The long arm of COVID

Almost half of 2020 has been spent battling this, as yet, uncurable disease and it seems like we have a long way to go. COVID has reached practically every country in the world, infected 5.11 million, and claimed the lives of 333,000 people, and the damage it is wrecking on economies and support systems endangers many more.

It has changed almost everything – and it may just be getting started.The long arm of COVID has the potential to trigger other health disasters – and in fact it is already doing so.

The need to focus on COVID-19 has meant that resources that would have been available for the fight against other health conditions have been drastically reduced. The arrival of COVID does not mean existing killer diseases have stopped spreading, and the lack of attention to them could have devastating effects. In Africa, deaths from HIV-related illnesses could double if essential therapies remain disrupted for a long time. Other contagious diseases such as measles, polio, and tuberculosis are in danger of a resurgence while the health care system is focused on COVID-19 – and having these illnesses could also make people more vulnerable to COVID-19 itself. Many of the things necessary for proper treatment or surgeries – beds, blood, healthcare workers, ventilators – are in short supply. Experts believe that “millions more people are expected to contract [tuberculousis] as a result of COVID-19 restrictions,” a figure that is frustrating because it rolls back progress made in the battle against a disease that has been acknowledged as the world’s biggest killer amongst infectious diseases.

Even those who have not yet fallen ill are in danger because the need for social distancing, quarantines, and general avoidance of hospitals and clinics has caused dangerous dips in immunization efforts across the globe. According to estimates from GAVI, the Vaccine Alliance, at least 13.5 million people will miss out on vaccinations due to postponement of campaigns and interruptions in routine vaccinations, with millions more potentially following. The long term danger posed by this to children is incredibly alarming, and it’s the reason why even before the quarantines have been lifted, efforts should be made to restart immunization programs with the necessary precautions in place. The DOH has already encouraged this in some areas.

This struggle for resources doesn’t only affect the battle against contagious illnesses, but other deadly and/or chronic conditions. Many elective surgeries and treatments have been put on hold during the pandemic. While this is understandable, we have to remember that “elective” as a medical term does not mean something purely optional – these are procedures “not immediately indicated in response to a limb- or life-threatening emergency” but a majority of these if delayed too long “have a potential to inflict significant harm.” This includes treatment for cancer, for those with kidney failure, and diabetes. Many organ transplants worldwide have also been delayed, both because of fears of infection and a significant and understandable drop in donors, both of organs and blood.

Even with resources available, many treatments are delayed by the simple fact that people are justifiably afraid to go to the hospital. While staying home is one way to help the community deal with COVID-19, knowing when to seek care for something other than COVID-19 symptoms is also important.

Of course, it’s the “knowing” that is the hard part. The focus of the information dissemination efforts of the DOH has been on COVID-19, and rightly so. Yet we can no longer put aside the needs of those suffering from other ailments and health concerns. I’d say that in the coming days, we will need a healthcare system that can fight battles on multiple fronts – except we’ve needed that for a long time now.

Our lives depend on our healthcare system – so our healthcare system should be something we can depend on. Our healthcare system must heal itself, better itself.

I’m no healthcare professional, and the first step towards a better healthcare system would be to listen to what healthcare workers have to say – something that should be a priority anyway, if we are to make the adjustments necessary to evolve our response during this pandemic. But there are aspects which from my perspective clearly require attention.  High out of pocket costs, the inequitable distribution of beds, healthcare staff, and regressive PhilHealth contributions are among them.

The government needs to provide guidance regarding when elective surgeries can resume, which would be allowed, and where these can be available – and this guidance should not only be made known to hospitals, but be in a form accessible to patients as well. Even if certain procedures are not yet allowed, there should be an attempt at a timeline, or an algorithm that would provide guidance for all parties so that reasoned decisions can be made before the health of patients begins to suffer from the delays.  Hospitals should have protocols for non-COVID illnesses, particularly those that take into account patient history, in order to ensure that patients receive the right kind of help. The alternative is tragedy – a little girl born with impaired lungs lost her life because the protocols were too rigid, and she was treated as a potential COVID-19 case and not given the specific treatment her medical history would have demanded.

We need to be able to compile and disseminate health information even when it does not relate specifically to COVID-19. In this, programs for other illnesses can benefit from the adaptations we have made to combat the pandemic. Innovations such as the DOH COVID-19 tracker site and the virtual pressers can and should be repurposed to facilitate awareness and cooperation regarding other illnesses as well. Telemedicine, which is the subject of at least one bill in the legislature, should also be advanced as a manner to provide remote yet personalized care to patients. The referral system of the DOH for HIV-related illnesses should be improved and adapted for other chronic illnesses that require regular maintenance medication and care.

There are many ways that we can and should do in order to provide health services and protection to those who do not have COVID, but who have somehow become victims of it. COVID-19 is public enemy #1. But dealing with other health conditions cannot wait until the pandemic is over.

The long arm of COVID-19 casts a wide shadow – we must not forget the other dangers hiding in the darkness.