Fast Company asked leaders\u00a0what\u2019s been lost and\u00a0what\u2019s been gained for the future of medicine.<\/p>\n
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Article by<\/strong><\/a> Ruth Reader and Ainsley Harris — Fast Company<\/p>\n James Merlino,<\/i><\/b><\/a>\u00a0c<\/i>hief clinical transformation officer of the Cleveland Clinic<\/i><\/p>\n The old saying in crisis is \u201cnever let the opportunity go to waste.\u201d We\u2019ve learned a couple things. One is that this has reemphasized the importance of safety. We\u2019re doing thermal screening for healthcare providers. We\u2019re testing any patient who\u2019s coming in for any surgery or ambulatory care. If they\u2019re COVID-positive, we\u2019ll delay their procedure unless it\u2019s an emergency.<\/p>\n The second thing is we\u2019re seeing technology innovations, such as virtual rounding done on an iPad and virtual [visits]. Before COVID hit, we were doing 3,000 virtual visits a month. In March, we did 60,000. Then there are small things, such as putting IV pumps and ventilators outside the door in our COVID ICU.<\/p>\n We have to learn how to live with COVID. Some hospitals may suffer. But I want to believe that this is going to make us deliver care more efficiently. We\u2019ve been talking about social determinants and chronic health for a long time, but this is our opportunity to step in. COVID-19 preys on the elderly, on the socially disadvantaged. Going forward, we have to manage COVID-19 with more consistent care.<\/p>\n Nancy Lublin,\u00a0<\/i><\/b><\/a>CEO of Crisis Text Line,\u00a0<\/i>a nonprofit organization that provides free mental health texting services\u00a0<\/i><\/p>\n If you were feeling things before, if you were struggling before, if you had an addiction or an eating disorder or anxiety or depression or a bad relationship, those things just\u00a0became a lot harder<\/a>. And even if you were perfect before, you are not perfect now.<\/p>\n<\/div>\n 53% of our texters before COVID were under the age of 17, and now the biggest age group we\u2019re seeing is 18 to 34. Their lives have just been turned upside down. They were adulting, and now they\u2019re home with their parents. Or they\u2019re quarantined with roommates whom they didn\u2019t really know that well, or sheltering alone, and that\u2019s really hard. Or they have little children. Dating has been disrupted for the 18-to-34 age group\u2014for everybody.<\/p>\n When COVID first hit America, we saw a massive influx in anxiety. They were using words like\u00a0freaked out<\/em>,\u00a0panic<\/em>, and it was mostly about symptoms. That shifted into what we consider the second wave of feeling: the\u00a0impact<\/i>\u00a0of the quarantines. We\u2019ve seen a 78% increase in domestic violence, a 44% increase in sexual abuse. We\u2019ve seen a huge increase in financial stress, people worried about homelessness, or thinking about financial ruin.<\/p>\n Mental health and well-being should be part of our education. One of the most important things is how to communicate with people, how to disagree with people, how to have productive relationships. And yet we don\u2019t learn any of this. Instead we learn calculus\u2014which I still haven\u2019t used.<\/p>\n Christos Christou,<\/i><\/b><\/a>\u00a0i<\/i>nternational president of Doctors Without Borders<\/i><\/p>\n Because of COVID, it is now extremely challenging to move our resources and our people to those places that need them. We\u2019re not allowed to fly from Canada or Europe to Yemen, Tanzania, etc. And we are not allowed to export any material, because of nationalism, a very selfish approach by states, which are fighting against each other for supplies. They want to show that they can protect [their citizens]. They will ban any exportation of PPE and, in the event we get a new vaccine, they will make sure that they can stockpile it.<\/p>\n There are multiple crises within the COVID crisis. TB patients are not allowed to access any hospitals at the moment, and they need treatments every day. HIV patients, the same. We have war traumas. Some of the facilities have been repurposed, so it\u2019s not easy for us to run surgeries. Malaria kills millions of people. We have the treatments, but [they\u2019ve] been affected\u00a0a little bit\u00a0because of all these debates about the chloroquine. We [also] have a rapid test for malaria. [But] the company that is producing this test has decided now that there\u2019s much more profit by repurposing it into a rapid test for COVID.