COVID-19: THE NEW CHALLENGE OF HEALTH CARE GLOBALLY 4

The world currently faces its greatest scare since after World War Two as the COVID-19 pandemic continues to ravage it, causing an unprecedented loss of lives and livelihood. The virus has swept through all the continents except Antarctica, claiming more than 100,000 lives globally and plunging the world’s economy into brutal recession. The health care system being in the frontline of the battle has in no way been spared, as it struggles under the daily increasing pressure of meeting up with the demands of a pandemic situation. 

Being a novel virus, many facts are yet to be established about SARS-CoV-2 (Severe Adult Respiratory Syndrome -Corona Virus 2), the causative organism of COVID-19. It is however known to be highly infectious with an R0 of about 2.2. Thus, as at 16 April 2020, there were 2,119,700 infected cases globally. In the majority, the disease presents with mild symptoms like cough, sneezing and fever with some cases being totally asymptomatic. Very severe infection present with respiratory distress, which may progress to respiratory failure and death. The case fatality ratio is not yet established as it varies depending on the population of study. 

Covid-19 assumed a pandemic proportion in March and was declared so on the 11th of March by the Director General of WHO. Prior to this time, measures had begun to be put in place by different countries to flatten the epidemic curve and raise the capacity of the health care systems to handle already existing cases. These measures were however intensified following the declaration. In a bid to reduce transmission, many countries are undergoing periods of total shutdown, with public enlightenment on the practice of regular hand washing, and the use of hand sanitizers and face masks. Raising the capacity of the health care systems to cope with the pandemic has however been very challenging. Catering for the high number of patients that storm health facilities at the same time has put immense pressure on manpower, finances and health facilities. More specifically; isolation centres, ICU beds, ventilators, personal protective equipment, diagnostic kits and drugs. Before now, statistics showed that almost half of the world’s population have no access to health care either due to shortage of manpower or health facilities. This shortage is more acute now in the face of the pandemic, not only because of the overwhelming number of cases, but the number of the health professionals who have either been infected or have died. Furthermore, not all health professionals have the technical know-how to combat the virus. Special demands are for pulmonologists, intensivists, infectious disease physicians and other health workers in related fields. So far, clinical trials on hydroxychloroquine, azithromycin, hydroxychloroquine-azithromycin combination, ritonavir-lopinavir combination, and more recently remdesevir are still on-going with no concrete evidence of successes yet. Also, efforts at developing vaccines are not expected to yield results until 2021. 

In response to these challenges, many countries have enforced lockdown of states, created isolation centres and invested in local production of hand sanitizers, face mask, ventilators, diagnostic kits and PPEs where the means are available. China erected new hospital buildings dedicated to COVID-19 while South-Korea introduced boot-type and drive-through methods of mass-testing. On a global note, health care systems are beginning to adopt digital health technologies as doctors, patients and home care providers are turning to telemedicine to reduce exposure to COVID-19 and it has been found to be effective. The WHO has also made free online courses available to train health professionals to effectively manage COVID-19 cases. 

Many believe that COVID-19 though a pandemic, would shape the face of health care for the better. Countries are being forced to re-examine their supply chains for critical health and livelihood-related products. This consequently will make them pay more attention to domestic production of pharmaceuticals, medical supplies and equipment. Also, national health care systems will become more public health centred, with increased funding for primary care. In the global scene, it is expected that having realised the enormous economic effects of managing a pandemic, billions more of dollars will be plunged into research, vaccines, therapeutics, non-medical methods of prevention and emergency preparedness. 

Chances are that COVID-19 has come to live with us an endemic disease. Chances are, it has not. Whichever the case may be, no effort or resource is being spared at national and international levels as the world prepares for the worst. Yet hoping that maybe, the darkest days are over.

Emakuneyi Ejiro