Future proofing healthcare systems: Why now is not the time to get complacent

Many countries are successfully flattening the Covid-19 curve and gaining control of new cases. So, with the focus shifting to getting economies and society back up and running, can we now chalk up a victory against Covid-19?

Far from it—and the recent resurgence in cases demonstrates just why we can’t afford to be complacent.

No silver bullet in sight
Previous pandemics provide a worrying glimpse of what could lie ahead. SARS in 2003 and the major influenza pandemics of the past suggest that Covid-19 is going nowhere fast. And the next wave could hit soon.

Scientists are stepping up the search for a vaccine, but clinical trials are in their infancy.

An effective vaccine would be unlikely to gain regulatory approval until the end of 2020 or early 2021, with large volumes only available toward the end of 2021. Even then, supplies would likely be restricted initially to frontline healthcare workers and high-risk patient groups. And for most countries, national immunisation campaigns are not on the cards in any case – at least in the short term.

Trials of therapeutic treatments are in their early stages too. There’s emerging evidence that drugs like Remdesivir and low-dose steroid treatment dexamethasone can benefit some patients, but there’s no near-term option for severe cases that could cut fatalities and the burden on ICU capacity.

Meanwhile, the holy grail of herd immunity remains elusive. In Europe, Belgium is estimated to have the highest population exposure to Covid-19, with 6.4 per cent having contracted the virus, compared to 4.4 per cent in Italy, 3.4 per cent in the UK, and 0.7 per cent in Germany. Even hard-hit urban areas like New York have less than 20 per cent exposure in the broader population – well below the estimated 60 per cent+ exposure rate required for herd immunity.

The wider population is paying the price too
Elective and non-elective surgery has been postponed as hospitals and medical staff have been redeployed to deal with Covid-19, creating a serious backlog of cases.

Chronic patients have had to self-manage, with routine consultations suspended, and there has been a drastic drop in the rate of cancer screening, diagnosis, and treatment. Whole generations of non-Covid-19 patients are currently being let down by health systems, with implications for long-term outcomes and mortality that could far outweigh the impact of Covid-19 itself.

Getting healthcare systems back on their feet
So, how can we get our healthcare systems back to full strength?

Routine healthcare service delivery must restart now, while maintaining capacity and reinforcing resilience against further waves of Covid-19.

There are five key steps that can be taken to achieve those aims:

1. Restore public trust in the healthcare system
To reengage the public, we need “Covid-19-safe” delivery environments, backed by a clear public health message that primary care centres and hospitals are safe and open for business. Essential health services must be rapidly reinstated, while self-care and virtual visits should still be encouraged for minor ailments and routine consultations.

2. Restart routine healthcare services
Most hospitals need to reprioritise cases to work through the backlog of non-Covid-related cases. On the front line, full compliance with PPE standards and regular testing will remain key to protecting individual safety and prevent healthcare professionals from spreading the virus as patients return. Precautionary measures for triaging hospital, primary health centre, and care home visits for Covid-19 risk should continue, as should supply chain mobilisation, to guarantee reliable access to PPE supplies.

3. Fast-track the adoption of remote care technologies
The management of the Covid-19 crisis has highlighted the opportunity to adopt innovative remote care technologies. In many countries tele-health and virtual consultations have been increasingly used to manage routine care, alongside remote monitoring of Covid-19 patients during their recovery period. Many of these interventions are proving more clinically effective, more cost-effective than standard practice and are preferred by the patient.

4. Strengthen the system to cope with future Covid-19 and pandemic shocks
The challenge now is to ramp up the resilience of our healthcare systems, empowering them to manage future waves of infection without resorting to the extreme crisis management measures deployed in the first phases of the Covid-19 response. Key elements are likely to include:

• ICU surge capacity. Dedicated Covid-19 ICU capacity remains vital and must be reinforced by rapidly deployable repurposing and capacity-scaling plans designed to tackle future peaks – whatever their size.
• Mass early screening and testing capabilities. Countries that introduced early mass testing have managed Covid-19 more effectively, enabling more widespread and rapid self-quarantining and earlier identification of emerging hotspots.
• Track-and trace-methodologies. With improved tracking and tracing of cases, nationwide lockdowns, curfews, and quarantines should become a thing of the past, replaced instead by individual and targeted isolation strategies. Open technologies that safeguard patient confidentiality will be crucial, as will substantial additional human public health capacity and volunteers.
• Secure stockpile of critical supplies. From PPE to ventilators and essential medicines, now is the time for healthcare systems to assess and secure the safety stock they need to manage any second wave of infections.
• Clear prioritisation of access to new treatments. If, and when, a successful vaccine or therapeutic treatment is developed, the largest manufacturers have already indicated that demand is likely to exceed supply capacity. By exploring innovative partnering approaches, countries can provide additional capacity and accelerate access to all their population.
• Collaboration, disease control and operational control systems. The control systems that have helped manage the crisis response so far have been underpinned by detailed data, operational transparency, and cross-agency collaboration. This legacy will ensure healthcare systems stay responsive and agile well beyond Cpvod-19.

5. Learn vital lessons from the pandemic

Countries with previous broad exposure to pandemics like SARS and MERS have responded to this crisis more efficiently than countries without this experience.

Yet even these countries have been taken by surprise by the sheer scale and virulence of Covid-19, and by their high dependency on global supply chains and response mechanisms.

This approach in response to the current crisis can accelerate long-overdue changes required to make healthcare systems more efficient, effective, and patient centered, and restore health security to individual countries.

Covid-19 has given us an unmissable opportunity to learn, to change, and to do better, should a second wave or new pandemic occur in the future.

Let’s make that opportunity count.

Mohamed Berrada is a partner and head of MEA Healthcare Practice at Kearney; Jerry Cacciotti is a partner at Healthcare Practice at Kearney San Francisco, United States and Michael Thomas is a partner at Healthcare Practice at Kearney Middle East