<\/p>\n I\u2019m afraid for those places we cannot access. In Northwest Syria,\u00a0[after] Idlib was bombed [in February],\u00a0people were in desperate need of food, accommodation, and health services. All of a sudden, with COVID, everyone forgot about this situation. But this doesn\u2019t mean that their problems evaporated. Yemen is another place. In the past few days we have confirmed that there\u2019s a local transmission of COVID, and there\u2019s zero capacity. I\u2019m not talking about ventilators or ICU beds. They don\u2019t even have the test, the diagnostic. This is one of my nightmares.<\/p>\n The other one is related to those places where people live in high-density settlements. I\u2019m talking about communities like Cox\u2019s Bazar in Bangladesh, the Greek Islands, the favelas in Brazil, the\u00a0[refugee]\u00a0camps in Kenya. Anything related to good hygiene or stay-at-home policies in these place is just a luxury. [It\u2019s] not an option.We have to rethink health systems. It\u2019s obvious that only public health systems and national health systems are going to provide the solution. If we leave it to the free market, their rules are different: Their driver is profit making. They have every right to do so, but you cannot ask for vaccines or therapeutics and diagnostics from those people. In this [pandemic], we should not allow anyone to profit from the solution.<\/p>\n Dr. Gianrico Farrugia,<\/i><\/b><\/a>\u00a0CEO of Mayo Clinic COVID has enabled us to create virtual health as a new normal. Not only in terms of remote monitoring and acute medical care, but also for advanced care at home. For example, electrocardiograms can be done on a smartwatch to diagnose heart failure or to measure potassium.<\/p>\n As a nation, we have been promising and not delivering on telehealth now for several years, and that has had to do with licensure, regulation, billing, but also just healthcare\u2019s reluctance to change. With those barriers removed, we\u2019ve been able to move from maybe 400 to 35,000 virtual visits a week.<\/p>\n<\/div>\n Some of the regulations that have been relaxed need to become permanent\u2014and in a way that can be enforced so patient safety does not suffer. We [shouldn\u2019t] go back to where we were, because we would have lost a huge opportunity\u2014this tiny silver lining in the pandemic, which is the digital revolution of healthcare.<\/p>\n Yonatan Adiri,<\/a><\/i><\/b>\u00a0CEO of Healthy.io, a company that uses cellphone cameras to create clinical grade at-home tests for urinary tract infections and kidney disease<\/i><\/p>\n I don\u2019t buy that this has been the watershed moment for\u00a0healthcare. The forces of status quo are very strong. Physicians can now practice across state lines; Medicare will reimburse remote patients\u2019 sessions at the same price as in-person. People thought these things would take a decade to happen. We now have to work to keep this the new normal. All it takes is one company making false claims that creates a safety or efficacy issue and the whole thing will be rolled back.<\/p>\n Some things cannot be accelerated. I think that\u2019s the truth here. The FDA\u2019s approach [to approving COVID-19 tests] is like, we\u2019ll let you accelerate certain parts of your protocols, but if your evidence doesn\u2019t meet efficacy, we\u2019re not going to let it pass in the name of doing. To teach a person how to swab the back of the nose at home is a very, very complicated thing to do in big numbers.If this had happened 10 years ago\u2014without computation, without DNA sequencing, without cloud, without bandwidth, without high-resolution selfie cameras\u2014it would have been a million-and-counting dead, and not 300,000 dead.<\/p>\n Andrew Diamond,<\/a>\u00a0<\/i><\/b>chief medical officer at primary care company One Medical, which offers outdoor testing sites for COVID-19<\/i><\/p>\n<\/div>\n
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