If the Coronavirus has taught us anything, it has exposed the holes and flaws in the Canadian healthcare system. Hopefully, we can all learn from these failures and ensure a stronger and more robust healthcare system for the future.
Part-Time Caregivers
Healthcare is essential to living a good life. When it began, it became obvious that clustering patients in close proximity has its challenges. Senior living and retirement homes are a clear point of failure that COVID-19 has exposed. Now, it is time for the government to take action and show respect for the care of our elderly. The ‘for profit’ companies that operate the majority of healthcare facilities have placed their profits way ahead of the citizens that are their customers.
Having care workers operate on a part-time basis and work for multiple facilities will be shown as incredibly dangerous. Once infected, these care workers transported the virus from one facility to the next. The residence of these facilities, who are the most vulnerable patients, have suffered an incredible loss of life within these facilities. This transmission pathway not only impacted the residents and the informed patents, but adversely affected the caregivers and their families too.
Insufficient PPE
Not having inventories of masks, gloves, and face shields has placed Doctors, Nurses, Caregivers, and First Responders at grave risk too. The lack of PPE or ‘personal protective equipment’ formed a major part of Canada’s and the world’s problem when it came to responding to COVID-19. China makes most of the PPE and millions of items sold to Canada and other countries were defective upon receipt, which greatly exasperated the problem. Of course, insufficient inventories of these essential items put everyone who came in proximity of these healthcare professionals at risk as well. The manufacture of PPE needs to be returned to Canada to reduce the dependency on China and its inadequate response to the supply chain. As a minimum, it needs to be diversified to reduce risks.
Sourcing of Drugs
With a majority of drugs and pharmaceuticals manufactured offshore, mainly in China, it has put countries, including Canada, at a huge disadvantage when it comes to having the necessary drugs on-hand to meet our domestic needs. It is time to bring this production home, or to diversify the source of supply to de-risk the supply chain.
Inadequate Hospital Capacity
With the rapid influx of COVID-19 patients being admitted to hospitals, the shortage of beds and staff has shown to be a huge issue. Hallway medicine has overwhelmed most hospitals. Governments need to place a new priority on having sufficient bed space to accommodate the normal statistical influx of elderly, other medical needs for a variety of ailments, as well as the onslaught of aberration events like COVID-19. The shortages extend to lack of equipment and too many pieces of equipment that were broken and therefore not serviceable at a time of need. Hospitals need to step-up their game and have the right resources available as well as trained staff to better manage the next virus event.
Many emergency-room doctors argue Canada’s ERs are already as stretched as they can get and are worried about what would happen if they suddenly had to start treating COVID-19 cases en masse.
From the public-health perspective, the greatest challenge may be as simple communicating across all parts of the health system across the country, said Dr. Jasmine Pawa, president of the Public Health Physicians of Canada.
“We cover a very wide geographic area,” she said, though she added that Canada has made great strides over the course of the SARS experience and the H1N1 flu outbreak in 2009.
Dr. Alan Drummond of the Canadian Association of Emergency Physicians, who works at the hospital in Perth, Ont., says he doesn’t want to fearmonger, especially considering all the lessons Canada has learned from past outbreaks, but the reality of life in the ER gives him pause.
“Our day-to-day experience in crowded hospitals, unable to get the right patient in the right bed on a day-to-day basis makes us really question what the integrity of our health-care system would be like in a major severe pandemic,” Drummond says.
Inefficiencies and Inequities
“The U.S. performs worse than average among similarly large and wealthy countries across nearly all measures of preparedness for a pandemic,” Cynthia Cox, director of the Peterson-Kaiser Health System. “The coronavirus outbreak is already exposing inefficiencies and inequities in our health system, and it is likely to put much more strain on the system in the coming weeks.”
While Canada may not have the same problems as the USA, we do have similar problems. Specifically, when it comes to inequities in the healthcare system. Under socialized healthcare, the idea is that it is equal for all Canadians. However, we have seen inequities for seniors, and the homeless. Action needs to be taken to remove this imbalance in the future.
Lack of Testing
Next, brings us to testing. Had sufficient resources to test patients been available, the crisis could have been reduced, but not eliminated.
