Some observations FROM cORONA oUTBREAK

The impact of Corona on our economy, politics, well-being and of course healthcare is still to be comprehended. Philosophers, politicians, scientists and public health experts will pronounce their verdicts in due time.  With no ambitions on complete analysis, below are some observations from perspective of a citizen and IT professional working with healthcare.

In the beginning of February 2020, sitting in front of a TV screen in one of the Germans rehabilitation centres, I was watching the evening news. First signals of Corona were coming out from China. Seemed to be so remote and alien to all of us. A respectable medical professional was assuring the audience that the German healthcare system had all the barriers to prevent the virus spreading in the country. Should some isolated cases nevertheless happen, they will be coped immediately. Nobody spoke about epidemic, and of course no pandemic was in question. The predominant view was that the system is stable, effective and ready anytime to protect its citizens.

For decades the European system relied on its protocols, verified procedures applicable to stable living, but not to massive crises.  Corona taught us to be humbler in our views and assessments: even medical experts are no Gods. Yes, protocols and guidance are important in healthcare. They work relatively well in everyday life, but should Public Health envision unexpected scenarios? After all Military experts are playing with war scenarios almost every day evaluating the required resources under different circumstances. Thanks God only playing, but now our healthcare system is at real war with the virus. Maybe healthcare experts can learn from practices developed by other industries?

 IT in Healthcare is not a Luxury.

  Telemedicine in Healthcare was discussed for years. Corona taught us that IT in Healthcare is not just a nice ribbon which is good to have when everything else is put in place. Information sharing is as critical in healthcare as buildings or roads .

   Prof. Dr. H. Lothar Wieler, President of the Robert Koch Institute stressed during one of his press conferences: should Germany be more advanced in Telemedicine implementing electronic health record across the country years ago , it would have been much easier now to collect data on corona test results  to understand e.g., why certain patients barely notice infection while other die.

Scientists from all over the world are working now on antibody tests probing various medications. About 200 substances are under scrutiny. Solidarity Project driven by WHO enrols patients from 100 countries in one randomised clinical trial to test and compare the efficiency of Covid -19 treatment.  Coordinated efforts driven by countries Public Health institutions require a strong informational support. Cloud storage as well as analytical tools coupled with Artificial intelligence technology can dramatically reduce time to develop prognostic models as well as compare the outcomes of medication test.

Examples are coming. Companies such as Amazon, Microsoft are contributing with their Cloud technologies to track incidents of Corona spread. Facebook is using Crowdtangle tool analysing anonymous contents people publish on social media to get insight in their emotions and behaviour during the pandemic.

BlueDot, a Toronto-based artificial intelligence company, was first to spot the mysterious virus causing pneumonia in Wuhan. On December 30, their systems, backed by machine learning algorithms, flagged the outbreak of a new infectious disease. They alerted hospitals, governments, businesses, and other clients from the private sector about the danger. Only 9 days after BlueDot’s discovery, the World Health Organization (WHO) made an official announcement about the spreading of Covid-19

Millions of people are spontaneously using ZOOM or Skype for remote conferencing or online education courses. In the near future we may see that Healthcare will be one of, if not the major driver of IT innovations surpassing industries such as banking or retail.

Pragmatic attitude to security

Politicians will adapt a more pragmatic attitude towards IT security. Almost a decade ago, companies such as SAP, Oracle, Microsoft and others were proposing their plans for implementing a national electronic health record in Germany. Competitors were sitting together evaluating their strong and weak points to develop jointly an effective system that would help health providers to get a deeper insight in individual health patterns.  The project was blocked by political authorities due to security reasons. The argument “what may happen when some evil minded penetrate the system?” seemed to be unbeatable. Corona showed that in critical times people tend to prioritise Life and Health over Privacy.

It does not mean of course that privacy should be sacrificed. One cannot underestimate the importance of security in data transmission especially when it concerns human health, even life. However, security should not impede technologies that can potentially save lives. On the contrary: it should drive those innovations forward. Perhaps we should revise our approach to IT security: from “we should not implement IT solutions for security reasons” to “how can we improve security to implement those solutions”

Social solidarity.

  Crises usually provoke the best and the worse in people. Corona threat revealed who we are as individuals and citizens, who is your true friend and who is just the one with whom you happen to spend lots of time.

For years Healthcare domain was swept by discussions regarding patients’ empowerment or engagement in care processes. Corona disease demonstrated that people can and are ready to assume responsibilities for themselves, their families and the society. Citizens appear to be more self organised as they even have imagined. We hope that this trend will continue.

Never before we saw such a strong solidarity between patients, citizen and health providers. Today you are a doctor, tomorrow you may be lying next to your patient in ICU. We are all in the same boat and our joint mission is not to allow this boat to sink. The German region Heinsberg on the border with Netherlands has suffered the most from Corona virus. Out of 250.000 of its residents 1.281 were infected, 34 died and 550 successfully recovered. The region is now turned into a laboratory where virologists are testing the virus behaviour: how it spreads, how it effects various population groups, why some people have only minor symptoms while other die, the behaviour of antibodies and future sustainability of immune system to corona virus. Thousands of residents volunteered to participate in the study, 1000 were selected as representatives of a German population as a whole. The study scrutinises households, people connections and life habits even house pets (cats were particularly cooperative according to researchers’ observations).

Solidarity is revealing itself in small things: bringing food to those who can be more vulnerable to the virus and hence should not leave their houses or even planting flowers at the front doors of their neighbours just to bring smiles on faces, smiles that erase fear.

The City of Rostock is the first city free from Corona virus. In two weeks there were no new cases registered. According to their Mayor such achievement was possible because people understood that self-isolation is necessary to stop virus from spreading. That gave health providers a window to prepare and adjust properly hospitals ICU beds.

At the outset of pandemic  Germany had 28.000 ICU beds. The number recently raised to 40.000 as hospitals prepare themselves for Corona virus patients. The country is conducting more than 50.000 corona tests a day and no shortages in ventilators. But the battle is far from being over. Until proper treatment or vaccine is found the virus is not in retreat. On April 21 Robert Koch Institute has announced that vaccine is currently being tested on people. We will be waiting hopefully.

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