A ROUGH RIDE FOR THE FRONTLINE WARRIORS

Pandemics are large-scale outbreaks of infectious disease with a high burden of morbidity and mortality over a wide geographic area and cause significant economic, social, and political disruption.

The healthcare sector is at the epicenter of this unprecedented global challenge. As the Covid-19 pandemic rages across, it has brought unprecedented strain on hospitals and clinics, from a shortage of testing and medical supplies to issues in access among rural and under-served populations. The disease has put a spotlight on some of these inequities, while also revealing holes in the healthcare delivery system that can have lasting side effects on patients and providers.

In its initial days, there was increased pressure to understand and predict the surge and its impact on individual care facilities, by not only healthcare administrators but also public health officials and government entities charged with making decisions about stay-at-home orders. The goal was to control the outbreak, flatten the curve so that the number of patients requiring intensive care beds and support wouldn’t exceed capacity. However, there is little to indicate we have got on top of this still-developing Covid-19 challenge. On our last count, global infections stood at 9 million, with deaths standing around 470,000.

The difficulties faced by the average citizen cannot be fully fathomed. While on one side, the great lockdown has induced a vanishing of incomes and increased their expenses on the consumption side due to shortages of essential items. And by any freak chance if one finds himself or herself a victim of this virus, then the situation truly becomes a pandemonium.

“For an average middle-class family today, the threat of shooting medical expenses is very immediate and real,” says LC Singh, Executive Vice Chairman at Nihilent. “He further notes that since early ages, humans have responded to adversity using either of the two modes, fight or flight, but this time, neither is a plausible option. We will have to embrace the situation as a part of life and quickly learn to adapt to the new normal.”

IS THE VIRUS FLATENNING THE HEALTH CARE INDUSTRY

The medical devices industry has taken a hit. Most countries import consumables, disposables, and capital equipment including orthopedic implants, gloves, syringes, bandages, computed tomography, and magnetic resonance imaging devices from China. And even the in-country manufacturers are finding it difficult to source important raw materials and electronic components from Chinese factories.

The case is the same for the pharmaceutical industry as well. The sustainability of a spurt in demand will soon become a function of securing the supply. For almost all global pharma companies, their supply chain is intertwined with China one way or the other. If the current situation prolongs, the cost of essential drugs might increase for all. According to a survey, emergency care, anesthesia care, and pain management drugs are the ones getting affected due to shortage. Just consider how the cost of Paracetamol in India has gone up to INR 400-450 per kilogram from INR 250- 300 per kilogram from the pre-COVID days to now. The prices of vitamins and penicillin have risen by over 50%. While the rich will get through these increases unscathed, it will be financially weak who will be disproportionately impacted.

Private healthcare providers also continue to struggle. While on the cost side, there is tremendous pressure to improve on their preparedness, and are required to invest in additional manpower, equipment, consumables, and other resources, a sharp drop in outpatient footfalls, elective surgeries, and international patients has impacted their income. Many small hospitals and nursing homes have been forced to shut their operations since their cash flows have dried up. Given that the sector’s costs are predominantly (around 80 percent) fixed, it is expected that there will be losses and severe impact on cash flows, financial distress looms on the horizon.

Clearly, this pandemic has had its consequences ripple through to all walks of life. For instance, in many hospitals, chemotherapy services are shut, and ones that are functioning are often out of reach due to travel restrictions. The HIV patients can’t reach their antiretroviral therapy centers, trans-persons are finding hormone therapy out of bounds, and expecting mothers aren’t getting ante-natal check-ups. Immunization services have also been affected, suspending door-step vaccination services. Though temporary arrangements are made due to lockdown, most are not able to avail of the services provided, thereby putting children at risk and susceptible to other diseases. However, there are many positives that have emerged from this ongoing chaos.

The public and the private sector have come together to fight in unity. Regulations have been relaxed to encourage wider participation. The number of manufacturing units that have reconfigured themselves to manufacture respirators, signals how the private sector rose up to the occasion.

