Tuesday, Aug 03

Fitness In A Pandemic: Shedding Off Dead Weight And Staying Healthy

Pre-pandemic were certainly days we totally revelled in and considered a routine as we heartily hugged family and friends, walked freely and comfortably sat close to people without any apprehension of an ominous germ creeping through their bodies and incapacitating them almost to the point of death. This was the norm until the unruly invasion of the SARS-COV-2 (COVID-19) virus which brought the world to a standstill without a prior notice.

More than just bringing health to our stark consciousness, it unveiled also certain habits which may likely predispose persons to some health risks when one does not maintain a physically active lifestyle. By now, it is no brainer that COVID-19 is spread by droplet transmission which enters the body as a new host through the mouth, nose or eyes. Palliative measures of social distancing and handwashing were globally recommended to avert the infection. The imposed lockdown, which resulted in the closure of business activities, public places, fitness and activity centres and consequently altering the social life of people unarguably hampered many aspects of lives. For the people religiously resolute in routine fitness activities, they have had to find innovative ways of staying healthy and safe at the same time. That notwithstanding, the impact of the pandemic has been massive, making health and fitness and immune booster to put up a fight against the dreaded virus, a challenge.

Candidly, the primary devastation of the pandemic is to our health. And our health predominantly serves as a building block for our lives, organizes and charts the path to its fulfilment as well. It has brought to the fore the significance of having and living a healthy lifestyle, which when progressively inculcated as habits, will transform the overall state of mind and health of its attendants.

For all– young and old, regular physical activity remains an important strategy for staying healthy. Compared to being sedentary, moderate-intensity physical activity is associated with better immune function. Likewise, regular physical activity is associated with lower levels of anxiety and perceived stress which many are feeling in the wake of the COVID-19 pandemic.

Hedging One’s Bet By Boosting Immunity

Improving one’s diet has somewhat become a conscionable thing to do in COVID times. The food you eat plays a key aspect in determining your overall health and immunity. Eating low carb diets will help control high blood sugar and pressure. Also a low carb diet will help slow down diabetes and a focus on a protein-rich diet will keep one in good shape. Regular consumption of vegetables and fruits rich in Beta carotene, Ascorbic acid & other essential vitamins are also vital. Certain foods like mushrooms, tomato, bell pepper and green vegetables like broccoli, spinach are also good options to build resilience in the body against infections.

Emphasizing the need for an immune system, the President of Ghana, Nana Akufo-Addo in his 11th COVID-19 update address to the nation, urged Ghanaians to continue adopting a healthy lifestyle, particularly good eating habits to boost their immune systems as the fight against the pandemic continues. The President advisedly noted that, citizens must consume foods that contain Vitamins A, B6, C and E to strengthen their immune systems.

We must keep fit, and we must continue to eat our local foods to boost our immune systems. This is how we can prevent our healthcare services and our heroic healthcare workers from being overwhelmed, due to an increase in demand for hospital care.

To this end, he recommended foods such as ‘kontomire’, oranges, ‘dawadawa’, millet, cashew nut, crabs, plantain, okro, brown rice and mushrooms.

Fortunately, all these foods can be found in Ghana. So, patronizing these foods, ensuring our personal hygiene and improving our lifestyle habits, should become part and parcel of our daily routines.

In times upended by COVID-19, it seems as if our immune systems have received more attention than ever before. Many unhealthy behaviours, brought on by the pandemic as a result of working remotely, make it harder for our bodies to fight off infections. But to remain alive and well, the first line of defence is a healthy lifestyle. The novel nature and lack of immunity against the coronavirus has prompted a worldwide pursuit of effective treatments for COVID-19. That includes repurposing drugs with known safety profiles, including Vitamin C, an established immune system booster and antioxidant, which make it a logical choice to explore in COVID-19. This strategy is needed in response to infection with the novel coronavirus to ensure a strong immune response to stop the virus from replicating in the body, and to avoid the over-the-top, destructive immune response the virus itself can generate, if it does.

Ridding Excess Weight Via Fitness Integration

Days into the lock down in Ghana, following government’s advice to all Ghanaians to consider eating locally produced foods and exercise regularly which was in tandem with the World Health Organisation recommendations, people also began to engage in 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity per week as the lack of it could result in consequences for the immune system. Interestingly, COVID-19 did not only have positive impacts on Ghanaians to exercise, but it also disrupted the lives of many who had regular sporty and physical activity.

Ghana was part of the many countries worldwide that cancelled and put on hold all sporting activities like football, volley, weight lifting, and more when restrictions were imposed. Many jobs were at risk, and that included gym trainers. The closure of gyms and fitness clubs, physiotherapy centres, and playgrounds was costing the people who had made it routine to stay fit. The pandemic pretty much has made people who were constantly and actively on the go to work and other engagement with other activities sitting ducks.

The lockdown and the eventual easing of restriction has never brought things to normalcy as some shops, restaurants and organisations remain closed with staff having to work remotely. Others have had to take their products and services online now to stay safe. What this means is that, people who hitherto raced the clock to work via various mode of commute will now have to loiter in an unnervingly small space and spend insane hours behind the desk. The regimen will be something like from bed to the kitchen, from the kitchen to the desk with sporadic breaks and couch intervals. This monotony in work schedule is bound to have a toll on the health of a person when the eating habits and menu are mostly greasy with less greens. When this happens, developing manhandles will be the least of your worries as calories build up in your system due to your current sedentary lifestyle. People who eat a well-balanced diet tend to be healthier with stronger immune systems and lower risk of chronic illnesses and infectious diseases.

