by Nanditha Nagamani Praveen
Image: Antonio Casas / Flickr
The first cases of COVID-19 began to surface in January 2020, and nearly a year and a half later, the world is still reeling from the painful impact of a global pandemic that has killed over 3 million people. With its ability to spread through the air and infect millions on the go, this pandemic has caused economies to stagnate, air travel to come to a standstill, and millions of jobs to be lost in this long battle between the human body and a tiny nano-scale particle that is little more than a strand of RNA surrounded by a lipid capsule. However, the most adversely affected in this whole saga is the healthcare system, the very system created to handle crises of this sort.
Despite the advancement of medical technology in recent times and our rapidly growing knowledge of these minute mechanisms that helped us develop a vaccine in record time, our ability as humans to handle a pandemic of this scale is still severely limited. Governments and individuals can only do so much to reduce the spread of the virus through measures like social distancing and hygienic practices. This begs the question, is the healthcare system we have in place sustainable? In the face of the failures we have seen in developed countries, can we have the faith that we will be able to handle a similar situation in the future or something of even greater magnitude?
Weak governance has allowed for this crisis to grow into one of unimaginable proportions. Even as stronger, more transmissible variants of the virus mutate and evolve, some politicians are more focused on stifling criticism instead of controlling the pandemic. Nations logging hundreds of thousands of new cases each day see colossal turnouts at public election rallies blatantly disregarding public health and safety.
However, it’s not only weak governance that should be the main point of concern. Even countries such as Singapore and New Zealand, where strong governance, and consequently, health system resilience (“the ability of populations to prepare for and effectively respond to crises, by reorganising systems to manage the new conditions while maintaining core functions”) exists and is nurtured, have responded to the crisis well so far. However, even in these countries, can we be certain that crises in the future will not cause the system to collapse?
The few successes we have seen are not the product of a sustainable healthcare system. Instead, they result from strict restrictions on social activities out of a fear of the collapse of centralized systems. We still don’t have a system in place that empowers people to take charge of their own healthcare. Centralized healthcare systems have only managed to survive because we have no other choice but to make sure they do. These systems capitalize on disease and illness to sell treatment rather than encourage prevention, but we have no alternatives in the face of a pandemic like this one.
What we need is to be less dependent on these systems altogether. Individuals and communities need to have scientific knowledge to take responsibility for their own health and wellbeing. Centralized healthcare systems are simply not capable yet of dealing with outbreaks like this, because the sheer magnitude and speed of the spread of disease result in casualties at a rate far beyond their capacity. Worldwide, 1 in 10 healthcare facilities does not have sanitation services, let alone the resources needed to deal with over 150 million patients at the same time. Using patient satisfaction data, which is a common method employed by centralized systems to drive health-care improvements, is dangerously inaccurate too. We need to find a way to empower ordinary citizens to deal with crises through local clinics and practitioners who can deliver the same quality care as centralized hospitals. This can be done through miniaturization of huge, high-ticket medical equipment and innovative ways of creating containment and treatment zones, such as mobile systems for developing countries.
The idea of centralized care is probably one of the biggest reasons for situations like this pandemic to become unmanageable. It is time for governments to look into the core of the healthcare system and its fallacies, and address and find a solution to the fact that right now, we are operating with cure as the central idea rather than prevention. Centralized care can be and needs to be diminished, and replaced with a decentralized, efficient prevention-based system so that humanity doesn’t need to face a system crash when we need it the most.