Lessons from the pandemic

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It is more than a year and a half since the Covid-19 virus first emerged. And despite the rapid roll out of several highly effective vaccines, the disruption caused by the pandemic continues to persist.

In India, Brazil and the Philippines, national healthcare systems have been swamped to the point of collapse by surging case numbers, while strict social and travel restrictions are severely disrupting life in countries that have succeeded in reducing the spread of the disease.

The challenge for governments is finding a balance between enabling freedoms to allow life to return to normal, particularly economic activity, with restrictions to limit the spread of the virus and protect national healthcare systems.

For most, that balance has been near impossible to find, as countries have swung between strict lockdowns and surging case numbers.

For those at the eye of the storm – healthcare providers, the challenge has been to carry on delivering all normal essential services while at the same time adapting to cope with the extra strain of the pandemic.

Among the most successful responses is the UAE, whose well-funded healthcare system has been able to adapt rapidly to the changing requirements of the pandemic.

From the speedy construction of field hospitals in the first days of the pandemic, to executing complex supply chain manoeuvres to enable country-wide vaccination programmes, the UAE’s strong decision making at a government level, combined with the adaptability of its healthcare system, provides many valuable lessons for healthcare decision makers around the world.

“The responsiveness of the country’s leaders and the healthcare system is why the UAE is at the forefront of the response to the pandemic,” says Mubadala Health senior director of rewards and performance, Christine Belanger. “Integrated network practices like digitisation, coupled with the wider emphasis on preventive measures underpin the country’s approach.”

Global collaboration

In a highly complex system, collaboration has been a key factor, say senior figures across the UAE healthcare sector.

“The more you collaborate, the more successful you are,” says Dr Omar Najim, executive office director at the Department of Health (DOH), Abu Dhabi.

“In Abu Dhabi and the UAE, we didn’t treat this as simply a disease that needed to be treated,” he says. “This is a pandemic, everybody from police, education, community development to charities and healthcare, came together on this. Collaborations extended to the private as well as public organisations introducing many initiatives. It also went beyond borders.”

Najim’s comments came at the first Mashreq-JLL-MEED Healthcare webinar on 29 April, which brought together leading figures from across the UAE healthcare sector to discuss the country’s repose to the pandemic, and to identify lessons that can be learned from the crisis and used to improve preparedness for future events.

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Naijm says that in a global crisis, it is vital for countries to work together to beat the disease.

“Action needs to be taken not just locally but globally,” he says. “It is extremely important to accept that we are all in this situation together, and to recognise preparedness as the way forward”.

He says that Abu Dhabi’s response from the start has been shaped by its globalist approach.

Abu Dhabi and the UAE has hosted some of the biggest clinical trials for Covid-19 vaccines including Sinopharm and Sputnik, as well as over 260 research activities that resulted in 20 publications globally.

“We are happy to share this knowledge, experience and planning through the Hope Consortium,” says Najim.

Established by Abu Dhabi’s Department of Health in November 2020, the Hope Consortium is a UAE-based Covid-19 vaccine supply chain initiative supported by both local and global partners.

By March 2021, the consortium has provided over 20 million vaccine doses and is aiming to provide up to 6 billion doses by the end of this year.

Innovation in care

The acceleration of digital healthcare services has been one of the most important responses to the pandemic and many healthcare leaders say that this provides an opportunity to reassess the delivery of healthcare systems.

As a result of the need for faster access to data and more precision in the delivery of care, Covid-19 has enabled the UAE healthcare system to overcome “institutional inertia” to increase the digitalisation of services, says Malathi Arshanapalai, group chief quality officer and group chief medical officer at healthcare group Aster DM.

Arshanapalai says that this requires a wholesale change in the way information “moves” to the patient.

“Healthcare as a patient experience unit has to be more innovative, creative and out of the box,” she says.

“We have had to change the way we deal with our patients and how we separate Covid wards from non-Covid wards, including staff,” says Arshanapalai. “Upskilling was brought into place. Patient care could never stop.”

The acceleration of digital healthcare services has been one of the most important responses to the pandemic and many healthcare leaders say that this provides an opportunity to reassess the delivery of healthcare systems.

Concerned about the strain on staff from the pandemic, Arshanapalai says that greater use of telemedicine in non-emergency cases has emerged as one of the key solutions to address human resource constraints, through apps developed both independently and with vendors.

While there are many lessons that will be learned from the past year to build a more resilient and patient-centric healthcare system, the most recurring theme is the need for faster access to accurate, up-to-date data.

To achieve this, the crucial next step in evolving the UAE’s healthcare services, say the webinar panelists, is to establish a centralised system for smart patient data collection and treatment.

“At a federal level, there has already been an announcement for a single platform for health information exchange,” says Najim. “It will allow anyone to securely access the patient data in one place.”

Preserving cashflows

The pandemic had an immediate impact on cash inflows especially during the early part of the outbreak from March to May 2020, as healthcare providers were forced to defer elective procedures and faced capacity shortages.

“It is essential for providers to ensure they are acting proactively enough in terms of cost efficiencies and ensuring they have sufficiently comfortable liquidity positions to endure sudden blows to their cash inflows,” highlights Karim Amer, SVP – head of healthcare and education at Mashreq Bank.

“It has been proven that having a sufficient cushion of liquidity has been nothing short of crucial, [indicated by] similar situations of economic crisis, especially for a sector that is expected to spearhead the fight against a global pandemic,” he adds.

Future investments

Najim says that three key areas of investment that will shape the UAE healthcare sector in the coming years.

“Digital healthcare is a fantastic opportunity in all ways,” he says. “The second key area is life science, and there is a big push for this in Abu Dhabi, not just from a healthcare point of view, but also from a security perspective to ramp up very quickly the next time [we’re faced with a crisis]. And there needs to be more focus by entrepreneurs and health care providers on solutions for prevention and wellness.”

Najim says that one very important lesson from the pandemic is that people with good health were already better prepared to ride through the crisis than those with chronic health issues such as obesity or diabetes.

“There is a big greenfield for everybody to invest in terms of prevention and wellness,” he says.

In addition to the digital transformation of healthcare services, the pandemic has highlighted the need for change in the design and installation of healthcare physical infrastructure.

“The infrastructure requirement has evolved,” says Sandeep Sinha, head of healthcare – Mena at JLL. “During the pandemic, the hospitals and regulators have undertaken numerous measures like adding field hospital beds (temporary infrastructure), drive-through screening centres etc. The overall patient pathway has changed as the pandemic created a need to relook at hospital design and architecture.

Going further, Sinha expects that this will lead to a redesign of the healthcare processes and the actual asset eg, the creation of separate wings for quarantining communicable disease patients, developing capability to have flexible infrastructure (IP beds being converted to ICU beds, modular hospitals etc.), comprehensive infectious diseases departments and improved ratio of ICU beds.

“Regulators need to refine guidelines for disaster management and incorporate learnings from the pandemic before approving new healthcare facilities in future, he says. “Moreover, accreditation bodies need to focus on post-pandemic design requirements and hospital/clinic processes.”

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Mashreq Healthcare white paper – Lessons from Covid-19 Mashreq, in partnership with JLL, has launched the first healthcare white paper in a series that that examines the resilience of regional healthcare systems and the way ahead for the sector. Lessons from Covid-19 identifies the control measures taken across the Middle East to prevent the spread of the virus, while also reviewing how the pandemic prompted greater innovation and collaboration in the healthcare space. Download the paper here