Essence Of staying healthy

For the greater part of our day and lives, we spend it within the confines of our work environment although the scale has slightly tipped due to the pandemic, with some employees working from home. Many of those at risk from COVID-19, including individuals who are older and persons with comorbidities in the form of chronic medical conditions like osteoarthritis, hypertension and diabetes, tend to have lower levels of vitamin C, another reason vitamin C therapy would be considered a reasonable treatment of the virus. Experts also note that patients may develop a vitamin C deficiency over the course of their COVID-19 illness since, during an active infection, vitamin C is consumed at a more rapid rate. Insufficient levels can augment the damage done by an overzealous immune response. When push comes to shove, ensuring that one lives in absolute care for health is one which cannot be overemphasized.

woman doing yoga exercise at home royalty free image 1610056018 Therefore, ensuring fitness through healthy practices must be more than spot in one’s survival undertaking, it must be a lifestyle. The gyms may not be opened, however, there are lots of safe alternatives to getting physical activity without going against the preventive best practices recommended by the Control for Disease Center like social distancing and avoiding large crowds. Aerobics can be done successfully at home.

Another important point to consider is that avoiding crowds does not mean avoiding nature. Going for a brisk walk or jogging outside in uncrowded areas– outdoors, is still considered relatively safe. Push-ups, sit-ups, jumping-jacks and more exercises are great ways to stay fit away from the gym. For all intents and purposes, when the COVID-19 pandemic becomes simply a blot in the history of the world, one thing will certainly remain which is a more conscious regard for our health.

 

The ‘Luxury’ Of Mental Health In The Face Of A Pandemic

The ‘Luxury’ Of Mental Health In The Face Of A Pandemic

Implosion- In steering the path of our lives, we would have to fight more than one battle. But when the battles we encounter is as a result of an inward turmoil being reflected by an exterior occurrence, then there is the tendency for a tug-of-war to ensue on the inside. This undoubtedly disrupts the outward existence of man and his environment.

Since January 2020 that the World Health Organization (WHO) declared the outbreak of the COVID-19 pandemic to be a Public Health Emergency of International Concern, the WHO has been working round the clock to diffuse the ticking viral bomb. Also, since its characterization as a pandemic by the WHO, Public Health Authorities around the globe have been working tirelessly to contain the COVID-19 outbreak.

As fate would have it, with each stitch came a much bigger tear and more like putting a new wine into an old wine skin, the virus burst forth at its seams spreading ‘pollen’ of fear, dismay and destruction in every nook and cranny of the world. This time round, the crisis is generating stress throughout the world’s population as economies are currently in limbo.

According to a survey conducted by the World Health Organization, the COVID-19 pandemic has disrupted and halted critical mental health services in 93% of countries worldwide while the demand for mental health is increasing. The survey of 130 countries provides the first global data showing the devastating impact of COVID-19 on access to mental health services and underscores the urgent need for increased funding.

MENTAL HEALTH, A LUXURY GOOD

Shockingly, ultimate peace of mind has become a luxury as the pandemic drives a tent peg of despondency in the temple of most people. Peace of mind should never be an unaffordable commodity to be traded to the highest bidder, which in this case is COVID-19. Interestingly, Mental health is one of the most neglected areas of health globally. This was true before COVID-19; however, the pandemic has further aggravated the status of mental health.

According to WHO, there are several reasons why mental health has been ignored. The first one is an associated stigma. The second is a perception of mental health disorders as a “luxury good”, as opposed to actual illnesses. The additional top reasons include a fragmented and outdated service model. Some of these include the provision of mental health services mainly in psychiatric hospitals, severe lack of preventative mental health service; lagging policy changes and also a shortage of human resources. The pandemic has further heightened an already precarious situation as most mental health services are mere ‘house of cards’ which are bound to fall apart at the persistent huff and puff of the pandemic, thereby increasing demand for mental health services. Without a shred of doubt, consistent bereavement as a result of deaths occasioned by the pandemic, isolation due to lockdown, loss of income and fear are triggering mental health conditions or exacerbating existing ones. The consequential effects of such harrowing plights encountered on a global scale are that people may be facing increased levels of alcohol and drug use, insomnia, and anxiety. Meanwhile, COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke. Sadly, people with pre-existing mental, neurological or substance use disorders are also more vulnerable to SARS-CoV-2 infection– they may stand a higher risk of severe outcomes and even death.

SUTURING THE WOUNDS OF THE PANDEMIC

Without a shred of doubt, COVID-19 has the seeds of a major mental health crisis. Early reporting from Ireland shows a tenfold increase in the number of people seeking online counselling. This has snowballed into some people showing high degrees of psychological distress, such as healthcare workers, older adults, people with pre-existing conditions, children, those in precarious domestic situations, and fragile humanitarian and conflict settings. Together, these groups make up maybe most of humanity; these are our friends, family, neighbours, they’re us. Most of the discussion about addressing COVID-19-related mental health problems is focused on what we can do as individuals. The World Health Organization has published a helpful document. WHO has issued guidance to countries on how to maintain essential services including mental health services during COVID-19 and recommends that countries allocate resources to mental health as an integral component of their response and recovery plans. The Organization also urges countries to monitor changes and disruptions in services so that they can address them as required.