Testing is important not only because it gets people diagnosed and on an appropriate treatment if they do have an infection. It also establishes how widespread a virus actually is. Experts know the size of the problem, they know the rate at which people are being hospitalized or dying, and they can follow its movements. That leads to a more informed response.
Having adequate test capabilities for all potential and actual patients, as well as all responders and front-line caregivers of all categories, will save lives. Testing capabilities must be improved in the future.
Conclusions
COVID-19 revealed just how fragile the system is. A system that constrains costs by limiting the supply of essential services is a system that cannot cope with a pandemic. Perhaps no health care system can cope with the unprecedented surge in demand that this coronavirus can create. Pandemics require spare capacity, and the nature of health care is that someone will always find a use for spare capacity — there is always, for example, someone who would benefit from being in a hospital bed while they wait for a long-term care place. Responding to pandemics is, one might argue, the responsibility of our emergency management system, not our health care system; in this view, the problem is siloed and uncoordinated care, not insufficient health care.
As COVID-19 takes hold in Canada, every failing of our health care system – insufficient infrastructure, long wait times, doctor shortages – will be highlighted. Fixing those failings will require more resources. There are a limited number of places those resources can come from: provincial tax revenues, federal tax revenues, the generosity of private donors, or increased private funding. Canadian governments have some hard choices to make.
Personally, I believe that publicly funded health care systems are more efficient and equitable than privately funded ones, and that the federal government is in a better position to raise additional revenue than the provinces and territories. Thus, when the economy has recovered, I would like to see the GST/HST increased by two percentage points, and the funds transferred to provincial governments to meet their spending needs. However, I suspect other outcomes are somewhat more likely.
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References:
Osman, L. (2020). COVID-19: Canadian hospital space a concern despite lessons from SARS, experts say. Global News, a division of Corus Entertainment Inc. Corus News. Retrieved on May 1, 2020 from, https://globalnews.ca/news/6583037/coronavirus-covid-19-sars-hospital/
Scott, D. (2020). Coronavirus is exposing all of the weaknesses in the US health system. Vox. Retrieved on May 1, 2020 from, https://www.vox.com/policy-and-politics/2020/3/16/21173766/coronavirus-covid-19-us-cases-health-care-system
Woolley, F. (2020). Canada has so few acute-care beds that even the flattest of curves will overwhelm hospitals. Fixing the system’s flaws will require federal funding. Policy Options. Retrieved on May 1, 2020 from, https://policyoptions.irpp.org/magazines/march-2020/coronavirus-is-about-to-reveal-how-fragile-our-health-system-is/
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About the Author:
Michael Martin has more than 35 years of experience in systems design for applications that use broadband networks, optical fibre, wireless, and digital communications technologies.
He is a business and technology consultant. A recent contract was with Wirepas from Tampere, Finland as the Director of Business Development. Over the past 15 years with IBM, he has worked in the GBS Global Center of Competency for Energy and Utilities and the GTS Global Center of Excellence for Energy and Utilities. He is a founding partner and President of MICAN Communications and before that was President of Comlink Systems Limited and Ensat Broadcast Services, Inc., both divisions of Cygnal Technologies Corporation (CYN: TSX).
Martin currently serves on the Board of Directors for TeraGo Inc (TGO: TSX) and previously served on the Board of Directors for Avante Logixx Inc. (XX: TSX.V).
He has served as a Member, SCC ISO-IEC JTC 1/SC-41 – Internet of Things and related technologies, ISO – International Organization for Standardization, and as a member of the NIST SP 500-325 Fog Computing Conceptual Model, National Institute of Standards and Technology.
He served on the Board of Governors of the University of Ontario Institute of Technology (UOIT) [now OntarioTech University] and on the Board of Advisers of five different Colleges in Ontario. For 16 years he served on the Board of the Society of Motion Picture and Television Engineers (SMPTE), Toronto Section.
He holds three master’s degrees, in business (MBA), communication (MA), and education (MEd). As well, he has three undergraduate diplomas and five certifications in business, computer programming, internetworking, project management, media, photography, and communication technology. He has earned 15 badges in next generation MOOC continuous education in IoT, Cloud, AI and Cognitive systems, Blockchain, Agile, Big Data, Design Thinking, Security, and more.