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Sunday 12 July 2020

Healthcare will never be the same: 8 experts on the future of medicine around the globe

Source images: Lysenko Alexander / iStock; BiancaGrueneberg / iStock; OnstOn / iStock; asikkk / iStock; Mamba Azul / Stock



James Merlino, chief clinical transformation officer of the Cleveland Clinic

The old saying in crisis is “never let the opportunity go to waste.” We’ve learned a couple things. One is that this has reemphasized the importance of safety. We’re doing thermal screening for healthcare providers. We’re testing any patient who’s coming in for any surgery or ambulatory care. If they’re COVID-positive, we’ll delay their procedure unless it’s an emergency.

The second thing is we’re seeing technology innovations, such as virtual rounding done on an iPad and virtual [visits]. Before COVID hit, we were doing 3,000 virtual visits a month. In March, we did 60,000. Then there are small things, such as putting IV pumps and ventilators outside the door in our COVID ICU.

We have to learn how to live with COVID. Some hospitals may suffer. But I want to believe that this is going to make us deliver care more efficiently. We’ve been talking about social determinants and chronic health for a long time, but this is our opportunity to step in. COVID-19 preys on the elderly, on the socially disadvantaged. Going forward, we have to manage COVID-19 with more consistent care.


Nancy Lublin, CEO of Crisis Text Line, a nonprofit organization that provides free mental health texting services

If you were feeling things before, if you were struggling before, if you had an addiction or an eating disorder or anxiety or depression or a bad relationship, those things just became a lot harder. And even if you were perfect before, you are not perfect now.

53% of our texters before COVID were under the age of 17, and now the biggest age group we’re seeing is 18 to 34. Their lives have just been turned upside down. They were adulting, and now they’re home with their parents. Or they’re quarantined with roommates whom they didn’t really know that well, or sheltering alone, and that’s really hard. Or they have little children. Dating has been disrupted for the 18-to-34 age group — for everybody.

When COVID first hit America, we saw a massive influx in anxiety. They were using words like freaked out, panic, and it was mostly about symptoms. That shifted into what we consider the second wave of feeling: the impact of the quarantines. We’ve seen a 78% increase in domestic violence, a 44% increase in sexual abuse. We’ve seen a huge increase in financial stress, people worried about homelessness, or thinking about financial ruin.

Mental health and well-being should be part of our education. One of the most important things is how to communicate with people, how to disagree with people, how to have productive relationships. And yet we don’t learn any of this. Instead we learn calculus — which I still haven’t used.


Christos Christou, international president of Doctors Without Borders

Because of COVID, it is now extremely challenging to move our resources and our people to those places that need them. We’re not allowed to fly from Canada or Europe to Yemen, Tanzania, etc. And we are not allowed to export any material, because of nationalism, a very selfish approach by states, which are fighting against each other for supplies. They want to show that they can protect [their citizens]. They will ban any exportation of PPE and, in the event we get a new vaccine, they will make sure that they can stockpile it.

There are multiple crises within the COVID crisis. TB patients are not allowed to access any hospitals at the moment, and they need treatments every day. HIV patients, the same. We have war traumas. Some of the facilities have been repurposed, so it’s not easy for us to run surgeries. Malaria kills millions of people. We have the treatments, but [they’ve] been affected a little bit because of all these debates about the chloroquine. We [also] have a rapid test for malaria. [But] the company that is producing this test has decided now that there’s much more profit by repurposing it into a rapid test for COVID.

WE HAVE TO RETHINK HEALTH SYSTEMS. IT’S OBVIOUS THAT ONLY PUBLIC HEALTH SYSTEMS AND NATIONAL HEALTH SYSTEMS ARE GOING TO PROVIDE THE SOLUTION.”
- CHRISTOS CHRISTOU, DOCTORS WITHOUT BORDERS

I’m afraid for those places we cannot access. In Northwest Syria, [after] Idlib was bombed [in February], people were in desperate need of food, accommodation, and health services. All of a sudden, with COVID, everyone forgot about this situation. But this doesn’t mean that their problems evaporated. Yemen is another place. In the past few days we have confirmed that there’s a local transmission of COVID, and there’s zero capacity. I’m not talking about ventilators or ICU beds. They don’t even have the test, the diagnostic. This is one of my nightmares.


Source: Ruth Reader and Ainsley Harris | Fast Company

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