Although 89% of countries reported in the survey that mental health and psychosocial support is part of their national COVID-19 response plans, only 17% of these countries have full additional funding for covering these activities. This all highlights the need for more money for mental health. As the pandemic continues, even greater demand will be placed on national and international mental health programmes that have suffered from years of chronic underfunding. Spending 2% of national health budgets on mental health is not enough. International funders also need to do more: mental health still receives less than 1% of international aid earmarked for health.

Those who do invest in mental health will reap rewards. Pre-COVID-19 estimates reveal that nearly US$ 1 trillion in economic productivity is lost annually from depression and anxiety alone. However, studies show that every US$ 1 spent on evidence-based care for depression and anxiety returns US$5.

A new World Health Organization survey shows that critical funding gaps are halting and disrupting crucial mental health services in Africa, as demand for these services rise amid the COVID-19 pandemic. That notwithstanding, the WHO is doing everything possible to move discussions on mental health to the forefront of what matters most in the ongoing pandemic disruptions.

BEATING THE CLOCK OF COVID-19

The Director-General of the World Health Organization, Dr Tedros Adhanom Ghebreyesus, once opined that “Good mental health is absolutely fundamental to overall health and well-being. COVID-19 has interrupted essential mental health services around the world just when they’re needed most. World leaders must move fast and decisively to invest more in life-saving mental health programmes – during the pandemic and beyond.”

Per reports gathered from the WHO from their survey of 28 African countries which was undertaken as part of the first global examination of the devastating impact of COVID-19 on access to mental health services, it underscores the urgent need for increased funding. Of the countries responding in the African region, 37% reported that their COVID-19 mental health response plans are partially funded and a further 37% reported having no funds at all. This comes as the COVID-19 pandemic increases demand for mental health services.

The Regional Director for Africa from the WHO, Dr Matshidiso Moeti, revealed that “Isolation, loss of income, the deaths of loved ones and a barrage of information on the dangers of this new virus can stir up stress levels and trigger mental health conditions or exacerbate existing ones. The COVID-19 pandemic has shown, more than ever, how mental health is vital to health and well-being and must be an essential part of health services during outbreaks and emergencies.”

The survey further revealed that African countries account for 15 out of the top 30 countries globally for suicide per 100 000 people. While there is scant data on how COVID-19 is increasing mental health conditions on the African continent, one study in South Africa found that 10–20% of the 220 people surveyed reported potent experiences of anxiety and fear as a result of the pandemic. Another survey of 12,000 women in low-income communities in Uganda and Zambia found an increase in persistent stress, anxiety and depression.

The WHO assessment of mental health services took place in July and August 2020 and 27 of the 28 African nations which responded have included mental health in their COVID-19 response plans, underscoring the growing recognition of the importance of this once neglected area of health.

Dr. Moeti revealed that with increasing pressure on health systems and rising demand, stretched and chronically underfunded mental health services are under increasing strain.

“While at the global level, up to 70% of countries have responded to the challenges posed by COVID-19 with telemedicine, in Africa, governments have set up counselling helplines and increased training for key health responders in basic psychosocial skills. Even before the pandemic, the region had one of the lowest mental health public expenditure rates, at less than US$ 10 cents per capita”.

COVID-19 is adding to a long-simmering mental health care crisis in Africa. Leaders must urgently invest in life-saving mental health care services. “We also need more action to provide better mental health information and education, to boost and expand services, and to enhance social and financial protection for people with mental disorders, including laws to ensure human rights for everyone.”

Weighing the odds: Pfizer and Moderna creates “a Lamborghini when what most countries really need is a Toyota”

Weighing the odds: Pfizer and Moderna creates “a Lamborghini when what most countries really need is a Toyota”

With the entrance of the novel coronavirus (SARS-CoV-2) in late 2019 and its subsequent spread around the globe, concerted efforts have been made to mobilize and initiate the development of a vaccine for COVID-19. Invariably throngs of individuals and institutions in academia, biotechnology, government, and pharmaceuticals embarked on one of the most consequential scientific endeavors in living memory. Innovators, indeed, dashed to develop inoculations against the novel coronavirus. Vaccine developers equally went straight down to work, cooking up a storm in their laboratories in high anticipation of coming up with a winning panacea to the coronavirus.

Sitting on the edge of their seat like expectant ‘fathers-to-be’ in the waiting room, government officials frantically paced, belting out timelines for potential emergency use of vaccine candidates between the fourth quarter of 2020 and the first quarter of 2021. Just like the apprehension which characterizes childbirth, governments, especially in countries where they have experienced breakthroughs in their vaccine production are beaming with smiles of victory.

As it stands, it is quite easy for nations to be a tad apprehensive about mass distribution and vaccination of citizens despite 90% effectiveness of vaccines assured. Nonetheless, Britain has taken the lead in the relay match, followed closely by Russia and Bahrain in vaccinating citizens against the COVID-19 virus.

