Social Distancing and lockdowns: Examining the Healthcare industry and Economic fallout from covid-19

By Nikhil Thadani and Zakir Mir

Background

With the passage of each day It has become abundantly clear that effect of COVID-19 will be far reaching. Healthcare systems in most countries were already overburdened, and after Covid-19, most countries have been scrambling to attend to patients with the Corona Virus. The volume of COVID-19 cases is indeed overwhelming and this is posing an unusual demand for ICUs and ventilators which are in limited supply.

Whilst the challenges posed vary from country to country, some patterns are emerging. For example, primary care providers have long been optimistic that healthcare access can be delivered digitally. However, to this date the actual scale of the digital adoption of services has not lived up to expectations.

Furthermore, there have been different healthcare approaches to the pandemic from country to country, and no unified or universal approach seems to have been utilized during the current crisis. This could be due to the waning influence of organizations such as the WHO, or more decentralized global healthcare provision worldwide due to nationalistic and isolationist policies pushed by various governments in recent times. However, this could also be a result of different requirements, social needs, demographics and geographical conditions prevalent from country to country.  

Different countries have tried different approaches, and we summarize some of the more successful countries to date, when it comes to combating healthcare problems.

South Korea and Singapore

South Korea and Singapore have been adopting very technologically advanced digital solutions towards contact tracing and testing. South Korea has recently seen some positive developments in their fight against the virus, with zero new cases being reported as of today. Furthermore, Singapore has had a relatively controlled outbreak of the virus thus far. Both countries have not had the need to implement restrictive measures such as lock downs or curfews. Testing and tracing have been key features in the healthcare response, while members of the public have been alerted to potential neighborhood outbreaks through the use of smartphone apps. These preventative measures, coupled with social distancing, patient isolation and comprehensive treatment, have led to a very low death rate in South Korea.

New Zealand

Remarkably, New Zealand has almost managed to overcome the pandemic caused by COVID-19, yet the country is still being cautious. New Zealand considered many models which showed what could happen if no action was taken in a timely manner. The Prime Minister Jacinda Ardern announced on March 14  that anyone entering the country would need to self-isolate for two weeks, and at the time, these were the toughest border restrictions posed by any country in the world. Despite the fact that there were only 28 confirmed cases, on March 19th the Prime Minister Ardern banned foreigners from entering the country. Later, on March 23rd Ardern announced that the country was going into lockdown when there were 102 confirmed cases and no deaths. New Zealand has significantly increased its testing to the point that it can carry out 8000 tests per day. New Zealand has carried out 126,066 tests. In comparison the UK (a country with around 13 times more people than New Zealand) has completed 719,910 tests. However, the real sign that the tests are working is the rate of positive test results observed. New Zealand’s test positivity rate is around 1%, suggesting that there is not widespread community transmission in the country.

Germany

Germany has managed to achieve the highest rate of testing and the greatest number of ventilated beds. It has a well trained and experienced workforce to support and deploy medical facilities to their full potential.  As a result, Germany has had lower death rates when compared to the rest of Europe.

Lessons learnt to improve technology

Surely there are many lessons to be learned which are likely to help develop technology in public health systems. Some examples are linking data in sentinel labs to the development of technological solutions which can immediately satisfy testing needs and analyze data in different geographical locations. This can allow public health officials to draw real time insights related to the spread of disease and take appropriate corrective measures.

South Korea has taken the lead in managing disease contacts by using smartphone technology with quite exceptional results. Germany has also developed central dashboards to better manage bed and care availability within hospital settings, which has been shown to significantly improve efficient bed usage.

The dispensing of telemedicine for direct patient care in public health emergencies has also gained importance. In the US, personalized online screening is being used to expedite the screening process for potential Covid-19 patients, without exposing healthcare providers and others to risks. In England, a new telehealth system has been deployed for primary care at a scale that would have been beyond limits only a few weeks ago. England has deployed the new digital first pathway as a route to managing healthcare intake processes and directing patients to the appropriate services. 

Lockdowns Across the Globe

Countries like the UK, US, EU, India and in fact many other countries across the globe have enforced varying degrees of lockdowns e.g. restaurants’ & bars, shops, schools, saloons, gyms, swimming pools have been closed. The citizens are strongly encouraged to stay at home to avoid the spread of COVID-19. In some countries like India, a curfew has been imposed in big cities.

Researchers around the world are well on their way to discovering the vaccines for COVID-19. Oxford university has completed tests on animals and has commenced tests on humans. Based on research, some vaccine producing pharmaceutical companies are ready to produce vaccines in India e.g. Serum Institute, Pune, India and Bharat Biotech.   

Until the time the researchers come out with the final vaccines, social distancing is the only intervention to help individuals stay healthy and prevent spread of COVID-19. Lockdowns are expected to break the transmission chain and give more vulnerable populations a fighting chance of surviving this pandemic.

Lockdowns will help in mitigation to a degree i.e. slowing down the epidemic but without stopping it completely.  The need of the hour is to reduce demand on healthcare while protecting those most vulnerable to infection. Suspected cases and their households will have to be isolated and social distancing will have to be maintained for quite some time.

Effects on some major healthcare providers in the Gulf and worldwide

As published in many newspapers, a health care provider NMC which was listed on London Stock Exchange, founded by an Indian Entrepreneur Mr. Bavaguthu Raghuram Shetty, has seen its stock plunge before it was suspended from being publicly traded amid allegations of fraud. This led to the resignation of most senior management personnel and it was later discovered that the company had more than $4 billion in undisclosed debt.

Many healthcare providers have been overwhelmed and undersupplied in the crisis. Most notably, some of the richest regions in the world, such as New York and other parts of the US, did not have access to adequate supplies of personal protective equipment. Furthermore, many hospitals in the US became overcrowded and unable to satisfy patient demand. This has led the public to question the efficacy of the private healthcare system, and whether funds had been utilized efficiently by private companies managing hospitals before the onset of the crisis. In addition, certain public healthcare systems, such as the Canadian system, and the healthcare apparatus in place across many European countries (i.e. Italy and Spain), have also experienced overcrowding, doctor, staff and PPE shortages. This does raise the question of whether many countries have been funding healthcare provision adequately, and if so, whether these funds have been utilized efficiently or appropriately pre-crisis.

It can be seen that countries which manage the delivery of healthcare most efficiently have been able to curb the effects of the virus with the fewest disruptions and least fatalities. Other countries, such as the USA, which spend huge amounts of funds on healthcare, have seen awful levels of death and economic decimation. In the wake of this economic mismanagement, there should be an inquiry into how healthcare providers can become more efficient and be held accountable for inefficiencies. The public should not have to pay the price for a failure in public health administration by private actors.

The healthcare sector is also one industry which should be impacted in a positive manner, when it comes to pure finances. The outbreak is giving private and public healthcare providers access to funding from insurance companies and governments, the like of which they have probably not seen before. For example, US healthcare providers have been billing most Covid-19 patients for treatment, and recently, former presidential candidate Bernie Sanders publicized cases where patients had been charged as much as USD $36,000 for covid-19 treatment! Therefore, the public has the right to demand more transparency in healthcare delivery, and perhaps digital adaptations can be one step, among many, towards this.