Covid-19 continues to dominate 2021

Like 2020-Global Dose horribilis (Latin for “Awesome Year”) – Covid-19 dominates 2021.

Hopefully this year will be easier to handle.

This new infection has been described as unpredictable, but it wasn’t.

For over a decade, political and healthcare leaders have warned of the need to prepare for a pandemic.

In 2005, former US President George W. Bush said: “A pandemic is a lot like a wildfire.

“If detected early, it can disappear with limited damage. If allowed to smolder undetected, it grows into an Inferno that spreads rapidly beyond our ability to control it. There is likely to be.”

He was thinking about a flu-like pandemic.

The World Health Organization (WHO) has reported nearly 20 years of emerging infectious diseases that “may have first appeared in the population or have existed for some time, but their incidence or geographic range is increasing rapidly.” I have warned you.

A list of priorities for diseases that require urgent research and development was published by the authorities in 2015.

They were Crimean-Congo hemorrhagic fever, Ebola and Marburg virus disease, Lassa fever, MERS (Middle East respiratory syndrome) and SARS (Severe acute respiratory syndrome), Nipa, Rift Valley fever, and disease X.

Disease X “represents the knowledge that a serious international epidemic can be caused by a pathogen that is not currently known to cause human disease.”

Roadmaps have been developed for each.

I I have written At the beginning of last year, “especially with the globalization of travel, there is a possibility that new infectious diseases will occur,” he said, keeping in mind diseases that have little effect on the country, such as Ebola hemorrhagic fever and SARS outbreaks. I left it.

But the Covid-19 pandemic removed the wind from my sails.

The controversial question is whether Covid-19 is Disease X itself, or a precursor to the more deadly form of Disease X coming this year.

Many scientists warn that more unknown viruses carry more than 50% (25% -90%) mortality of Ebola.

Towards 2021, many healthcare disciplines last year need attention again this year.

Other Covid-19 cases

The number of cases of Covid-19 continues to grow, with at least 3 to 4 out of 10 Malaysians at risk for serious illness.

Vulnerable are men, men over the age of 50, and one or more of hypertension, diabetes, heart disease, chronic kidney disease, asthma, obesity, and chronic lung disease.

Covid-19 affects vulnerable and deprived people disproportionately, with the Sabah case exemplifying the latter.

Immigrant workers are our Achilles heel.

It was about a quarter of the Covid-19 cases at the end of May last year.

However, their testing increased only in November.

As of December 27, 205,896 people were screened with a positive rate of 21%.

Consider the number of positives when all estimated 2 million workers are screened.

On January 1, all migrant workers were required to be screened.

However, overcrowding, one of the root causes of the epidemic of migrant workers, has not been adequately addressed by the delay in enforcing the Minimum Standards for Housing and Equipment Act (revised 2019).

The Institute for Health Metrics and Evaluation at the University of Washington in the United States has estimated 28,743 daily infections (including untested ones) and 3,547 by April 1 (2021) in Malaysia, based on the current Covid-19. Predicts death. scenario.

Pandemic control

Personal and shared responsibilities in managing Covid-19 remain, but new knowledge will change in 2021.

The former includes physical distance, use of face masks, frequent hand washing, crowds, confined spaces and avoidance of close contact.

The latter includes testing, contact tracing, quarantine / quarantine, treatment, vaccination, and appropriate messages.

More tests, treatments and vaccines will be available in 2021 to enable faster and more extensive tests, more effective treatment of positive cases and, hopefully, prevention of spread by vaccination. ..

Vaccines do not end the pandemic, as at least 60-70% of the population must be vaccinated.

Is this possible by the end of 2021?

Buying a vaccine is the easiest part. What is vaccine logistics and delivery, and preparation for mass vaccination?

Once vaccination is initiated, another risk of proliferation becomes a reality if the general public does not continue to adhere to their individual responsibilities as described above.

Non-Covid-19 disease

The incidence of non-communicable disease (NCD) will continue to increase with an increase in undiagnosed, uncontrolled numbers, as there is no coordinated effort to control it.