 THE PRICE OF A LIFE

The pandemic has auctioned lives to the highest bidder; economy. A study, published in the journal Environmental and Resource Economics revealed that, the price the UK government was prepared to pay to save lives during the COVID-19 pandemic was far lower than in many other developed nations. In a cross-country comparison across nine nations - Belgium, the US, Germany, Korea, Italy, Denmark, China, New Zealand and the UK - researchers used epidemiological modelling to calculate how many lives were lost through delaying lockdown, estimating that a UK lockdown date just three days earlier would have saved 20,000 lives.

It further linked those policy decisions to the financial cost lockdown had on GDP, resulting in a 'price of life' estimate- the amount of money governments were willing to pay to protect their citizens' lives, reflected in the economic activity sacrificed. The price of life in the UK was among the lowest at around $100,000, and lower still once under-reporting of COVID-19 deaths is accounted for. In contrast countries that were quicker to go into lockdown, such as Germany, New Zealand and South Korea, put a price on life in excess of $1million.

"Price of life estimates are of critical importance given that government intervention has the ability to save life, yet trades off against other goods," said lead author Ben Balmford, from the University of Exeter Business School. “Comparing across countries those who pursued an early lockdown strategy reveal themselves to be willing to pay a high price to save their citizen's lives, only rejecting prices above $1m. However, some countries, those which imposed lockdown relatively late-on in their respective pandemics, were clearly only willing to pay far less."

The breakthrough vaccine development with the introduction of Moderna and Pfizer Covid-19 vaccines demonstrated efficacy in more than 90 percent of phase 3 trial participants. Regrettably, the disparity which is likely to be generated by the distribution and inoculation of people globally is that only a very small fraction of the global population will be able to reap the rewards of this achievement.

Forbes asserts that, to remain stable, the Pfizer vaccine must be stored in specialized freezers kept at an ultra-low temperature of negative 94 degrees Fahrenheit. Such storage units are manufactured at a select few “freezer farms” and priced at $10,000 to $15,000 apiece.  While the Moderna vaccine doesn’t demand as deep a freeze—the requisite negative 4 degrees Fahrenheit is comparable to a standard home freezer—both must be administered in two doses a month apart, a logistical hurdle not uncommon but certainly not ideal in a quest for worldwide inoculation.

“Even hospitals in the United States and Europe, where governments have already bought up hundreds of millions of doses of the mRNA vaccines, will be hard-pressed to secure the equipment necessary for their safe storage and transport— especially those in small towns and rural areas where many residents, due to adverse socioeconomic and health conditions, are disproportionately vulnerable to Covid-19.

“The same is true of remote regions in Africa, Latin America, and Asia. Airlangga Hartarto, head of the Covid-19 task force in Indonesia, told Reuters that in his country, the Pfizer vaccine has already been ruled out as a viable option— so unlikely is it to survive distribution between 270 million people across 17,000-plus islands.”

Pfizer and Moderna, according to Forbes “have created a Lamborghini when what most countries really need is a Toyota—a vaccine that can be manufactured, stored, and administered simply and cheaply, preferably via existing distribution channels”. Luckily, such alternatives exist. “One is the adenovirus vaccine being developed by companies like AstraZeneca and Johnson & Johnson, which uses a nonlethal cold-causing viral vector as its means of inoculation, rather than synthetic proteins as mRNA vaccines do. Adenovirus vaccines are, however, hampered by one deep and fundamental flaw. Recipients would risk developing immunity not just to Covid-19, but the vector itself, meaning after initial rounds of rollout, another candidate might have to be developed from scratch. The AstraZeneca vaccine and others of its ilk can be thought of as Mercedes—not as high-maintenance as a Lamborghini, but certainly not as practical as a Toyota”.

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“With such metaphoric comparisons, “chances are high that vaccination against Covid-19 won’t be a one-and-done affair, but an annual or even biannual reoccurrence like the seasonal flu shot. Alternatives to mRNA vaccines that are more logistically feasible and cost-effective for all won’t be available quite as immediately, but have a far greater chance of reaching more people in need when they do hit the shelves. Two to three months is my best guess, at which point we’ll have a better idea of which populations the Pfizer and Moderna vaccines cannot penetrate. In a pandemic, no country is an island— a lesson China is learning on a weekly basis as new infections arrive in one form or another from overseas. A vaccine all but exclusive to urban, high-income countries won’t cut it. The more pragmatic solution is a vaccine viable and affordable to all”.

 

 ENSURING EQUAL DISTRIBUTION OF VACCINES

With more than 1.5 million lives lost to COVID-19, world leaders in General Assembly demand urgent action to guarantee equitable distribution of life-saving vaccines. Emmanuel Macron, President of France, proposed a donation mechanism to ensure that a portion of the first vaccines doses are used to vaccinate priority groups in developing countries.  Those doses, whether they come from Europe, China, the Russian Federation or the United States, or whether they result from donations from States or pharmaceutical companies would be allocated effectively and fairly, based on WHO recommendations.  He stressed, however, that vaccines will not be enough.  Unless primary health systems are strengthened in the most vulnerable countries, and unless health workers everywhere are trained, the overall health response will remain suboptimal. Echoing the French President’s sentiments, Justin Trudeau, Prime Minister of Canada, called on Member States to unite in pursuing global efforts ensuring full, equitable access to a potential vaccine.  “The pandemic has taught us difficult lessons about inequality both at home and between countries,” he said, noting that advanced economies have spent 20 per cent of their GDP to support their citizens during the pandemic, while developing economies can only afford to spend 8 per cent.

