ensuring ecological sustainability and expansion of the digital infrastructure.
2. Global collaboration in technology & R&D, ahead of singular nations.
Covid-19 has proved that independent national “in silos” initiatives in healthcare do not work. Whereas research facilities searching for quickly available therapy and vaccination solutions now exchange information unbiased by national egoism. Attempts are being made to roll back the global distribution of work in the development and production of ventilators and protective equipment. But in a crisis such as this, we need more and not less international cooperation. What has now become painfully clear in this pandemic also applies to the same extent for chronic illnesses such as cancer and diabetes. No country will be able to defeat these “creeping” pandemics on its own. The pre-existing pre-pandemic healthcare load was huge already, but the “long Covid” or “long haulers” will subsequently add to that chronic disease burden by 10-20%.
3. Smart technology to highest clinical efficiency, operational efficiency, patient experience; human lives first.
Before the Covid-19 pandemic, global health spending was around 7T€ per year. Despite this huge sum, calls are now emerging for additional investments to prepare for further pandemics. This cannot be financed and will therefore accelerate a rethinking process: Instead of putting more money into moderately efficient healthcare systems, we will increase the efficiency of existing systems while enabling more people to access to modern healthcare. Of the seven trillion euros spent on healthcare globally, less than 1% is invested in technologies that boost the overall efficiency of the healthcare system. If we expect physicians and caregivers to provide high-quality and empathic care, we should also ensure they have the technical resources they need to carry out their tasks as comprehensively and productively as possible.
4. New alphabetical order. Move over 3 As (Affordable, Accessible, Accredited) to 6 Ps (Primary, Preventive, Precision, Personal, Predictive Proactive) healthcare.
More than two billion people currently find themselves more or less in quarantine—while only a fraction of the population is actually infected. In the current phase of this pandemic, the “one size fits all” approach is the only alternative we have in the face of an absence of adequate tests and apps. At the same time, we are also seeing the limits of this procedure that we have declared as the standard for other illnesses. It’s not common to have individualized treatment protocols for an average man, that does not exist at all in reality. The outcome is unsatisfactory results at high costs. More than ever, the aim must be to provide the right treatment to the individual patient at the right time—in other words, we need greater investment in precision and prevention, that is, in diagnostic procedures and digitalization instead of funding random therapies.
5. Data and facts driven medicine, not anecdotal opinions or isolated events.
Give me some data and I will tell you a few pointers, but give me all data and I will give you the world! Nothing is truer than this at this point of time.
In this pandemic we are experiencing a renaissance of science as an indispensable advisor for politics and the public. In a crisis, the methodically logical, scientific situational analysis, weighing of options, and the methodological development of solutions proves to be the superior alternative to speculation, conjecture, and opinions. What this pandemic has made us aware of applies in general for medicine: Science and technology form the basis for medicine—and the myth that medicine is a form of art is being further eroded.
6. Digitalisation and smart innovative technology will be the new norm. Shed the old fossilised inertia and remove the falsehood clock.
Currently, telemedicine, remote control of diagnostic systems and robots, diagnostic recommendations based on big data and artificial intelligence, and medical apps are revealing their enormous benefits—greater productivity, faster availability, less administrative work and, of course, the spatial separation of physician and patient. We are undergoing a paradigm shift from “Why digital?” to “Why still analogue?”. And from the risk/opportunity debate of data privacy versus digital progress, a concept of “how can we achieve both in the shortest amount of time” will arise. The rise of AI, VT, AT will be a daily routine.
7. Patient centric care; patients a part of decision-making cycle.
The Covid-19 pandemic literally impacts each and every one of us. The boundary between “healthy” and “sick” becomes blurred. People who have otherwise never given much thought or attention to the healthcare system have now become inescapably aware of just how far the system lags behind the dynamic developments, efficiency, and customer orientation of other sectors in our lives. They are justifyingly asking themselves: Why is it, and does it have to be this way? The current situation offers us a great opportunity to break free from this “it was always that way” mindset and to also place the experience of individuals in the healthcare system along with their families and friends at the centre of our focus and rethink our priorities.