Reflecting on Nihilent’s own contributions, Vineet Bahal, Senior Vice President at Nihilent says, “ We were always committed to the healthcare sector and this time, I can proudly say, that we have gone beyond the call of duty.” A unique product from Nihilent named COMIT (COVID-19 Positive and Mortality Incident Tracker) is already finding itself in the middle of the action in New York City and the State of New Jersey in the United States. COMIT is designed to help forensic pathologists and doctors track, investigate and record deaths from COVID-19 or comorbidity.” And he quickly adds that the cloud-based deployment has provided the product team with valuable real-time feedback. Talking about the future roadmap for the product, we are working on enhancements on a war footing for time is against us in this fight.

Vineet is excited about the product and the impact it is delivering and says, “ We are exploring opportunities to deploy this product in other countries too, and quite close to signing a few agreements. This product deserves the attention and backing from health officials and departments from around the world, for we are all in the pursuit of a noble cause”, he concludes.

AN OPPORTUNITY TO RE-IMAGINE HEALTH CARE

The health of a nation will mirror the health of its healthcare institutions, especially so in the hour of a crisis. And commenting on the current situation of these institutions and its committed frontline warriors, Minoo Dastur, CEO at Nihilent says “ The healthcare professionals have had to face the pandemic’s unkindest cut of all. Despite the availability of vaccines which are showing promising results, nevertheless good hygiene and sound precautions should be the best ally in our war against the coronavirus and managing the subsequent outbreaks.”

For organizations from within the healthcare sector, getting their operations back to normalcy is going to be a long winding journey. As a starting point, however, we present 4 distinct horizons along with specific focus areas. The first horizon, ‘Survive’ is about managing the turbulence, and seeks to address the immediate challenges that COVID- 19 represents to businesses, their customers, workforce, technology, and business partners. The second horizon, ‘Stabilize’, seeks to assess recent business performance and address near-term challenges and the lockdowns economic knock-on effects. The third one, ‘Revive’ seeks to create a detailed plan to return the business to scale quickly as COVID- 19 situation evolves and its impact becomes clearer. The fourth wave, ‘Reimagine’ seeks to accelerate business growth by adapting to the new normal, by studying what a discontinuous shift looks like, seizing the opportunities through innovation.

From our experience, we can identify the following trends, which will shape the healthcare industry in the coming times.

• Data analytics : with increasing cases of pandemics, there is an imminent need to hasten the process of clinical trials and drug development. The pharma industry has enormous amounts
  of clinical and molecular data available with them.

  Infrastructure for big data and social listening will also play a key role. There is also tremendous potential in the use of judicious use of RWD (Real World Data) to reduce the cost and time taken for development and clinical trials.

• Flexible manufacturing : coming out of the SARS epidemic of 2002-03, 3M realized it wasn’t fully equipped to handle unexpected explosions of demand in the event of a crisis, or what it calls an “X factor.” It decided to build surge capacity into its respirator factories around the world. More and more medical device manufacturers will start adopting such strategies, and the hard lesson on the risk around plugging into a global supply chain is only going to accelerate this trend.

• Digital health :we clearly see the emergence of digital health as the next big trend to impact the healthcare industry. Practices such as telemedicine, video consultations, health-related videos, and health tracking and monitoring apps are gaining popularity. Due to the spike in interest and a surge in the investments pouring into this space, even tech companies that have not dabbled in the health care space before are now entering the field.

• Preventive healthcare using wearables : Personal electronic devices such as smartwatches, smartphones, fitness trackers, and the like can give us an unprecedented amount of data to continuously collect and share a patient’s health data with doctors or hospitals. These devices can also provide valuable contact tracing for countries using them to monitor the contagion of the disease. We are progressively improving our ability to glean insights.

• Emphasis on Wellness as against Healthcare : over the last few decades years critics have pointed out how in spite of spending increasing sums on money on healthcare, the average health of the population continues to decline. We sense a gathering of momentum around value-based healthcare around the world with many thought leaders, in their call to focus on measuring outcomes rather than the cost of resources deployed, for health is increasingly seen as a fundamental human right.

With dwindling revenues, government measures in terms of liquidity infusion, tax reliefs, and other waivers will be crucial for the survival of health services providers. Given the stress test by Covid-19 and the minute attention it has brought, we see a very positive outcome for public health in times to come.

A business consultant with a master’s in bioinformatics, Anoop uses her vantage point to share unique perspectives on healthcare and wellness. She continues to explore the intersection of biology, technology, design, and commerce, for opportunities with the potential to deliver dramatic health gains to society.