Timeout is not a tapout

The practice of public health policy is both similar and distinguished from the clinics. To beat any pandemic like #COVID19, a clinical sense of urgency is needed besides a systems grasp of operations.

My colleagues and I dive head on into the ‘organs’ of the very system that we seek to cure: governance, financing, logistics and supply chains, human resources and information systems. We quietly do a little ‘surgery’ here, a little ‘injection’ there, and – heaven forbid – commando procedures or systemic chemotherapy, when a definitive cure is hard to find.

As with clinicians, we avoid arguing with our patients. Because we all care for them. Unlike clinicians, however, the ‘disease’ of our patients, often reflected in bad decisions, does affect our own families.

We get tired, too. Our conscience is burdened by the many ‘what ifs’ that arise from the outcry of our clinical colleagues. Every fellow doctor, nurse, midwife, medical technologist, support staff who gets infected (or worse, gets KIA) makes us worry – did a delivery of PPEs not reach its destination? Every patient who gets passed around because of hospitals that are already full bears down on us – could we have anticipated this surge of cases better?

There is always a point in treating a patient where the doctor has to gently but firmly face the patient and tell him or her the situation as it is, and the consequences of particular decisions. We are also at that point in the sphere of public health policy.

As with our clinician brothers and sisters, we ourselves cannot ‘timeout.’ There is this misunderstanding that the timeout called for is for health workers’ benefit. No, ladies and gentlemen. Your health workers are still out there seeing patients and making sure that the system that allows these interactions to do so won’t collapse.

The requested timeout is, in technical terms, a non-pharmaceutical intervention (NPI) of locking down population movement. It is a remedy to slow down the source of infection. And it comes at a cost to the economy.

But this cost to economic survival can be minimized, if those responsible will properly use other ‘medicines’ besides the lockdown. Fast and efficient contact tracing (which runs from reliable RT-PCR testing to listing close contacts and then to quarantining these close contacts) is one such medicine. Contact tracing will allow us to humanely and safely identify and care for those who may have been infected. Contact tracing will allow the economy to run, will signal to health systems the surge to expect and will help healthcare workers brace for and manage this surge.

So please, dear patient, listen to your doctors.

– Dr. Albert Domingo, Health Systems Consultant, @AlbertDomingo on Twitter