8. Healthcare, a society collaborative effort.
Covid-19 insistently raises an old familiar question: To what extent is health a public commodity; what role should government play and to what extent is this a matter of private responsibility? The solution will be a combination of both. On the one hand, we see enormous solidarity in civil society. On the other, the boundaries between the public and private sectors are becoming blurred—companies are getting involved by providing (public) hospitals with know-how and specialist staff as well as with hardware and software through donations; the public sector approves financial support so that companies can continue to pay their employees during the crisis. The speed and effectiveness with which mutual aid is offered and granted create a spirit of unity and a basis of trust on which entirely new public/private partnership models can be built for a better healthcare system. Now onwards the strongest link in our chain is our weakest link; my neighbour’s ill health can destroy my wellness status.
9. Nimble innovation formats.
One of the positives of the current situation is that many procedures and processes are speeding up. Innovation cycles and testing periods for medical devices have shrunk from months to just a few weeks. In the prescribed procedures the availability of testing methods or therapies takes priority over the consideration of specific interest groups and over administrative necessities implemented up to now. Of course, the special rules being applied now will be rescinded rightfully when the pandemic is over; but the swiftness we are witnessing at the moment will serve as a lasting benchmark and will ultimately give rise to an agile new “normalcy”.
10. Fairer payment.
One of the most important lessons of the present time is that the obvious is not always obvious. It would be hypocritical if the respect and profound thankfulness that we feel toward those who are now working in patient care and treatment did not result in a lasting improvement of working conditions, wages, and the overall reputation of care professions.
11. Healthcare pricing policies reforms: Just use of government land, audit all “charitable trusts”.
This requires an urgent course correction as per yesterday. Hidden costs, charitable cover up facade trusts who do all but charities, need a review and audit. Hospitals built on government land are openly defying the law to siphon money of our nation out of the system. Under the garb of the noble service to healthcare, let’s not forget to clean up the “dirty pictures” too.
12. Fair, equitable, accessible Covid vaccinations for all, vaccination immunity passport.
Vaccinations are the most vital and important public health intervention tool to save lives. More than 60m lives are projected to be saved by immunisations from 2000 to 2030, which is staggering. Then vax hesitancy is so absurd. Vaccinations must be fair priced or indeed lowest cost in the pandemic, equitable for all, accessible to all. Public awareness is the key.
13. Move over, MBAs: Clinician run and operated hospitals.
From here and on, the healthcare model will revolve around doctors-run establishments and clinicians-run hospitals, since we need, now more than ever before, to look at health and medicine beyond an excel sheet. Medicine isn’t numbers or Ebitda only; it’s deeply rooted in empathy and compassion. Patients aren’t numbers. They are souls and living humans who come to doctors in the hope of care.
12. Genomics, molecular engineering, regenerative medicine, longevity medicine.
The only way forward. Medicine can’t be genetic now. That will make it inaccurate and obsolete, we need to reinvent ourselves. Genetic coding, sequencing will rule the industry.
13. Link IT compliance, Aadhar card, “health card” into a seamless integrated platform.
Citizens expect the government to provide free healthcare. Cliches like “healthcare is a state subject” , that “Centre has to allocate funds” are passé.
How can any country support an ever increasing population’s healthcare, when 2% only pay income taxes? You want healthcare, international standards, free? Sure. But first live up to your moral and ethical responsibilities to pay your taxes.
14. Mask up, Vax up and Namaste.
This will be our way of life. Now. For a while. For a long time. But that’s acceptable. Masks are much better than ICUs.
15. Value our doctors, unsung heroes of today and yesterday.
Doctors are an invaluable asset to our nation. We in India are over a million and a half short in healthcare workers. Doctors have served selflessly for the last 18 months in this catastrophic pandemic, without a single day’s break, suffered losses of lives in the medical fraternity, risked getting infected and dying, risked their own family’s and children’s and parents’ health, but didn’t give up. We will not give up, we cannot give up. We will overcome this crisis. We will serve our nation as our inherent moral responsibility. No greater responsibility can fall on human shoulders than to be a physician. We love our role, rejoice in the recovering of patients and stand with families in moments of grief.
India will triumph. Jai Hind.
Prof Dr Sanjeev Bagai, a Padma Shree awardee, is the chairman of Nephron clinics.