Healthcare lessons from the Covid-19 crisis

Health experts are urging authorities to rethink their approach to tackling outbreaks such as Covid-19 which, driven by the highly contagious Delta variant, is continuing to surge across much of the world despite the massive push for vaccinations.

Speaking to MalaysiaNow on the takeaways from the pandemic so far, they said the Covid-19 crisis had exposed the limitations and weaknesses of healthcare policies.

Dr Salvatore Chirumbolo, a clinical biochemist from the University of Verona in Italy, the first European country to be hit by the pandemic last year, said one fundamental lesson was to focus on treating positive cases with symptoms over the tracing of contacts alone.

“Contacts comprise a huge number of people who will not develop an illness compelling them to be hospitalised,” he told MalaysiaNow.

“The awkward consideration that such people ‘might’ be hospitalised forces politics to arrange lockdowns and restriction measures.”

Adding that this strategy was “completely failing”, he said the alternative was to catch those with early symptoms of Covid-19 and to treat them at as early a stage as possible.

“This would reduce the overload on public healthcare and hospitals,” he added.

In December last year, the World Health Organization (WHO) warned that worse pandemics could lie ahead, urging the world to “get serious” about preparing for such events.

“This pandemic has been very severe,” WHO emergencies chief Michael Ryan said. “It has spread around the world extremely quickly and it has affected every corner of this planet, but this is not necessarily the big one.

“We need to get ready for something that may even be more severe in the future.”

Malaysia recorded a daily high of over 20,800 Covid-19 cases last week and a record 360 deaths on Sunday.

More than 1,000 patients are currently in the ICU with hundreds in need of breathing assistance.

Putrajaya said on Aug 5 that it would begin using the number of new cases with serious symptoms as an indicator for states’ transition into the later phases of its National Recovery Plan, replacing the indicator of new cases alone.

Finance Minister Tengku Zafrul Aziz who has been tasked with coordinating the recovery plan said the number of new cases had become less relevant given the country’s vaccination rate as most cases were asymptomatic or mildly symptomatic which reduced the burden on the public healthcare system.

Salvatore said in the post-Covid era, authorities would need to enlarge and enhance what he called peripheral caregivers.

They will also need to rapidly assess patients’ conditions and reach anyone in need of prompt treatment, he said, adding that private healthcare providers should work with the public sector to provide a network of caregiving utilities.

“Expand the caregiving expertise to single, authorised and endowed physicians in any area of the country to hamper the progression of infections from the first week of symptoms,” he said.

“Prevention of hospitalisation and intensive care is the priority, aside from vaccination.”

In many countries, the pandemic has also exposed the realities of healthcare systems that are underfunded and understaffed by underpaid, overworked health practitioners.

Salvatore said authorities should focus on increasing the network of physicians, practitioners and caregivers to treat people at the onset of illnesses, especially infectious viruses such as Covid-19.

“They can access and operate on people immediately when symptoms arise, either face to face or, more simply and feasibly by remote or telehealth.”

M Mohan, the director of local health service provider Click2Health, said aside from a revamp of primary care, authorities should work towards the creation of a streamlined medical record.

“The records are scattered everywhere,” he said. “If doctors want to know a patient’s medical history, how would they manage the patient and prescribe medication without medical records?”

He suggested a platform similar to Putrajaya’s MySejahtera app which would give doctors easier access to patients’ medical records, adding that some developed countries have begun to explore this idea despite concerns over privacy.

On a more widespread approach, he said people should be educated about the importance of staying in good health, given the number of Covid-19 deaths with comorbidities.

“People need to take charge of their health,” he said.

“Now everyone blames the government, even though they are not taking care of themselves or eating properly.

“We don’t have that mindset of individual responsibility for our own health.”

This, in the end, would be the long-term solution to easing the strain on the healthcare system, he said.