The· National healthy community builder (Cospen) The program launched by the Ministry of Health, Rural and Regional Development in 2014 to address this issue has not yet affected.

Last year, the quality of NCDs and care was postponed, and the impact will continue to be felt this year, increasing illness complications and putting pressure on the healthcare delivery system.

Other infectious diseases such as dengue fever, diphtheria and rabies will continue to suffer.

The adoption of technology tools such as online platforms to sell and deliver medicines means that healthcare is managed by the non-healthcare sector. — Bloomberg

Public trust and health policy

Public confidence in symptomatic medicine continues to decline, as evidenced by the purchase of traditional and complementary medicines that go beyond medicines.

Healthcare is increasingly being offered by non-medical departments using technical tools such as online purchase of medicines.

Budget allocations to the Ministry of Health do not guarantee improved patient safety and quality of care unless waste, inefficiencies and the role of intermediaries are significantly reduced.

As long as the ministry develops health policies without genuine consultation with stakeholders, success will be limited or lacking.

As evidenced by Congressional responses, PeKaB40 screening and adoption of the MySalam insurance scheme are unlikely to reach their goals.

If the Ministry of Health continues its current approach to Covid-19, its credibility will be increasingly questioned and then diminished, especially if cases and deaths continue.

Problems such as public discomfort due to the double standard in the implementation of SOP (Standard Operational Procedure). The ministry refused to share data with the state government and the general public. The province did not have a meaningful involvement with the private sector, universities and civil society. And lack of transparency, misleading decisions and messages, and threats must boil.

When the deficit of trust reaches a turning point, pressure on change cannot be stopped and anyone in government must be obliged.

Increased medical expenses

Health care costs will continue to increase due to the aging of the population, infectious diseases such as NCDs and Covid-19, new technologies, increasing demand for patients, and the unlimited role of intermediaries in healthcare.

Out-of-pocket spending will increase in both the private and public sectors.

More families will face financial ruin if they or their relatives suffer from a catastrophic illness such as cancer, heart attack, Covid-19, or become redundant.

Healthcare inflation will continue to rise unabated.

More general practitioner (GP) clinics, and even private hospitals, are closed primarily due to financial unsustainability.

Health care workers

Physician overproduction has not yet been properly addressed.

However, the general public is wise as it reduces the number of applications for private medical schools, leading to mergers, acquisitions and closures of some schools.

The absence of GP in high-dose Covid-19 vaccination results in increased vaccine degradation in the delivery process (which affects their efficacy and, in some cases, safety), as well as delays and limited success.

medical technology

New technologies such as smartphones, portable diagnostics, smart drug delivery mechanisms, digital therapies, genomic sequencing, machine learning and artificial intelligence will continue to impact healthcare.

The issues of patient confidentiality and security, patient safety, and the success and failure of new technologies continue to cause problems.

Technology should not be allowed to depersonalize healthcare.

New technology is just a tool. Whether they add or compromise humanitarian health care has to do with how and why it is used.

Discrimination and careful evaluation are essential, not technical vibrancy.

Responsible for your health

By staying healthy, health care is avoided.

You need a healthy diet, proper weight maintenance, regular exercise, good rest, safe sexual activity, avoidance of smoking, moderate drinking, and up-to-date vaccinations.

This requires effort, smart lifestyle choices, and occasional health checks.

Covid-19 can be avoided by adhering to the above personal responsibilities.

We wish all readers the health of 2021. Please ensure your safety.

Dr. Milton Lam is a former president of the Federation of Private Healthcare Professionals and the Malaysian Medical Association. For more information, please send an email to starhealth @ thestar.com.my. The expressed views do not represent the views of the organization to which the writer is associated. The information provided is for educational and communication purposes only and should not be construed as personal medical advice. The information published in this article is not intended to replace, replace, or reinforce your own consultation with a healthcare professional. Star We disclaim all liability for loss, property damage, or personal injury directly or indirectly incurred by our reliance on such information.