Abdul Malik Soomro
Since the outbreak of Covid-19 in Wuhan in December 2019, Ruthless virus has unfurled to more than 188 countries and territories, including 346,000 deaths among 5.5 Million infections confirmed throughout the world. The effects of Coronavirus (SARS-Cov-2) have not peaked yet and the World Health Organization has already officially declared COVID-19 as a pandemic – The highest level of a health emergency – On 11 March 2020. Access to healthcare is a fundamental human right, but the strain that the COVID-19 pandemic has placed on healthcare systems everywhere has, in turn, affected many people’s primary care provision. First and foremost, we should understand what primary healthcare is? The World Health Organization (WHO) defines primary healthcare as “a whole-of-society
approach to health and well-being centered on the needs and preferences of individuals, families, and communities.” “Primary healthcare,” the WHO explained, “ensures people receive comprehensive care — ranging from promotion and prevention to treatment, rehabilitation, and palliative care — as close as feasible to people’s everyday environment.” As much as primary healthcare is cardinal, Healthcare providers have principal importance too; They have considerable issues to contend with. As a society, when we examine the role played by these men and women, our doctors, nurses, physical therapists,
and the janitorial staff; We should know that they carry an immense burden on their shoulders each day, in the hope that lives of complete strangers can be saved. They have to make the hardest decision like who gets to live, and who does not amid this pandemic; which has serious aftermaths on their mental health. Moreover, there are several other impacts on healthcare professionals for instance: Due to fears relating to the spread of the new coronavirus, healthcare providers around the world have been minimizing in-person contact with their patients. The pandemic has jeopardized regular prenatal visits to
the obstetrician or even made them impossible. However, the U.S.- based obstetricians have reportedly either switched to less frequent in- person appointments. Similarly, some specialist doctors have switched to telemedicine after quibbling a lot and come to the result that telemedicine is more convenient and safe, allowing pregnant women and others to receive the support they need without placing themselves at risk by attending clinic appointments in person during the pandemic. Besides, pregnant women may have fear for other reasons. For example, what happens if they contract SARS- CoV-2, the new coronavirus? What will the birthing experience be like during the pandemic? This
seriously has influences on the mental health of patients too. In the same manner, in the United Kingdom, some hospitals have banned all in-person visits to maternity wards in this period, and in Germany, some hospitals are reportedly banning partners from entering the delivery room. Besides, Doctors are making a tough decision to protect other people like partners, who would usually provide reassurance and support during the delivery, may not have permission to enter the delivery room or visit in the maternity unit. Furthermore, in the U.S., the CDC recommends that healthcare systems prioritize urgent visits and delay elective care to mitigate the spread of COVID-19 in healthcare settings.
Likewise, in the U.K., the National Health Service (NHS) also recommends that people seeking medical advice should take the online route or phone their doctor or the NHS helpline. People should only attend a doctor’s office in person, the NHS says, if the doctor has expressly asked them to do so due to serious concerns. But the cancellation of a significant number of planned elective surgeries during the pandemic has left many people in the U.K. fearing for their long-term health and feeling like “collateral
damage.” Adding more to impacts of Coronavirus (SARS-Cov-2) on Medical professionals; missed vaccines could lead to other outbreaks which will cause more trouble for healthcare providers. UNICEF has noted that the number of children receiving their vaccines has dropped significantly late. Sacha Deshmukh, Executive Director of UNICEF U.K., has warned that “up to 117 million children could miss out on vaccines due to the global pandemic.” In addition to the very real physical risks that they run,
there is also the inevitability of considerable mental distress. Healthcare workers due to Limited resources have to choose who gets a chance to live, and who will be left to die. Pandemic or no pandemic, healthcare resources in Pakistan are already inadequate to cater to our usual requirements.
Even in times of normalcy, healthcare professionals in Pakistan face chronic shortages of even the most basic equipment and supplies. These chronic shortages are about to expand manifolds in the coming weeks if the number of Covid-19 casesincreases in Pakistan. The shortage of resources is not strictly limited to equipment and supplies, but also the human resources required to deal with this challenge.
While we are quite confident that healthcare workers will be eager to serve at the proverbial frontlines, the fear of the virus is very real and we have already seen media reports of physicians refusing to go to report for Corona duty because they fear for their lives and that of their loved ones. Recently, a young doctor, Usama Riaz from Gilgit-Baltistan, lost his life working at a medical facility screening pilgrims
traveling to the province from the Pakistan-Iran border at Taftan. Adding more to Impacts on the mental health of medical professionals, they have to Refuse to allocate precious life-saving resources to a gravely sick person who may be having even the slight chance of living because they have to safe others who have better chances to survive is a heavy cross to bear: He died because I decided he should not be given a chance. With mental health enjoying the lowest rung in our healthcare priorities, ironically somewhere near public health in our medical education system, the mental scars these healthcare
workers will develop can have long- reaching consequences for themselves, their families, and their medical practice. Amidst the joys of seeing a patient recover from the throes of Corona and walk out, there will be the devastating lingering images of those who died gasping for breath. Or the parent they blamed themselves for infecting and ultimately losing. In normal times, especially where there are adequate resources to go around, First come, first served usually works very well in allocating hospital beds and resources, the patient who arrives first generally gets admitted first, provided it is medically
indicated. However, as our hospitals have been saturated with max number of patients now, Doctors have to use TRIAGE SYSTEM: The system dates back to 1792 when the Surgeon in Chief to Napoleon Imperial Guard applied a process known as medical triage. In this system, the wounded during the war were divided into three different categories: those who will recover without treatment, those who will die whether or not they are treated, and those for whom treatment will make the difference between life and death. It is the third category that requires urgent care, particularly in situations of resource
shortages, like as in war or today in a pandemic situation. However, there is a difference when it comes to applying triage in a pandemic. As the situation escalates, healthcare workers will be forced to make choices and decisions which will literally boil down to life and death. They will be the ones who will be choosing who may be given a chance to live, and also those who will be left to die. Such decisions will take an immense psychological and emotional toll on healthcare professionals who will be left to bear the dreadful burden of choice. To Conclude, it can be said, The pandemic has made it crystal clear that
we are one world that has more in common with each other than we’d ever dare to believe. The best defense against disease outbreaks and other health threats is preparedness, which includes investing in building strong health systems and primary health care. If we don’t invest in both, we will face not just health consequences which health care professionals are facing, but the social, economic, and political fallout that we’re already experiencing in this pandemic.
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