Developing countries have been tipped to lose out on the race in winning an equal bid in the distribution of vaccines, as whoever can pay the most at the earliest stage of production gets to the front of the queue. For those who cannot secure their tranche of the vaccines, they are found smartly capitalizing on their resources to gain the inoculation batches. Some middle-income countries with manufacturing capacity have also been able to negotiate large purchase agreements as part of manufacturing deals. While other countries with the infrastructure to host clinical trials such as Brazil and Mexico have been able to use that as leverage in procuring future vaccines. Oxfam International asserts that, one of the leading vaccine candidates, developed by Moderna, has received $2.48 billion in committed taxpayer’s money. Despite this, the company has said it intends to make a profit from its vaccine and has sold the options for all of its supply to rich nations at prices that range from $12-16 per dose in the US to around $35 per dose for other countries putting protection out of reach for many people living in poverty. While it may be making real efforts to scale up supply, according to reports, the company only has the capacity in place to produce enough for 475 million people, or 6 percent of the world’s population.

Oxfam and other organizations across the world have called for a People’s Vaccine; one available to everyone, free of charge and distributed fairly based on need. This will only be possible if pharmaceutical corporations allow vaccines to be produced as widely as possible by freely sharing their knowledge free of patents, instead of protecting their monopolies and selling to the highest bidder. With bated breath, one can only hope of a total success of vaccination program rolled out without complexities and complications being an albatross, thereby complicating an already fragile and precarious situation; a cure for all and not just some privileged lot.

COVID-19 Accelerates Digitized Health System

The world on December 31, 2019 began a war not against humans, ideologies or aliens but against a minute virus that can never be seen with the eye. A war not fought by soldiers, words or machines but by frontline health professionals.

In a war where saliva is deadlier than a bullet, and all participating are armed with facemasks, reinforced with sanitizers and secured with constant handwashing. This type of war, the biological warfare, is unlike the warfare usually experienced where blood, smoke and shattered buildings characterize the battlefields.

Though this warfare has seen some blood spill, the common trait found when comparing World War II to COVID-19 is the aftermath; change from the normal to a new normal.

According to McKinsey, after World War II “there was no postwar miracle; the actions that forged recovery were all human made. Good policies, political commitment, and hard work made it happen. The same will have to be the case in recovering from the coronavirus crisis. Not the same policies, of course—the conditions are too different.”

However, with the coronavirus war, the dictate of recovery would be digital which has already started taking form. At the initial stages of the outbreak, most countries placed restrictions on movement where people stayed indoors all day and businesses stopped operating except those that engaged in delivery of essential products and services.

While the virus was declared a pandemic, activities and interactions were boosted online as it was revealed that the virus spreads through physical proximity. Almost all transactions were moved to electronic platforms for fear of getting too close with another whom you may not know may be infected and also to prevent touching cash as notes and coins were likewise said to be carriers of droplets that could possibly carry the virus.

Shopping for the littlest thing including groceries moved to online platforms which increased delivery services. Education was moved online as it is nearly impossible to prevent students from touching, hugging or speaking to one other.

In the world of health, the fear of having to go to the hospital without the virus and getting infected at the hospital deterred people from visiting in person. The stigma of being looked at from the corner of the eye at the hospital for reporting symptoms like headache, cough and running nose led to the preference of online consultations with doctors.

The thought of getting infected by carriers of the virus caused health professionals to equip themselves with digital knowledge to reduce the number of people who visited the hospital except it was a dire situation.

Since the pandemic era, suggestions are the health system will never revert to its position of the pre-COVID, literally and figuratively, neither will it remain where it is now as the system is rapidly evolving. Prior to COVID-19, telehealth and home care were niche areas that had not yet reached its potential but were gradually taking shape. However, the advent of the novel coronavirus came along with a new dawn for the face of telehealth. Now, telehealth is undoubtedly the initial point-of-care for many non-emergent issues.

The rising need for Telehealth/ Telemedicine

The use of telehealth has been growing in the past few years, though more slowly than expected but they say, out of every crisis arises a new opportunity. Telehealth is said to be the distribution of health-related services and information via electronic information and telecommunication technologies. This allows long-distant patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. These platforms also enable families of patients to speak with their loved ones in acute care. 

For Telehealth, this may be an opportunity whose time has finally come. The volumes of telehealth consults have gone up in several multiples since the pandemic struck.  John Kravitz of Geisinger Health has seen a 500% increase in telehealth visits within the first couple of weeks since the outbreak. In anticipation, Geisinger has trained over 1000 providers (and counting) on conducting telehealth visits with patients.

According to reports, Geisinger before Covid-19, had an average of about 40 telehealth visits per day but following the crisis, has an average of 4,000 to 5,000 telehealth visits daily.

