COVID-19

How it Reshaped the Healthcare Industry

As of 10 June, 213 countries and territories have reported over 7.4 million COVID-19 cases and 410,000 COVID-19-related deaths. Non-COVID-19 patients around the world have suffered as healthcare priorities have changed, supply chains have failed, and clinical trials have been suspended. Here we examine how COVID-19 has reshaped the healthcare industry, and how it can recover from this, and future pandemics.

Healthcare industries around the world have been challenged, from France and Italy – considered the world’s best – to less developed areas, such as China, Brazil and Iran. Hospitals in Wuhan were quickly overwhelmed due to a lack of medical resources and poor disaster control management, and many healthcare workers were infected. Temporary hospitals were built within weeks with capacity for the treatment of tens-of-thousands of COVID-19 patients, and over 40,000 medical professionals were sent to Wuhan. Despite this, a lack of resources and knowledge at the start of the outbreak led to a high mortality rate.

Other parts of China were proactive; they built resources and implemented contact tracing to successfully contain local outbreaks. Despite the warnings, albeit potentially delayed, many healthcare systems across the world were not prepared for the resulting pandemic, lacking timely and coordinated interventions to control transmission, and essential equipment. Hospitals and community care providers were forced to reorganise and scale up capacity in the midst of the crisis.

Italy and France had more patients requiring intensive care beds and ventilators than were available, and doctors were forced to make difficult decisions on who could receive treatment. Decentralisation, privatisation and underfunding of the Italian National Healthcare Service likely restricted a timely and coordinated response. Patients in Paris were sent for treatment in other regions of France, as well as Germany and Switzerland. In both countries, health services were overwhelmed.

Severe disruption to manufacturing and supply chains, combined with global competition and huge demand, has put acute strain on healthcare markets. Production lines were quickly repurposed to manufacture essential ventilators and protective equipment, and some European countries relaxed standards for urgently required goods. The imbalance of the industry was also exposed; whilst many countries experienced shortages, disadvantaged populations without the means to pay quickly faired worst.

The response to the outbreak was balanced against the continuity of essential services, including the management of emergency and chronic conditions, and vaccination programmes. Healthcare professionals continue to face disruption to patient management, with impaired supply of preferred therapies and a reluctance to switch patients’ medication without face-to-face consultation. Estimates of direct and indirect mortality in the coming years will reveal the true effect of the pandemic.

These challenges, as well as social distancing and limitations on travel, have also led to major disruption to clinical trials, with sites inaccessible, investigators unavailable, and enrolment suspended or delayed. The impact varies by therapy area, with trials in critical or life-threatening conditions, as well as drugs that extend life, typically prioritised. Risk/benefit assessments will have to consider fewer follow-up visits, COVID-19-related morbidity and mortality, and poorer physical and mental health.

The COVID-19 pandemic has highlighted the importance of the healthcare industry in the global economic infrastructure. Increased government funding and resiliency in supply chains will be required to better prepare the industry for future waves of COVID-19 or other infectious diseases. Such changes to the healthcare industry will impact the integrity of clinical trials and likely lead to delays in the launch of essential new drugs.

 

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