Any ordinary day
Healthcare must continue in the face of the extraordinary
1 June 2020
Opinion by: Professor Jeffrey Braithwaite is Founding Director of the Australian Institute of Health Innovation at Macquarie University and President-Elect of the International Society for Quality in Health Care.
Where have all the people gone? There has been a huge drop in visits to GPs for the treatment of chronic diseases. Likewise, emergency departments have reported dramatically decreased numbers and pathology tests are down.
Recent reports out of the United States show childhood immunisations have nearly ground to a halt because health providers are overwhelmed by COVID-19 patients and people are shying away from seeking health services.
While social distancing is meant to protect us from COVID-19, there is another threat looming.
On any ordinary day, before COVID-19 became part of the lexicon, around half a million Australians visited the doctor, the hospital or rehabilitation facilities. This need – what’s called the burden of disease – doesn’t just go away because a pandemic is declared.
Clearly however people are choosing to delay or avoid seeking medical care. It is easy to sympathise. Would you go to your usual medical appointments and risk being close to other sick people? Will you even be able to get appointments and continue treatment plans unimpeded? Sometimes even the unknown can paralyse our actions.
We should also be aware of and ready to support the very real ongoing health, welfare and rehabilitation needs of people who are recovering from COVID-19. For many it will be a long road to recovery.
Telehealth is now available, so people don’t have to leave home for a medical consult, but not everyone – the medical profession and people at home - has the necessary technology nor the confidence to use it well.
We have learnt from earlier crises in other parts of the world the terrible consequences of disrupting good primary healthcare such as GP visits, maternity clinics and children’s immunisation programs. These are the foundations of good healthcare and must be protected.
If I had one request for our community it would be to maintain your usual healthcare regime as much as possible.
Some form of COVID-19 induced restrictions to movement are likely to continue for many months, so please nurture a relationship with your doctor, specialist, pharmacist and physiotherapist. Do not for instance neglect your asthma action plan or your rehabilitation exercises. And do recognise all health professionals are under pressure.
That’s the key to staying as healthy as possible.
While some of the logistics for delivering ‘ordinary’ healthcare may look different and evolve over the next six months, most services are still there to support you.
Childhood immunisation is a prime example of care that must continue uninterrupted. Not only do we need the vast majority of children to be immunised in order to protect the whole community from diseases like measles, timing is also important. The scheduling of vaccinations is based on careful research around considerations such as the likelihood of a child at a certain age to contract the disease, and how many doses are required to give full protection.
In Australia, 94% of one-year-olds receive their immunisations for meningococcal, measles, mumps, rubella and pneumococcal on time. While we are always striving to bring this figure closer to 100%, it is very good – but relies on families adhering to the schedule. Going to the GP or baby clinic.
With coronavirus fears, there is a genuine concern some people may feel they should stop or delay a visit to the doctor or hospital. That’s a behaviour change we just do not want to see.
Winter is here, so get your flu shot, too. Last year across Australia more than 300,000 people needed treatment for flu.
Getting the balance right between keeping people well, and not overwhelming the health system, is the very serious aim.
While our health system is far ahead of the countries in West Africa struck by the Ebola virus in 2014-2016, and of course we have—so far—flattened the COVID-19 curve, we should not be complacent. There are lessons to be learnt from Ebola.
Enormous effort was focused on combatting this terrible disease that killed more than 11,000 people. In the meantime, families were too frightened to visit their local hospitals and doctors. In Liberia, outpatient visits dropped by 60%, antenatal consultations dropped by 40% and measles vaccinations dropped by 45%. And yet something similar is happening now in America, one of the world’s richest countries.
While we don’t expect this degree of disruption in Australia, it is something to be aware of as people negotiate their way around the changing social distancing directives.
The Australian health system is well funded and has a professionally trained workforce however we have never faced anything like COVID-19—which is not going away despite our best efforts to reduce infections. We need to survive the extraordinary while also maintaining the ordinary. And wash your hands.
CENTRES RELATED TO THIS NEWS
Centre for Healthcare Resilience and Implementation Science
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Chrissy Clay, Research Outreach Coordinator on chrissy.clay@mq.edu.au
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