Health Maintenance in a Pandemic

 

The telephone rang. It was the doctor. I hadn’t been to see her in over a year. I should have, of course. If only for the obligatory annual check-up. It was not that I was being neglectful but, like just about everybody else, I couldn’t just walk into the doctor’s surgery as in the before-times. The times have changed so much in the last few months that hospitals and doctors’ offices have become no-go areas for the relatively healthy. The need must be truly urgent for one to brave the hazards, real or merely perceived, of entering an Emergency Department, a clinic or doctor’s office. So, unless one was practically keeling over, one tries to avoid such establishments in the way that one would try to avoid the... plague. The ultimate version of social distancing.

Our way of being is changing fast for better or worse, the relationship with our doctors being among the first casualties. And of course, not all caring institutions are the same. Some, or even many, are anything but, becoming instead, either by accident, or even design, places of uncaring and frequently, untimely death due to COVID-19 being allowed free range within their premises. In the province of Ontario, Canada, for example, 9,625 care-home residents have been infected by COVID-19. Of this number 2,471 have died. A  25.7%  death rate, nearly ten times greater than that among other COVID-19 infected Ontarians. These staggering figures need their own separate commentary.

The grim statistics have, so far, not affected hospitals or doctors’ offices. We keep away from them and they, reciprocally, hold us at arm’s length. But if access is restricted, how does one consume health care? (We are all consumers now). Does COVID-induced anxiety supercede all other concerns about our health?

But the morning call did come from the doctor, enquiring about my state of health. She wanted to know how I was, and was there any service that I needed? Then, in a flash, I realized that here was yet another Covid-induced shift. ‘Telemedicine’ and ‘telehealth’ had arrived. Although telehealth had been lurking in the fringes of traditional health care for well over a quarter of a century its impact had indeed been no more than marginal. “Telehealth”, we had been told, “is a collection of means or methods for enhancing health care, public health, and health education delivery and support, using telecommunications technologies.” And within this, telemedicine was anticipated to deliver medical service directly to the individual consumer.

Now the public health arm of telehealth has been in full display since the opening stages of the pandemic, when public health officials, and presidents, potentates and prime ministers, and heads of world organizations stepped forward, with long faces, to warn, if not exactly of impending doom - but close enough – to concentrate the mind, leavened albeit with sensible advice on how to mitigate the pandemic’s spread. The one exception need not detain us here.

The new communications platforms that a pandemic demands create opportunities for those who live in well-resourced countries, but the full promise will, for the foreseeable future, remain unfulfilled for people living in poorer parts of the world. However, for the present emergency, there is perhaps a silver lining in that COVID wields a lighter, gentler touch over some of these countries. With this in mind, and with prospects of effective vaccines just about to be realized, we can all have a less stressful Christmas and a normal 2021.

Cheers.

Tell Fren Tru