Hospital infrastructure and the post-Covid reality : Karan Thakur – ET HealthWorld
The Covid-19 pandemic has arguably been the biggest disrupter for human life in living memory. Never has a single event – political, economic, social or health related changed the paradigm for the entire human race as has the pandemic and the ensuing months. The pandemic was initially predicted to challenge the health system across the globe for 2020. However, as the events of 2021 have shown, the pandemic even in the face of hitherto unseen restrictive measures like lockdowns and standstill-ing of the economy and with a viable vaccine, continues its ebbs and flows across countries. The resilience of the human race has been met with a resilient virus that can mould and evade thereby causing insufferable hardships on citizens across borders.
While the challenges and the myriad crippling effects of Covid have been well documented, it is only but fair that we pause to analyze the health system created thus far and how it will fare in the post pandemic world. Different countries, economies and geographies have created varied models of health systems, each with its own distinct advantages and disadvantages. The advanced world has created state of the art infrastructure that kept its citizens in good health but at a staggering cost. Similarly, public systems helped provide equitable access to citizens but are stymied when they need to be delivered consistently and across larger populations. What is undeniable is that most systems faced an existential crisis during the waves of Covid-19. The challenges that these systems faced leads one to conclude that in the post covid world, all systems across the world will need to revamp and better prepare for eventualities like those attained actuality in 2020.
Covid-19 has often been characterized as a ‘pause’, however, more apt would be to see this a moment to reset. Health systems have been presented with a unique opportunity to reset the design, delivery and capabilities as they exist to a state that will help provide equitable treatment for all patients. To achieve this reset, multiple issues need to be addressed. First, the need to create dedicated infectious disease wards is the need of the hour. Covid-19 was not the first infectious virus to infect humans and it certainly will not be the last. Hence, the need to compulsorily create either dedicated or capable infrastructure that can be pressed into service in case of a disease outbreak in the future. Various models to create temporary wards that can be created within days have been successfully experimented with and offer another possible solution for capacity ramping of health infrastructure. Similarly, technologies that allow for the creation of negative and positive pressurization inside wards that can be activated on-the-go need to be deployed in all hospitals henceforth. This will ensure that existent infrastructure has the capability to manage infectious diseases as and when required in the future. Second, hospitals will need to re-look at self-sufficiency with the widest possible lens. Traditionally, hospitals have adequate contingencies and back-up for utilities and other vital infrastructure. The pandemic has shown that adequate buffers or capacity to self-generate medical oxygen, medical gases etc. need to be factored into the design of future hospitals. At the same time, the need for hospital infrastructure to ensure access to care for all patients irrespective of their disease status needs to be dwelled upon. The pandemic, while rightly focusing on managing patients of Covid-19 soon became a crisis of the non-covid. With reduced or no access to care, cancelled surgeries and treatments like chemotherapies and entire hospitals being converted for covid care – non-covid patients struggled during the wave peaks of the pandemic. Future health infrastructure will need to ensure that segregation – physical, operational and of process needs to be central to hospital design. This will help ensure adequate availability and access to health infrastructure for all patients.
Thirdly, the reality of lockdowns and hospital conversions for Covid only treatments highlighted the lack of adequate health facilities in the proximate areas of where people reside. Tales of community centers being converted for “ICU level care” or resident associations stocking on high end medications and medical oxygen all highlighted the lack of a localized approach towards health care delivery. Health infrastructure will need to get more localized and ingrained in the community milieu in order to adequately respond to the healthcare needs of local populations. Health centers that can offer continuity of care, especially for certain non-communicable diseases or conditions that require life-cycle management like hypertension, diabetes or dialysis care will need to be created at an urgent pace.
Fourthly, the use of technologies to improve access to care has been highlighted during the pandemic. It was heartening to witness that technologies like telemedicine, not novel to the current times, were finally adopted by doctors and patients alike. Similarly, use of new technology and digital platforms to offer a range of health services, condition tracking, electronic medical records etc. showcased the immense multiplier effect that technologies can have on the delivery of care. The use of the Cowin app for conducting the world’s largest vaccination drive has highlighted the agnostic nature of technology and how its use across social spectrums is possible.
Lastly, the country needs to create more healthcare workers. India lags in all health human resource parameters even when compared with its peer nations. The need to rapidly expand the teaching infrastructure while at the same time up-skill existing healthcare work force to build capabilities of emerging health challenges needs to be taken up on a war footing.
Covid-19 has extracted a terrible price from humanity with the disrupted lives, homes, societies, and nations. While we regroup, it is our moral imperative to learn from the lessons of the pandemic and tread on a path to create health infrastructure that can do justice for all its citizens.
Dr.Karan Thakur, Vice President- Operations & Communications, Indraprastha Apollo Hospitals, New Delhi
(DISCLAIMER: The views expressed are solely of the author and ETHealthworld.com does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly.)
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