Factors inhibiting slower adoption

On a global scale, two factors inhibit the wide adoption of telehealth. They include: reimbursement constraints and patient and provider reluctance.

Telehealth is hardly an explored category due to the significant risks of reimbursement. According to the American College of Physician (ACP) Telehealth Survey 2020, about 24 percent of ACP members are utilizing e-consults on a regular basis. This is because medical communities as well as technologies are beginning to think of telehealth as one of the cost-efficient alternatives over conventional health care.

However, health practitioners are slow to adopt because of the following reimbursement risks: documentation risk; where the details of the consultation are not recorded, misdiagnosis; where an illness is mistaken for another and wrong treatment as well as prescription is given, training and infrastructure development; where this is likely to cost a fortune and lastly, payment and compliance regulation; where there is no constructive equipment to enforce payment by patients.

With patient and provider reluctance; patients’ perception of telehealth had been ‘this provider must not think my problem is not important since they are seeing me via telehealth’ but following the pandemic, the perception is gradually moving to ‘this provider cares about me and therefore is seeing me via telehealth’. Whereas service providers’ perception used to be ‘this person would have gone to the hospital if ill’ but now it’s ‘this person needs immediate response’. 

Difficulties in the use of Telehealth

For telehealth or telemedicine, there are three striking challenges that affects its usage. These include: discontinuity in patient relationships, cybersecurity risks and slow service delivery due to logjam online.

A recent report by McKinsey says, “when patients resume care, they may be more likely to seek it at health systems that have demonstrated safe operations in their ability to treat patients while COVID-19 remains present”. This is based on a recent “Consumer Healthcare Insights survey” which showed that, active communications and evidence of implementation of infection control measures (for example, mask requirements, physical distancing, sanitization) were the most commonly cited reasons which prompted patients to schedule care. It concluded that “the rapid adoption of virtual channels has created a crack in patient relationships and most likely to break it when telemedicine is fully accepted.”

Following the outbreak, most businesses, health inclusive, moved most of their operations online. This heightened the advantage of cybercriminals to swoop the vulnerabilities of online platforms. The World Health Organization, The Dept. of Health and Human Services of the United States and several state and local agencies have become targets. Meanwhile, health systems that have seen a doubling of their remote workforce have had to enable staff with Virtual desktop interfaces (VDI) and connectivity devices to connect to enterprise IT systems seamlessly with minimal data flow between devices in and outside firewalls. 

However, despite strong endpoint security, this large-scale shift to a virtual workforce also exposes new vulnerabilities waiting to be exploited.

In previous conversation, it has been established that people hopped on the wagon as health systems transitioned online. This led to an increase in visitors on health websites or in chat boxes. While most health systems such as Geisinger seem to have successfully scaled up their telehealth operations to meet up the demand, some have seen a rise in wait times that have negated the premise of “on-demand” care through virtual health tools. On the platforms of the health systems that are slow to adapt to the new normal, their service delivery is at a slower pace since their platforms are thronged.

Comprehensive growth plan for health systems

In a recent report sighted by The Vaultz from McKinsey, it indicated that should health systems apply the strategies used by businesses to recover from the 2008/09 financial crisis, it could be a comprehensive growth plan for health systems to adapt to the changing local market conditions post-COVID-19, while still aligning to future growth aspirations.

In the report, three steps were suggested: creating a growth transformation team, defining the approach, and building execution discipline and muscle memory to deliver the growth program effectively. 

Focusing exclusively on executing the transformation means establishing a dedicated, central team that articulates aspirations, defines the direction of the organization, coordinates activities, and measures success. Health systems may wish to consider establishing a team strictly focused on the strategic action plan around growth. This growth transformation team would likely require appropriate strategic, operational, and clinical representation to set organizational aspirations, make decisions on opportunities, and execute quickly. Stakeholders may seek a deeper understanding of the health system’s existing capabilities and sources of vulnerability.

With defining the approach, health systems should assess a comprehensive set of levers and choose the right multi-lever approach. Noting the levers as expanding scope of service, proactively shifting where care is delivered and expanding the continuum of care; investing in digital capabilities to ensure new patients can be seen and existing patients have appropriate continuity of care; and considering strategically aligned acquisitions.

The third recommendation is that health workforce should consider building the execution discipline plan among the core growth response team given the stress that they go through.

According to the report, health systems are assured of continued access to quality care across patient populations and growth if they consider a disciplined approach that is: grounded in a shared aspiration and a data-backed understanding of the starting point; characterized by a diverse set of initiatives that take into account market uncertainties and adapted to the local competitive environment; and implemented with rigorous performance management to ensure that timelines and metrics are met, and that tactics are modified as the ‘next normal’ comes into sharper focus. 

DANGER LOOMS AS COVID-19 SUSPENDS VACCINATION PROGRAMS ACROSS THE GLOBE

DANGER LOOMS AS COVID-19 SUSPENDS VACCINATION PROGRAMS ACROSS THE GLOBE

The conception of most countries which are doing superlatively well were achieved by the fusion of innovations and nimble minds which wisely gestated ideas, and through constant nurturing eventually birth them in the ward of preparation. Invariably, strategies, innovations and a drive greater than the incision created by the pained scalpel of recession, wars, financial meltdown and nuclear disturbing necessitated the transitions from the first stage of sedentary living to the digitized world we live in.

