The novel coronavirus (COVID-19) outbreak will stretch healthcare systems as they seek to prevent and delay spread of the virus and, for those in the Northern Hemisphere, defer the peak from winter pressures. However given their inherent fragmentation this will not be easy. It is possible to draw pragmatic insights from those countries and territories in the main transmission complexes:
- Robust arrangements are needed to triage patients to the right setting of care.
- Mitigating the potential bottleneck of intensive care beds is critical and deferring elective and non-urgent procedures will be necessary.
- Mobilizing staff with specialist skills (such as respiratory medicine) and supplies – in an agile way is key – as has been demonstrated in Hubei Province in China.
- Limiting the exposure of at risk populations such as the elderly and those with pre existing conditions, as well as enabling more diagnosis and self-management at home will help reduce or delay spread.
- Capacity needs to be reorganized in an integrated fashion and systems need to respond promptly as the situation evolves, for example bringing healthcare professionals back from retirement or asking young trainees to take on more responsibility.
- Whole ‘ecosystems’ beyond healthcare – schools, local government, transport, social care and others will need to work together seamlessly as the impact ripples out.
- It is important to ensure consistency and coordination of messaging by different players in the system at national, regional and local levels. And these messages will need to be accurate, clear and regularly updated. Misinformation could have serious consequences – socially and economically.
- The challenges are accelerating adoption of many innovations across the globe – including greater use of digital channels – and new apps to enable the public to stay informed and mitigate misinformation. In China the internet hospital is being adopted sooner than anticipated and in Japan flexible working is being introduced which will ultimately support those with family responsibilities
- Whilst there will be cultural differences, for example self-containment for an average of 43 days was feasible in China but may not be everywhere – there is learning to be shared and international cooperation is generally working well. And happily for the benefit of wider society, working in healthcare is a calling, and professionals around the world will continue to go the extra mile to limit the impact and improve the outcomes from the infection.
Hilary Thomas is a former Professor of Oncology and became KPMG UK’s Chief Medical Adviser in 2014 when she moved into the Life Sciences practice, having joined the KPMG UK Healthcare team in 2009. She works at the interface between big pharma companies and healthcare.