The COVID-19 pandemic brought with it a plethora of challenges to healthcare systems around the globe. We can recall the obvious and well-documented struggle of skyrocketing ICU admissions and a growing scarcity of ventilators, to name a couple of challenges. But one less apparent, more insidious struggle is the ramification of a lack of care sought by individuals with chronic and ongoing medical ailments. The effects on the health of the general population will continue to be observed today as we learn more about the long-term effects of the pandemic and its disruption to business-as-usual care and treatment.
While Australia was praised for its COVID response, there’s no doubt the pandemic prompted systemic change in the nation’s healthcare model. The once-in-a-lifetime event cast a sharp lens on the existing model, highlighting its strengths but also revealing cracks or the necessary room for improvement moving into a post-COVID world.
Decrease in Medical Intervention for Chronic Illness Unrelated to COVID-19
A 2022 study by the National Health and Medical Research Council highlighted the effects of disruption to healthcare access during the pandemic. The study shows a significant drop in attendance and testing for chronic disease patients nationwide for the years in question.
For example, the volume of non-acute respiratory illness testing (excluding influenza and COVID testing) decreased by 33% in Victoria and 29% in NSW in 2020. Figures from the same year also show a 25.6% drop in diabetes testing in Victoria and a 19.1% drop in NSW. This is hardly surprising given the risk of COVID-19 transmission, especially to those more vulnerable patients already living with chronic disease.
Despite the apparent challenges we are now well aware of three years post-pandemic, Australia’s healthcare system remains one of the best in the world. For those seeking a career in the industry, it’s possible to gain skills to succeed in nursing by applying best practice lessons learned from the challenges of the pandemic. Let’s examine those in more detail.
Shift to Virtual Means of Care
As the pandemic was sure to illuminate disparities in the socioeconomic standing of patients, the resulting shift from a one-dimensional care model to a more nuanced, multi-tiered approach is paramount. The most apparent change is the progressive shift to virtual care models where possible, such as via Telehealth and E-scripts.
If you’ve had a doctor’s appointment in the last two years, there’s a good chance it was virtual. There’s another chance you were sent an E-script directly to your phone, which means no paper was involved and there was no need to be physically handed a prescription. This saves time, money and effort; in what would usually involve a trip to your GP and then to the pharmacy (and then back if you require an injection for example).
Of course, there are many setbacks with the use of Telehealth. Medical practitioners cannot use observation and physical testing virtually, it can be more challenging for children and elderly patients and a lack of privacy could be detrimental to a mental health discussion. A complex health diagnosis, especially that of mental health, may require the observation of body language and non-verbal cues. These may be equally as important, if not more important than verbal, self-described symptoms for instance.
Telehealth also favours patients who are more technologically savvy and is disadvantageous to those who are not or who struggle with language barriers for example. In that sense, the virtual model can exacerbate the gap between marginalised groups and therefore reduce the equity in healthcare access – a common result of the blanketing effect of the pandemic.
Increased Focus on the Interplay Between Healthcare, Policy and the Economy
It’s become increasingly apparent throughout the pandemic that access to healthcare and means of healthcare, including quality and quantity, are determined by policy, the economy and the socio-economic standing of the patient and that these factors interplay in a complex and influential manner. For example, patients living in remote rural parts of the country may have more limited access to Internet and phone signals and are therefore less able to engage in Telehealth, or conversely, they may be far away from a hospital so their treatment options may be somewhat limited. Furthermore, if those patients are in financial hardship or from a lower socio-economic class, then traveling to a hospital or specialist doctor may not be financially feasible.
It’s important to identify specific challenges and how exactly to overcome those on a smaller scale, before attempting to tackle larger, more overarching implications and inequities. When COVID cases spiked in aged care facilities in Victoria the largely casualised workforce exacerbated transmission across the sector. Aged care workers would routinely work at multiple centres, thus infections grew exponentially from one site to another.
The easy solution is to minimise casual employees in aged care and prevent them from working at multiple centres, which therefore requires reform to the current workplace model. The more complicated implications of this workplace reform include bureaucratic and administrative complications including an examination of the aged care sector workforce, and more specifically, why there is a dominance of casual staff to begin with. Policymakers must also consider the resulting implications of changing that model on affected staff and their working lives and worker’s rights.
All things considered, it’s apparent that to do this there needs to be collaboration between policymakers, key aged care actors, employers and employees. This also highlights the necessary interaction and inclusion of health, politics and economics in the equation when it comes to tackling complex, all-encompassing issues prompted by a global pandemic.
While the pandemic has prompted some significant and obvious changes to various industries, policies and customs, its effect on patient care and healthcare access is more insidious. Despite the apparent progression to virtual care where possible and an increase in its prevalence since the pandemic, other changes apply more in the interplay between healthcare, the economy and politics.