What are the main impact COVID-19 is having right now in the healthcare industry?
The COVID-19 pandemic has made all practitioners realise the importance of infection control and how the basic elements learnt in Medical School should be used to prevent causing harm to our patients and ourselves.
Healthcare practitioners and paramedics have quickly responded to the new threat posed by the COVID-19 virus and have used all available means to ensure delivery of service to patients in the most effective and safe environment despite the inherent risks to their own health. Even after witnessing all the dangers, the healthcare workers are living up to the challenge both in public and private sector. Private practitioners have adapted their practice to serve their patients without increasing risk of infection by implementing use of technology and strict infection control measures recommended by the health authorities.
What are the main challenges the industry is facing to fight against COVID-19 and what has been the response so far?
The main challenge posed by COVID-19 is the “unknown” i.e. there is not enough scientific evidence on the virulence, the transmission and obviously no clear information on treatment possibilities. Several renowned Professors are sharing the outcomes of their studies including treatment methods but there is no consensus at this stage compared to well-studied diseases like cancer and cardio-metabolic diseases.
It is clear that the virus will remain in circulation for years to come as mentioned in some papers. The pharmaceutical industry has responded very energetically to the global pandemic and substantial resources are being invested in finding a “cure” or a vaccine for the COVID-19. We have seen collaboration emerging between rivals of the pharmaceutical industry namely GSK and Novartis who are pulling their resources together to come up with a vaccine.
Another impact of the COVID-19 which is also affecting the pharmaceutical industry is the unavailability of transport – sea or air – to be able to ascertain continuity of supply, in some cases, life saving drugs to the population around the world. Pharmaceutical manufacturers are having to re-invent their route to market and supply chain to meet the challenges posed by lockdown in many Countries, ban on air travel, embargo on export of some products etc.
We have witnessed in Mauritius, chartered air flights being used for transportation of medicines, PPE, medical equipment and consumables, etc since no other options are available following the ban on commercial flights. It is still unclear how the industry will react, but surely, new means have to be developed for ensuring availability of API, manufacturing processes, route to market and marketing in response to the new “reality” which will prevail worldwide.
What is the role of Research & Development in this fight and when could we foresee a vaccine or efficient treatment?
R&D is rampant at the moment from the Top 10 Pharma companies of the world including Novartis, GSK, Johnson & Johnson, Sanofi, Gilead etc. and the race against time is “on” to come up with a treatment or a vaccine against COVID-19. Numerous formulations are under investigation and some are showing positive outcome but commercialisation of these products will still be subject to strong safety data which would have to be generated by robust clinical studies.
The current timelines range from 12 to 24 months. In the meantime, only preventive measures can protect the population at large and these measures have been widely communicated and recommended by WHO and most health authorities around the world. These preventive measures include social distancing and proper usage of personal protective equipment such as face masks, gloves, facial screens etc.
What have we learnt from this virus and could we be at risk in the future of other similar viruses emerging?
Viruses have always existed on Earth, even before the existence of mankind and will continue to exist in the future. They have also evolved to adapt to the ever-changing environment and have also been subject to a lot of human interventions in research lab. It is not excluded that new viruses will appear and could potentially be more virulent than COVID-19 according to experts.
However, the human immune system is so constituted that it will adapt and eventually overcome the new infectious agents either through Active Immunity i.e. vaccination / immunisation campaigns or by developing its own antigens/antibodies through exposure to the infection termed as Passive Immunity. Eventually, people resist better to an infection after the infectious episode e.g. H1N1, SARS, etc.
We should stay alert to the potential threats and change our lifestyle to include the protective sanitary measures as part of our everyday life. Simple measures such as proper hand-washing, sneezing or coughing in such a way to avoid spread of droplets to others around us, avoiding crowded areas when we are suffering from flu-like symptoms, basic personal hygiene, physical exercise to maintain body strength etc. should become our daily routine.
What will be the impacts of COVID-19 in the future and do you think the way we approach healthcare will change?
Locally, the impact of the COVID-19 will be strongly felt at all levels and in all sectors. The post-COVID economic downturn is extensively documented in reports from Global and Local Institutions including IMF, Bank of Mauritius, MCB, Ministry of Finance etc. The economic contraction will leave substantial negative impacts in the life of all Mauritian citizens. The Government will have to constantly juggle between investment measures and social measures to sustain the population and obviously this will directly impact the economic growth and the living standards of the population.
The public healthcare sector will witness a continuous increase in the demand of services provided to Mauritian citizens due to the anticipated decrease in the disposable income of the population, which could have allowed them to finance access to private healthcare facilities. Hopefully, a new mindset will emerge from the post COVID-19 pandemic, whereby people will realise the importance of healthcare services both in public and private sectors and will avoid misusing these facilities as regularly witnessed in the past.
Will technology play a more important role in healthcare?
Technology has always been part and parcel of the evolution of healthcare over time. Countless examples exist to demonstrate how technological developments have enable the progress of healthcare. Example such as imaging techniques ( X-Ray, CT Scan, MRI , etc), lab testing ( simple microscope, electron microscope, PCR etc), laparoscopy and endoscopy are all the fruit of collaboration between technology and medical practice and these have led to better diagnosis of patients and have offered more appropriate treatment options.
Bedside patient examination coupled with the medical knowledge is key to the diagnosis and treatment of patient and this is what has been the practice and teaching of medical schools. On-line consultations supported with relevant examinations and diagnostic support can eventually be a solution for certain minor pathologies however certain more severe pathologies will still require the physical examination by a qualified medical practitioner. There are legal and ethical implications which have to be considered as well as practical considerations.
Will the way pharmacies operate evolve? We have seen a sudden rise in online shopping and home deliveries, could this concern pharmacies as well?
Pharmacies are a very essential service in the overall treatment of patients as they are the point of contact between the patient and the medicines which can potentially cure them. If information given to the patient at this stage is not correct, the patient can potentially be harmed and this is why a qualified pharmacist is required in pharmacies.
Home deliveries could prove helpful and practical for certain types of medicines or for patients with reduced mobility provided the correct level of counselling is given to the patients. There are some security aspects to be taken into consideration, specially for potentially harmful products which should not be handled by children, controlled drugs, antibiotics, etc.
Pharmaceutical products are not like basic commodities which can be proposed for sale without expert consultation, diagnosis and treatment suggestions - this will be the biggest challenge for pharmacies proposing on-line shopping facilities. There are legal and ethical implications which have to be considered like requirement of a signed and stamped prescription for certain types of medicines.
What have we learnt from this crisis and what are the positive outcomes you feel will result in the healthcare system?
This crisis has shown that we can adapt our way of doing things and that there are alternate solutions: business can continue to operate without having all their staff present at the office, school classes, shopping and several routine life activities can be done remotely with proper implementation of technology. We are not and will never be safe or spared from any global health problem. The population will become more conscious of the importance of maintaining themselves in good health. Basic sanitary precautions and hygienic measures should become the norm going forward for every individual. We should always be conscious of the potential healthcare threats and adopt the healthiest lifestyle to prevent or protect ourselves from falling easy prey to such infections.
Healthcare authorities and institutions have to upscale the level of preparedness to face any kind of sudden pandemic. Misuse of healthcare facilities will decrease from the fear of potentially contracting an infection thus saving valuable resources for more serious conditions.
We should salute all healthcare stakeholders for their courage, engagement and vocation and we should all stand by them to show our appreciation.
A view of the healthcare industry in Mauritius and worldwide, by Ajay Gaya, Senior Manager - Wholesale, and Thuldeo Rampargass, Manager - Pharma & Animal Health.