Covid 19 & its impact on Health
The outbreak of COVID-19 pandemic has created a global health crisis that has a deep impact on world and everyday lives. Human are inherently social being, so, they prefer to have social life. due to this pandemic, the safety measures like social or physical distancing put in place to contain the spread of the virus by refraining from doing what is inherently human character,to find solace in the company of others.
Within this context of disease spreading rapidly, social and physical distancing, adherance to personal hygeine,use of mask, prolonged lockdown measures & closed factories, industrial plants, shops have not only affected health but also affects human psychology, behaviour, socio economic condition as well as economy.
COVID-19 pandemic has severely disrupted Prevention and treatment services for noncommunicable diseases (NCDs) along with other non covid diseases “Many people who need treatment for diseases like cancer, cardiovascular disease and diabetes, fractures & other non Covid disease have not been receiving the health services and medicines since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services remain intact for NCDs & other non Covid disease continue, even as they fight COVID-19.”
Health services have been partially or completely disrupted by COVID-19 pandemic in many countries. More than half (53%) of the countries have partially or completely disrupted services for hypertension treatment; 49% for treatment for diabetes and diabetes-related complications; 42% for cancer treatment, and 31% for cardiovascular emergencies, significant number for fracture or orthopaedic related problems & other non Covid disease.
Rehabilitation services have been disrupted in almost two-thirds (63%) of countries, even though rehabilitation is key to a healthy recovery following severe illness from COVID-19 pandemic or from orthopaedic related illness In the majority (94%) of countries, health staff working in the area of NCDs are partially or fully reassigned to support COVID-19.
The postponements of public screening programmes (breast and cervical cancer) are also widespread, reported by more than 50% of countries. But the most common reasons for discontinuing or reducing services are cancellations or reffered of planned treatments for time being, a decrease in public transport system available, prolonged lockdown and a shortage of staff because health workers have been reassigned to support COVID19 pandemic Alternative strategies have been established in most countries around the globe to support the people at highest risk to continue receiving treatment for NCDs & other non covid diseases. Globally 58% of countries are now using telemedicine (advice by telephone or online means) to replace in-person consultations or visiting out-patient departments.
Covid-19 pandemic has put enormous stress on health resourses around the world, In many countries it broke the existing health care system due to unavalability or lack of health resourses: in fact , Covid-19 has exposed already broken system in many countries. Countries fight with each other for health resources or there is internal competition within.This international phenomenon threatens health systems’ ability to prevent and treat the corona virus with shortages of essentials like hand sanitizers, masks, and pain relievers.
Healthcare unlike economy has generally been immune to recessions in the past. Demand for medical/healthcare has been a constant & uninterrupted since people get sick, whether times are good or bad, famine or pandemic.But the healthcare during COVID-19 recession is different. Since people are being asked to practice physical or social distancing and minimise outside activities, many people who otherwise be using healthcare are now choosing to stay home. Also, the goal has been to keep health offices clear & often close so as to reduce the risk of disease spread. People are postponing healthcare that is not urgent or in dire need.
The question still remains: how will the COVID-19 recession affects the healthcare economy? It was initially believed that the COVID-10 recession would be short, but that does not seem to be the case anymore. As long as there is community spread of the disease, it is not safe for people to re-engage or practice outside activities. There are both formal restrictions in place and a general hesitancy of people to expose themselves to risk of disease. It is unlikely that the healthcare economy will stabilise until the COVID-19 crisis is over or addressed.
The longer the recession lasts, the greater will be the economic harm & problems. Some can handle short-time shutdowns, but sustained shutdowns might be more difficult to manage. Relief funds will not last forever, and health offices, will have to make difficult decisions. Jobs will decline, which means fewer people will get paid, and those who are working may have to face wage declines. This will result in reduced spending, and the cycle will continue. However, Medical care that is being deferred/postponed today will eventually be sought out later. Postponed visits to clinicians and surgeries will be rescheduled for later.
Nevertheless, a recession still poses a challenge to healthcare professionals and healthcare institutions. It all depends on how long the COVID-19 pandemic spread continues and how long it takes for life of people to go back to normal.
Healthcare professionals are the backbone of the health system in any country. Due to the nature of their profession, millions of them risk their own health doing their daily work or service. So, who is protecting healthcare professionals or workers, who are so critical to the fight to the COVID-19 pandemic? Respecting for labour rights and decent working conditions are crucial to give these frontline healthcare professionals the protection they need for waging the long battle ahead to save lives of millions.
The impact of COVID-19 on healthcare professionals or workers
By July 2020, more than 1.7 million confirmed cases of COVID-19, 10.3 million recovered and over 677 K deaths had been reported by the World Health Organization (WHO), affecting more than 200 countries, areas and territories.According to WHO: roughly 3 22,073 cases of COVID-19 in health workers from 52 countries have been reported by 8 April 2020.
Data on the number of infected healthcare professionals or workers are not, however, being collected systematically, as many countries do not have adequate reporting mechanisms in place. However, that this number probably under-represents infections in healthcare professionals globally due to lack of systematic reporting, Infection among healthcare professionals or workers has been common since the emergence of the disease.
