Journal of Medical Sciences and Health

Introduction

The pandemic of COVID-19 is disrupting global health and the economy in a proportion unparalleled in modern history. The fallout from the COVID-19 pandemic has been challenging for the existing healthcare delivery system, due to a wide range of factors including impaired access to the healthcare system, travel restrictions, new guidance from regulatory agencies, and a shift in healthcare resources to fighting the pandemic.[1–3] The sheer magnitude of the ongoing COVID-19 pandemic, has changed the outlook of health care professionals by straining health systems worldwide and it will have an unprecedented impact on long term clinical practice.
The rapidly increasing demand on health facilities and health care workers threatens to leave some health systems overstretched and unable to operate effectively. An epidemic of this proportion needs a certain infrastructure to deal with. None of the countries, whether developed or developing or poor, were having such an infrastructure at outset of the pandemic. From logistics of essential commodities to healthcare facilities, everything is super-strained in almost all the nations. Having learned some of the harsh lessons of history, we are in a position to better plan for the next disaster and begin to undergo some fundamental restructuring of how our system’s organized and where we put our priorities.
One of the most neglected health aspects during the pandemic has been the mental health issues which people across all age groups faced. Social distancing and isolation guidelines led the old age people towards anxiety and sleep disorders.
Young kids were equally affected as schools were being shut down and open play areas being closed, leading to behavior changes and anxiety symptoms. Yet the most affected age group has been that of young adults, the working force and the immediate future of any country. Loss of jobs for non-essential workers and harsh working conditions for essential workers like hospital staff led to increased alcohol consumption, substance abuse, sleep deprivation and in severe cases suicidal thoughts.
This pandemic has given the opportunity to many doctors to experience a different work environment.
Team work has improved. Some of the changes will be for good as one of the things that a crisis like this does is it forces you to think more creatively. For instance, hospitals will inculcate infrastructure to segregate patients with COVID19 symptoms from asymptomatic ones and stream them to different isolation and urgent care centers to minimize exposure, and then condense down several fragmented primary care clinics into ‘One stop’ clinics set up where patients have everything completed in a single environment for their ailments.
Healthcare delivery system has shown a massive shift from the prevailing system allowing walk-in patients and in-person doctor visits to incorporation of telemedicine and artificial intelligence to facilitate contact less patient assessment, diagnosis and realtime patient data analysis.[4–6] Telemedicine will boost the healthcare system through faster access to appropriate interventions and access to services that may not otherwise be available. This requires frequent online training sessions for nurses, paramedic staff & health workers for protocols to be followed for detection, isolation and communication regarding suspected infections. Increased use of technology and opening up of telemedicine through transparent guidelines, will improve access to healthcare even in remote and geographically diverse locations.
As we expect the pandemic to end soon, the long term sequelae of the disease among those who were infected assumes a larger importance now, which in turn makes a general practitioner even more important in the hierarchy of treatment as they will be the first point of contact for any patient. Easy accessibility of all covid resources and a continuous endeavour on the part of GPs will not only enhance their knowledge but will also aid in recognising the early symptoms of long term covid sequelae, most of which are still unknown
As the burden of patients requiring emergent care rose in this pandemic, it led to diversion of most of the medical resources, both diagnostic and therapeutic, to these patients. Consequently, patients with chronic diseases, who have been not been able to avail routine monitoring and regular consult during this period, may have increased incidence of complications and worsening of disease. This can raise the overall burden of diseases, warranting the clinicians to have a foresight and preparatory arrangements for the same, in long term. All elective surgeries were deferred during pandemic impacting millions of patients. The post pandemic era will require reinstating surgical services to restore normalcy and to aptly decrease the backlog of pending cases.[7,8] A meticulous framework for evaluation and a holistic plan to incorporate sustainable surgical care in health care delivery system during future pandemics shall be required.
This pandemic could be a much-needed wakeup call, for the necessity of long-term changes to healthcare facilities. The countries will have to accelerate implementation of healthcare infrastructures strengthening by ambitious expenditure of GDP on this neglected sector. Augmenting the existing system by increasing number of medical colleges and hospitals is the need of hour.
A strong pharmacy industry has always been a pillar of affordable healthcare which will have to act over zealously to develop a doctor patient interface by using Artificial intelligence. Also, pharma sector will need to internalize new manufacturing skills to ensure surplus indigenous medical equipment’s and medicines to combat the situation and in long term to strengthen our healthcare delivery system.
Thus, as we unravel the mysteries of the ongoing pandemic there are opportunities in the future offering unique learning opportunities for the health care sector. Rationalizing and optimizing available resources with resilience shown on the coronavirus frontline during the crisis are some most important lessons learnt during the crisis. Importance of personal hygiene and re-enforcement of infection control measures have been acknowledged. Telemedicine revolution will be a vital factor in delivering health care in the future.