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How to manage outbreaks in the face of a healthcare crisis

Dr. Snehal Patel, CEO and Co-Founder, MyDoc

When the World Health Organisation (WHO) declared the recent 2019-nCoV Novel Coronavirus outbreak a Public Health Emergency of International Concern (PHEIC), I was in Bangkok speaking to a few business partners about expanding our digital healthcare services in the country. Naturally, in Thailand, there were a lot of concerns surrounding the 2019-nCoV coronavirus, more commonly referred to as the Wuhan virus.

Ever since the first reported case outside of China was announced on the 13th of January in Thailand, our clinical team has been closely monitoring the situation. When it hit Singapore 10 days later, just before the Chinese New Year break, our team was not preparing for the festivities, but rather preparing for a crisis. We knew our digital healthcare platform had the capability to respond quickly to the epidemic that was fast turning into a pandemic.

Image credit: Getty Images/XiaoLu Chu

First, let me quash some rumours: The latest coronavirus outbreak is not the fastest spreading, nor the most contagious or deadly viral contagion to impact us. Regardless, the spread of the virus was rapid, and indeed concerning, especially with the lack of knowledge and available treatments to fight it. With more than 17400 infections reported at the time of writing, the number has quickly and greatly surpassed SARS.

The traction is to be expected. When SARS broke out in 2003, there were around 700 million travellers worldwide. Today, that number has more than doubled, with data showing 1.4 billion travellers in 2018. Increase in human-to-human contact means diseases are more likely to be transmitted and carried across borders.

As we gain more insights and visibility to virus outbreaks such as the 2019-nCoV, it is apparent that the current healthcare system is ill-equipped to handle this type of surge in demand. Even as our team prepares for the surge in virtual consults in the coming weeks as people return to work after the Chinese New Year break, we realised we cannot do this alone.

Digital healthcare plays a vital role in the triage of potential disease cases. According to our internal data, upper respiratory tract infection (URTI) has always been one of the top diagnoses carried out on our platform. We have been advising patients with mild to moderate URTI/flu symptoms to consider teleconsultation as soon as possible to receive timely advice and prevent any delay of care.

This also allows clinical professionals to perform an immediate triage assessment without the patient going out to public areas, thus removing the risk of exposure to members of the public, as well as the doctor during a face to face consultation.

The key word here is triage. Telemedicine serves as an excellent initial contact point to help manage and mitigate the situation for both the patient and healthcare professionals. However, we cannot solve all problems. We must work with local authorities, clinical services, and various healthcare industry related partners, to create a cohesive ecosystem that can provide the right level of care in the safest, most efficient manner.

Image credit: AP Photo/Kin Cheung
In practice, this means that for patients that meet MOH’s suspect case criteria, their doctor can notify the MOH surveillance officer to arrange for an ambulance team with infectious disease control procedures in place, to pick up the patient for isolation and testing, and advise the patient to practise precautionary measures.

The danger of viruses like 2019-nCoV, isn't entirely in the speed and deadliness of the infection. As Dr. Tedros, the Director General of the WHO noted, “Our greatest concern is the potential for the virus to spread to countries with weaker health systems, and which are ill-prepared to deal with it.”

Indeed, China was able to react swiftly with sequencing the genome of the coronavirus, as well as building two temporary hospitals to handle the demands on its healthcare services. Having said that, the death toll within that time frame has also increased from 25 to over 360.

This is in no way a criticism of China's capability. On the contrary - this kind of speed and efficiency is impressive. However, this is also an attestation to the limitations of current healthcare systems. Without the infrastructure in place to support seamless communication between healthcare providers, there is a limit to what can be achieved in such a short timespan.

With the advent of 5G, coupled with new transfer protocols as well as video encoding capabilities, we are now in a better place than ever to capitalise on the abilities of communication, to facilitate faster and more reliable deployments of digital healthcare. The promise of low latency and high speeds have enabled near real-time communications to support doctors to perform better diagnoses.

Dr. Snehal Patel, CEO and Co-Founder, MyDoc
Even for countries that lack resources in their existing health system, experienced digital healthcare partners like ourselves would be able to work with local authorities to expand our services (such as virtual consults) nationwide and even across borders, should there arise a need for additional resources to meet demand.

We have the capability to respond to demand surges almost immediately, assist in collecting information and provide visibility on the existing situation, while local authorities and medical providers have a better understanding of the resources needed, as well as be better prepared to manage the situation at hand.

Telemedicine isn’t here to replace all healthcare and medical functions, but it can definitely be helpful to curb panic, and better triage patients. In the past couple of decades, we have had five major outbreaks that were declared a PHEIC. Today, we still see a high prevalence in the spread of vaccine-preventable diseases such as seasonal influenza and measles, both highly contagious.

If we are to respond better to these outbreaks, reducing the risk of spread and lowering the death toll, we must look towards technology as a key touchpoint for managing epidemics and pandemics. It is only with the more efficient use of resources, and a faster way to share information, can we truly develop an ecosystem that is capable of scaling and responding quickly in the face of a crisis.

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