Occupational safety of healthcare professionals
Ensuring the safety and health of healthcare professionals or workers is a matter of high priority. The health-care workplace especially hospitals are particularly vulnerable to the risk of exposure to COVID-19. According to current knowledge, the two main routes of transmission are direct interaction with patients and contact with respiratory droplets in the space closely surrounding an infected person. To date, the survival time of the virus on surfaces remains unknown; this further extends the risk of contact transmission to support personnel, such as laundry staff, cleaners and workers dealing with clinical disposal.
The protection of healthcare professionals or workers focuses on the prevention of contacting and spreading COVID-19. The transparent and timely dissemination of information on the transmission of the disease is key in this regard. The availability of personal protective equipment (PPE), as well as training and education in its correct usage, is also critical.
Specific infection control measures, such as visual alerts, respiratory hygiene and cough etiquette, masking and separation of persons with respiratory symptoms, and droplet precautions, physical or social distancing can help to prevent COVID-19.The use of PPE, such as masks and eye protection, may cause discomfort due to heat, skin irritation and breathing difficulties. Preliminary data from Wuhan, China during the COVID-19 outbreak suggest a high prevalence of cutaneous irritation and skin damage in association with the use of PPE, which increased with the duration of PPE use.
Mental and psychosocial support of healthcare professionals
The COVID-19 pandemic is placing healthcare professionals or workers in exceptionally demanding situations & at high risk. In addition to a heavy workload, they are coping with the fear of contracting the disease and of spreading it to their family, children and friends. Furthermore, the overall atmosphere of anxiety among the general population is impacting healthcare professionals or workers and their mental health.
Healthcare professionals or workers in highly burdened hospitals or institution are calling for psychological support to help staff cope with excessive working hours, high intensity of work and experiences with unprecedented death rates. With many countries shutting down schools and public life, health workers, many of whom are women, are confronted with high professional demands, while also have to organize their home life and look after their dependants, particularly if they have children or ill or disabled family members. In addition, health workers in areas that report high numbers of COVID-19 cases face tension between public health priorities and the wishes of patients and their families. The consequences of this range from anxiety to post traumatic stress disorders.
In some countries, healthcare professionals or workers and other public services workers are considering alternate accommodation during the outbreak, such as low-cost hotel rooms, guest houses to protect their families from exposure to COVID-19.
In response to the COVID-19 outbreak, many healthcare professionals or workers are facing heavy additional workloads, long working hours and a lack of rest periods. In many countries, struggling with an increasing number of cases requiring hospitalization is resulting in extensive use of overtime. In some countries, holiday restrictions have been imposed on health workers to ensure sufficient staffs are present at all times to respond to the COVID-19 outbreak. Decent working time arrangements help balance health workers’ well-being with health service requirements.
Women healthcare professionals are facing particular challenges during this pandemic. Globally, they make up more than 70 per cent of the health workforce. They also carry the burden of unpaid care work, such as taking care of children or elderly family members.
Impact on the health system
The capacity of health systems for rapid reorganization to respond to the crisis by mobilizing healthcare professionals or workers, while at the same time ensuring the ongoing provision of essential services along the continuum of care, is equally critical and challenging. Key strategies include ensuring occupational safety and health, decent working conditions, psychosocial support for healthcare professionals or workers, and providing training, knowledge and education mechanisms to rapidly repurpose healthcare workers and new recruits according to health system requirements. Introducing and scaling-up digital technologies to inform, train and guide health workers, especially in poor and remote locations, can improve transparency, service delivery and management during the pandemic.
The health sector is a major source of employment; in most regions, employment growth rates for health have been higher than for other sectors. Health and social work together accounted for more than 105 million jobs worldwide in 2013, 130 million jobs in 2018 and for an estimated 136 million jobs in 2020.
While in many countries, the private sector is playing an increasing role in providing health services, the leading role of the public health sector in ensuring equal access to health care as a human right is particularly prominent in times of crisis. Over the years, the increasing commercialization of health services has raised concerns among some stakeholders. Health care for all must be in the public interest. This does not necessarily mean that health care must be organized and implemented by public services only but that it can also be provided on a private basis.
Health care is a not a commodity and thus not a tradable good. In light of the ongoing COVID-19 outbreak, some countries, including Ireland and Spain, are now enhancing the role of private hospitals by integrating them in the public health system for the duration of the outbreak.
The private sector can also play a role in contributing to the fight of the Covid-19 pandemic beyond the health sector. In some countries, individual enterprises have taken initiatives to temporarily change business models during the crisis, helping to ensure production of medical supplies, such as PPE or ethanol for sanitizer products.
* Pashupati Chaudhary: Professor, Department of Orthopaedics (Consultant Orthopaedic and Spine Surgeon) at B.P. Koirala Institute of Health Sciences,Dharan, Nepal.
** Opinions expressed in this article are the author’s own and do not necessarily reflect the editorial policy of The Asia Live.