Truth is, if these nations were able to surmount the desperate siren calls of their citizen’s plea for help by rushing their recovery strategies into the emergency unit of implementation and salvaged situation at one time, a repetition of this can be achieved effortlessly, COVID-19 and all. Unarguably, multiple sectors across board have had an appreciably morbid bites of the effects of the pandemic with most decisions being put on the back burner to address the dominant issue served on a deathly platter by COVID-19. The health sector has by far had a rather harrowing experience and recount of event.

As the world desperately gasp for air and craves resuscitation and an injection of life into their economies, the virus is unearthing Africa’s preexisting health problems where previous medical tourists in the persons of some leaders who would have hitherto flown out of the country for their medical checkups, have been grounded like most international flights to face the stark reality of their country’s health predicament, as once donor countries are in a tight bun suturing their own internal wounds.

A survey by the Pan-African Afrobarometer research network revealed that more than half of all Africans go without the necessary medical care at least once in a given year. Also, four in every ten patients encounter long waits or never cared for, whereas one in eight have to bribe their way through to be cared for. It might seem déjà vu moments for most people as they have had close shave with death due to the aforementioned reasons but the ebb and flow of such cases haven’t died down yet and are bound to escalate in this pandemic times where people are being advised to stay home if they’re having a ‘mere’ headache.

Access to healthcare is a fundamental human right for all, but the strain that the pandemic has placed on the healthcare systems everywhere has affected primary healthcare, which according to the WHO “ensures people receive comprehensive care ranging from promotion and prevention to treatment, rehabilitation, and palliative care as close as feasible to people’s everyday environment”. With everyone’s attention on the health crisis, primary healthcare has been subjected to a rather precarious position.

Torn between getting immunized and being cautious.

In 2018, over 13 million children globally did not receive vaccines even before the pandemic disrupted immunizations according to UNICEF. Vaccinations which are heavily campaigned for and publicized particularly in Africa could see a sharp decline and a spiraling effect of an outbreak due to the disruption. Most mothers are in a state of confusion as the date for the children’s next immunization draws near.

Unlike rich countries where parents make appointment to follow a routine vaccine schedule at private pediatric offices or clinics, most African countries and some western countries have to engage in mass inoculations for a large number of children and infants in schools, market places and churches. Dr. Robin Nandy, the chief of immunization for UNICEF echoed the sentiment of some parents by saying that,

“in our quest to vaccinate kids, we shouldn’t contribute to the spread of COVID-19. But we don’t want a country that’s recovering from an outbreak… to then be dealing with a measles or diphtheria outbreak”.

Despite the note of caution, there is also that eerie feeling of a much bigger health catastrophe than the current pandemic. John Hopkins Bloomberg School of Public Health has suggested a disruption like this could result in as many as 6,000 additional children dying every day.

According to WHO immunization and vaccines department head Kate O’Brien,

“what we fully expect in these diseases will come roaring back, and what that means… is that we’re going to see deaths of children in numbers that are unprecedented in recent times.

Suspension of mass immunization

WHO’s regional office for Africa have underscored the importance of maintaining essential health services such as immunizations, as an abrupt interruption of vaccine activities make outbreaks more likely to occur, putting children and vulnerable people at risk. It does corroborate their European Regional counterpart which compiled a report dated 20 March 2020, detailing measures it can implement to mitigate the transmission of the virus and also reduce the impact of the outbreak on healthcare to COVID-19 resources. It stated that, “in planning these measures, due considerations should be given to minimizing the excess risk of morbidity and mortality from vaccine-preventable diseases (VPDs) that would result if services are disrupted.

“Any disruption of immunization service, even for short periods will result in the accumulation of susceptible individuals and a higher likelihood of VPD outbreaks. Such outbreaks may result in VPD-related deaths and an increased burden on health system already strained by the response to the COVID-19 outbreak”.

Currently, there have been a halt in vaccine programmes in at least 68 countries with some entirely stopping vaccination campaigns and this is currently having a staggering effect on the primary healthcare of women and children. Reasons for the halt in vaccine administrations are due to fear of contracting the virus harbored by the mothers, nurses being diverted to tackle the virus and getting vaccine supplies to clinics.

“In Ghana, immunization services have come to a halt in areas where movement restrictions are being enforced, while in other areas session sizes have been reduced, to limit overall group size and because some caregivers are hesitant to show up”, according to a report by the head of Vaccine Impact Research, Niranjan Bhat.

In spite of advocating for the suspension of vaccination programmes due to coronavirus, the WHO is among several entities expressing concern over its long term impact as pockets of cases rise. United Nation’s Children’s Fund (UNICEF) executive director says,

“Measles is on the rise, diphtheria, cholera. So this is going to be a real problem. As a world, we had conquered many of these preventable diseases for children. Now there are grave concerns these gains could be wiped away”.

Over 21 million children stand the risk of getting sick from preventable diseases in countries such as Chad, Ethiopia, Nigeria and South Sudan who have suspended their immunization campaigns and a threatening disaster is imminent as there’s a resurgence in measles outbreak in Africa according to a WHO finding.

