Public health experts have long warned of the likelihood of a high-impact acute respiratory pandemic. Even as China experienced a major crisis related to COVID-19 beginning in January 2020, other countries failed to use the time to adequately prepare. Now, with 225,237 cases and 9,276 deaths (as of March 19th), it is an emergency that will affect every single person on our planet.
As a health service provider in rural, remote areas of low- and middle-income countries (LMICs) in Asia, we have many reasons for concern, but also optimism. The robust containment measures taken by many governments across an entire country do appear to be having an effect. As draconian as some find it, I certainly support these firm and decisive measures to protect the health of millions. This is also the view of the WHO, who have praised China for their unparalleled containment strategy.
Health providers in high-income countries will struggle to cope with the onslaught of demand for care, but the major impact will be felt in low-income regions. We spoke with a major medical devices company yesterday – the wait list to get a respirator is now two years or more. Stock was allocated on a first come basis – there wasn’t a coordinated intergovernmental system to allocate resources equitably, and every country scrambled to protect their citizens. This will of course leave poorer countries behind. I don’t like to think that the profit maximisation incentive will prevail here, however the speed at which capital can be deployed means that that richer countries will get more essential devices and supplies.
Health systems in rural areas of poorer countries are not prepared for this. In the same way they are not prepared for many other killer diseases (ranging from diabetes, to hepatitis, to other respiratory diseases like COPD or asthma). Primary health infrastructure lacked funding long before COVID-19, struggling to treat the leading causes of morbidity and mortality. A new pandemic, albeit alarming, is no exception. While concerned by this crisis, I am equally concerned that when it inevitably subsides, people will still be dying from entirely preventable causes that the health systems are unable to support. The economic impact of those on day-wage labour will also be hit much harder than those living in the biggest economies in the world, with some form of social protection and deep government pockets to solve this crisis.
As I said though, there are a couple reasons that this crisis gives me optimism. I’m impressed with the unprecedented attention, coordination and resources that governments, agencies and the private sector are dedicating to efforts to contain and respond to COVID-19. It’s an indication that we have the collective willpower to address major health challenges head-on. Perhaps I’m being overly optimistic, but there will be an opportunity when COVID-19 recedes to refocus these awesome efforts on the continuing epidemic of diseases which cause millions of premature deaths in LMICs every year. The opportunity to accelerate systematic changes for future outbreaks by helping LMICs strengthen their primary health care systems, which is essential to disease surveillance and early warning systems, as well as the prevention and timely treatment of all health conditions. We must seize the opportunity.
I’m also incredibly encouraged by the current and potential role of digital solutions in responding to COVID-19. It’s essential that we adapt and act quickly through digital programs and services that protect these communities both from COVID-19 itself and the barriers it is creating to other essential health services. At reach52, this work includes rolling out COVID-19 focused chatbots and other digital services, helping ease the flow of non-critical cases away from busy health facilities and supporting isolated communities through the pandemic and beyond.
In the US, the federal government has responded with moves to spur a massive increase in telehealth access. In the Philippines, e-prescriptions are now temporarily allowed (e-mail, Messenger, Viber) for the most vulnerable during the current enhanced quarantine. Large multi-stakeholder initiatives, like COVIDcheck are also working to launch digital interventions to impact this issue from several different angles. I believe that many of these solutions and innovations will be here to stay, and long after the global community eradicates this virus.
At reach52, we’re accelerating our solutions to deliver both short term and longer-term goals, so we can ensure every community not only survives but thrives. If you’re interested in partnering to support the regions where we live and work during this seismic public health crisis, reach out to us. In the meantime, stay healthy and keep working hard to do your part.
Thank you for reading.