4 Critical Health Care Lessons Canada Must Learn From COVID-19

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This column is an opinion of Dr. Hance Clarke, director of pain services at the Toronto General Hospital (TGH), and Imran Abdool, president of Blue Krystal Technologies and Business Insights. For more information on the CBC Opinion section, please see the FAQ.

In the short term, we are fighting COVID-19, but the dust will eventually settle. It’s always like that. However, pandemics will recur. We have to win this battle and ensuring we win the wider war against pandemic preparedness.

For too long, health experts have warned of underfunding and a lack of resources in the sector. Unfortunately, these chickens have now returned home to roost.

A healthy population builds strong economies, but too often, these strong economies underinvest in their health sectors. Concrete example: After the 2007-2008 global financial crisis, Canada has become one of the strongest economies. Despite this enviable position, repeated calls for investment in health care and news clips from overcapacity hospitals have received only lukewarm response from policymakers.

Hallway medicine has become the accepted standard, as patients wait days in the emergency room for hospital beds. It was a warning sign that the Canadians had not heeded.

The current toolbox of government initiatives currently deployed to deal with a pandemic that is already underway is a bad solution for a system in difficulty. Given the lack of a vaccine or cure for COVID-19, the company is working to build ventilators and call on every doctor and healthcare worker to shore up the front lines – at best, a desperate reaction.

It is frustrating to know that Canada could have been much better prepared for this outbreak.

This is how the 450 respiratory therapists in New Brunswick are preparing to keep patients with COVID-19 alive with mechanical ventilators. 4:57

Prime Minister Trudeau recently paid tribute to Dr. Joe Fisher, professor in the department of anesthesiology and pain medicine at the Toronto General Hospital at the University Health Network (UHN), in his daily speech in Canada, for example. Dr. Fisher’s company, Thornhill Medical, has created a new portable, battery-powered, intensive care unit with a ventilator capable of monitoring vital signs. This is technology that should have been acquired long before we were in the middle of a pandemic.

However, investments in health care generated little interest in times of abundance. Instead of being able to seamlessly implement these devices during this huge increase in the need for intensive care ventilators, the coming months will be spent on efforts to build them as a potential dressing solution.

We have not learned from SARS and have not made the investments we should have in health care before the crisis begins. So we have to start collecting lessons learned during this stressful time again – otherwise they will soon be forgotten for the next pandemic.

First, research and development in health care is an area in which the Canadian government must invest as a routine policy. We cannot leave this task to for-profit companies only. Since the 1990s, for example, relatively few new radical drugs have hit the market – unlike the so-called “golden age” of antibiotics from 1940 to 1960 (which coincided with larger investments in public research in universities).

Second, the COVID-19 crisis demonstrated how easily the supply chain can be disrupted. But it’s not just the hoarding of toilet paper and grocery shortages, some prescription drugs already seem to be out of stock. Again, we have come to rely too much on for-profit companies to manage the drug supply.

For patients with chronic pain taking opioid medications, for example, various long-acting formulations are already out of stock without a clear indication of when they could be withdrawn. This shortage can have serious consequences, both physical and social – some patients may suffer in isolation as they face significant withdrawal from opioids, others may not be able to tolerate this distress and turn to illicit means to try to alleviate their distress.

As a result, we are concerned that Canada will experience a peak in opioid-related deaths during the current pandemic.

Preparations are underway across Canada for the worst-case scenario of the COVID-19 pandemic, including makeshift hospitals. 1:58

Third, we need to build advanced capacity in health care. When the economy is good, now is the time to invest in the growth and sustainability of our health care capacity – not cut or stagnate these budgets, which has been the path taken by the government these last years.

Finally, we must understand that, as our population ages, this requires a recalculation of the link between health and productivity. In addition to preparing for crises such as COVID-19, funding routine services such as joint and knee replacements must remain a priority to keep our citizens healthy and productive in the long term. This productivity is the basis of a strong economy.

Ultimately, ensuring that we are able to cope with surges such as COVID-19 must be balanced with a targeted annual approach to investing in healthcare that optimizes system dynamics and reduces downtime. ‘waiting. As patients see the necessary medical procedures delayed or canceled by hospitals right now, this means even more lost productivity which affects the economy, and for a full economic recovery after COVID-19, we will need labor at maximum capacity.

While COVID-19 is a tragedy, we must not let it become a double tragedy by repeating our mistakes. We need to learn, collect best practices as we go, and act on them.

The old phrase “don’t miss the forest for the trees” means that we have to keep our eyes on the big picture: a well-funded and managed health care system that can meet regular daily needs, as well as preparedness. to a pandemic for exceptional moments.


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