Candidly, WHO envisages that 117 million children could stand the risk of missing out on measles vaccines because countries globally are suspending national immunization programs in order to reduce the risk of coronavirus infections, and according to the Measles and Rubella initiatives, so far twenty-four low and middle-income countries including Mexico, Nigeria and Cambodia have paused or postposed such programs.

Experts have advised sustained efforts in routine immunizations, comprehensive data on registries of infants as most West African countries do not have data record of these children except parent-held record.

COVID-19 disrupts vaccine distribution

Now, we understand the gravitas attached to the helm of the pandemic’s garment as it offers no healing at a touch. By no small means, a new ‘pandemic’ hovers on the horizon and might color the clouds black soon if the proper channels for delivering vaccines especially to low and middle income countries are not being hastily attended to. Several reasons come to play to account for the disruption such as, reprioritization and channeling of health workers in dealing with the virus and also restriction impositions embroidered with social distancing.

The largest vaccine procurer, UNICEF, has admittedly come into agreement with the implication of an outbreak as disruption to vaccine distribution continues,

“obviously, when you have an outbreak like this and you have a large number of people seeking healthcare services, it does stretch existing capacity, and human and financial resources which are diverted to the response—and appropriately so”.

Granted, we have an almost insurmountable pandemic which might achieve a citizen status soon, or not, but the bigger picture of belling the vaccination problem is of an equal importance. Searching ways of seamlessly vaccinating children in every nook and cranny via a compilation of a cumulative data on outstanding population to be vaccinated should be of prime importance.

How to make The Elderly feel loved during a COVID19 Lockdown

How to make The Elderly feel loved during a COVID19 Lockdown

Just when we need each other more, we’re being forced apart

The battle to stop the spread of COVID19 is poised to dramatically increase the risk for loneliness, says 19th U.S. Surgeon General Vivek Murthy.

Social distancing, while a vital strategy to stem the COVID-19 pandemic, can worsen people’s sense of isolation.

“We find ourselves with a silent but common challenge of loneliness that people are struggling with all over the country and all over the world. And now on top of that, we're being asked to pull back from life-sustaining interactions with other people,”

Each day, as numbers affected by the worldwide pandemic escalate, one thing is clear: no matter where they live, the elderly face the highest risk.

 “The brunt of COVID-19 will be borne by the poor, elderly, and sick, and it is up to us to ensure they are not left behind,”  former US Surgeon General Vivek Murthy.

According to a 2012 study from the United Kingdom, seniors die of the usual causes, but isolation is one of the main risk factors that worsen preexisting conditions.

Loneliness more harmful than a Pandemic

Loneliness is as harmful as smoking 15 cigarettes a day. Because of their age and a higher prevalence of comorbid conditions, individuals over the age of 65 are considered to be especially at risk for complications related to COVID-19. But during the current pandemic, these older members of the population are also at a higher risk of succumbing to feelings of loneliness and isolation.

Simple things to make life worthwhile for the elderly?

Put them First

Tip: minutes doesn't seem like a lot of time, but when done consistently that small amount of time can make a big difference in how connected we feel.

Don’t get caught in bad news

It's tough to empathize if you are depressed. Dial down distractions and give undivided attention to people. “The cost to our relationships is significant. It impacts the quality of the interaction, and ultimately the quality of the relationship.

Serve

“We can call a neighbor ...and check on them to make sure they're doing okay. We can drop food off to somebody,” Murthy says. “We can write to people to let them know ... that we know, that they're going through a tough time and that we're thinking of them. These are small but powerful ways in which we can seek to serve others.”

 
Be innovative. 

At Fellowship, “to keep people’s spirits up, to keep them entertained and connected, we converted one of our spaces to a studio where we stream live activities and events and programming to an in-house channel that goes throughout the community.

We’re streaming religious services, entertainment, lectures, any type of content we can. We put out a schedule. We’re always looking to add to it. To ensure people have something to look forward, something to enjoy besides watching tv all the time,” noted Lawrence who runs  a care home.
 
On the brightside, so many individuals and organizations, musicians, artists, have come forward, streaming their performances online. Countless museums offer virtual tours. Churches, synagogues, and temples are streaming their religious services.

Fitness classes have even been thrown into the mix. 


Teach the technology.

The writer’s mother went from having no cell phone a few years ago, to an iPhone, mini iPad, and a second full-size iPad.If they are not familiar, walk them through new devices and tablets and programs and apps and streaming services. There are also online resources. SeniorNet and U3A.Online .

Apps like FaceTime, Facebook Messenger, Zoom, and Skype can help them to feel connected.
 
Pick up the phone. 

The landline (Yes! These do still exist.) Text messages just aren’t the same. Use the phone every day, on a regular basis, to call your older loves ones, even your older neighbors just to check in, even if it’s just to say hi.
 
Most of all, listen. 

“We need to try to understand this from their perspective, and hear their voices to tell us what they need,” stated Asaf Bitton, MD, MPH, assistant professor of medicine at the Division of General Medicine at Brigham and Women's Hospital and assistant professor of health care policy at the Department of Health Care Policy at Harvard Medical School.

“In many ways, this crisis may serve to deepen connections between generations and across communities.”

Tell us: have you been affected by the coronavirus?
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