What are the pros of a pandemic on a ‘struggling-to-stay-afloat’ healthcare system like the NHS?
Covid19. It’s been the world’s headliner; probably passing the multitude of front covers Brexit adorned but definitely falling short of the sky-high tower of breaking news surrounding Trump’s idiocy. It was the iron vice that tightened around the world’s throat. Literally. Suffocating people and testing society in every way imaginable seemed to be Covid19’s foremost motive. (Perhaps a preview into the future when climate change comes crashing down on us?) I digress. With just over 9 million cases reported as of yesterday with a death toll of nearly half a million, it’s safe to say that the pandemic had devastating effects.
The elderly, immunosuppressed, and even just ordinary beings who were in the wrong place at the wrong time through no fault of their own were targeted by this highly infectious coronavirus. Besides the health detriments, the measures taken to contain the virus such as social distancing, movement restriction orders, and being in lockdown have affected the wellbeing and mental health of many. These measures are necessary as it is the only way we can come out on top and save our community from a pesky cutthroat virus but it doesn’t mean that it’s ideal for everyone. For example, Manchester United striker, Marcus Rashford has been distributing food for school children as they are unable to eat without the provided school meal and that has been cut off when school was closed. A couple of months ago, the Food Foundation revealed that more than 200,000 children have had to skip meals because of coronavirus and that number could drastically rise in the circumstances we are in. Then there are economic repercussions — workers laid off who are unable to support their families and pay bills and slowed industries which impact salaries, charity, and production of resources which may badly be in need.
As a medical student, I’ve been trying to look at Covid19 from the perspective of the healthcare system (specifically the UK’s NHS). Frontline workers are overwhelmed and it is truly heartbreaking. Their efforts are admirable though being able to wake up every morning, don the whole PPE outfit and put their lives on the line repeatedly to save people.
However, as controversial as it may sound, I think it’s important that we look at the positive effects Covid19 has had on the NHS. In primary care, which includes all initial consults with a GP, the 30–40 patients who come in daily has been reduced to about 1 or 2. The practice isn’t being overwhelmed during this time so the patients who come in all urgent ones who have severe signs or conditions that have to be looked at closely. Since there are fewer patients, they can have more consultation time which allows a greater rapport to be built and helps the doctor diagnose with more accuracy. The pandemic has also increased the prevalence of telemedicine within healthcare. Video and phone consults, sending in photos, etc. Everything is appointment based so usually before coming in, you would fill in a form with all your details and any signs you’re showing, and from there, the nurse or doctor will triage the patients so the more urgent ones will come in while the rest have online consults. Covid19 has expedited the transition of healthcare into a telemedicine-like format which could be extremely beneficial in taking the pressure of the NHS. Despite being deemed one of the best healthcare systems in the world, the NHS is notorious for its long waiting times and lack of beds and staff. There are also complaints about the short consultation times from patients so with more patients communicating through an online platform, this may help the patients who need more time allocated to them.
On the other hand, every positive comes a negative. There are limitations to even video consults and photos — a sign may not be identified that could be crucial to the diagnosis and things like body language are missed out when the doctor can’t physically see the patient come into the room and interact with them. Despite technology being universal, it is still not accessible to many groups of people — the elderly and those in lower socioeconomic groups are the main ones. This disadvantage may need to be compensated for with more home visits and frequent contact with identified groups that lack stable Wifi or devices. Some may dismiss signs and symptoms which could be leading up to a serious condition that will only deteriorate during the time not spent taking medication from the hospital. When these patients eventually do see the doctor, the condition will be a lot harder for the NHS to manage which may add more stress to the system overall.
With secondary and tertiary care, telemedicine may not be as applicable as in primary care so Covid19 may have had some positive impact on GPs in primary care but far worse effects on secondary and tertiary care.
There will always be negatives to every change and if we identify the weak spots of a new system (telemedicine in this case), we can combat them while transitioning to this change. Even though the NHS is forced to make this change due to the pandemic, advanced telemedicine has been a futuristic ideal for healthcare for quite some time and hopefully, the widespread effect of digital medicine will reach secondary and tertiary care too. So technically, the pandemic has sped up innovation in this digital medicine field and forced us to look at alternatives to make the NHS more effective thus paving the way for the future.
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