Pandemonium in the Pandemic: An Impetus for Change in Healthcare Designs and Delivery Systems in the Post-COVID Era in the Indian Context

Hussain Ali John^* and Aarti Panchbhai

^*Correspondence: Hussain Ali John, Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), India, Email:

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Editorial

About 6.3 million people all over the world have lost their lives due to COVID. Out of 6.3 million, 530000 have been in India [1]. "6.3 million" is just a figure for us, because we can't possibly imagine the scale of despair and sadness the people who suffered and lost their lives have had to endure. Who can forget the hoarding of goods, shortage of essential medicines, oxygen, curfews, loss of livelihood and all the pandemonium this pandemic brought with it [2]. This pandemic has made one thing completely clear-"Life is a luxury which must be cherished and taken care of".

Darwin once said “It is not the strongest of the species that survives, but rather, that which is most adaptable to change" We must realize from this quote, that change is a part of life and if we don't change for the better, we will be left behind. No matter how hard or how unpleasant change is, change is what drives us to search for newer, better things. We all lost somebody or know someone who lost someone they loved, we owe the future to them, it is our duty to make better decisions and ensure that the future will be better than the present. The first case in India was reported on January 30th, 2020, from the state of Kerala [3]. From knowing almost nothing about the effects of the virus to developing the vaccine in record time. We as a human race have come together and shown if adversity hits us, we are ready to tackle the problem.

From learning new hobbies to using technology for education, from wearing masks in public to getting more acquainted with modalities for attaining better immunity, COVID has already changed us in a lot of ways. Apart from these, we have also made massive changes in our healthcare and healthcare delivery systems. Due to the rapid spread of the coronavirus, it became important to develop a chain of processes that protects the patient as well as the practitioner so no one is at undue risk. Proper optimization becomes quintessential particularly in the case of Dentistry as this healthcare speciality involves dealing with aerosols which can be a medium for the transmission of the disease. Aerosol can be defined as "A suspension of fine solid or liquid particles in gas" these are generated when we speak, cough or sneeze. As the coronavirus travels through the nasal and respiratory tract, extreme caution must be taken to minimize aerosol contact [4]. An effective and smart practitioner manages the patient’s symptoms, chief complaints while also protecting himself from the disease if it is a transmissible one like it is, in the case of COVID. The symptoms of this disease include fever, cough, tiredness, sore throat, headache, shortness of breath, chest pain etc. Apart from the knowledge of symptoms, it is also important to know that the symptoms take 5-14 days for a person to develop after contact with an infected person or a carrier of the disease. Even if a person is not showing symptoms, he/she can be a carrier resulting in inadvertent transmission of the disease [5].

Even before the patient enters, signboards are now present mentioning that no patient should enter if he/ she has any symptoms or are COVID positive and a signboard indicating that wearing a mask is mandatory. A thermal gun is now available at almost every clinical or the hospital and the temperature of each patient, worker and practitioner should be noted to avoid accidental contact with a carrier and proper monitoring for the safety of everyone. Different types of masks are available in the market like the 3-ply mask and N-95 mask, while it cannot be effectively enforced that the patient wears a specific kind of mask, wearing of mask should be made mandatory. A stand with alcohol-based hand sanitizer should be placed at the entrance of the clinic/hospital. The arrangement of the sitting area should be such that the attendant or the worker at the reception should stay at least 6 feet clear of the patients sitting in the waiting area. Even in the doctor’s chamber, such protocols should be followed. Before beginning any procedure, the patient must be draped and the practitioner should wear adequate PPE which includes but is not limited to surgical latex/nitrile gloves, shoe cover, face mask. Eye goggles, face shield. Care must be taken that these equipment are single-use and must not be reused for another patient. If a piece of equipment is reusable, the instructions for sterilization of the equipment are usually on the packaging. Apart from equipment, instruments must also not be reused unless they are properly sterilized. Disposal of single-use materials must be in different coloured bins as per the Biomedical Waste Management system rules of 1997, revised in the year 2016. The coronavirus has surely changed the way we view healthcare, it is not just a mere human necessity. More funds must be poured into it so we can keep improving the existing systems and keep up with the times, providing better and quality care to the patients and ease of use for the practitioner. The goal is to provide healthcare which covers all aspects of the human body and is universally available to everyone as healthcare must be a human right and not just for the rich few.

The new design and delivery systems are part of a bigger change where safety is of utmost importance.

References

1. https://covid19.who.int/
2. https://www.who.int/news/item/13-10-2020-impact-of-covid-19-on-people's-livelihoods-their-health-and-our-food-systems#:~:text=The%20economic%20and%20social%20disruption,the%20end%20of%20the%20year.
3. Arya V, Page A, Spittal MJ, et al. Suicide in India during the first year of the COVID-19 pandemic. J Affect Disord 2022; 307:215-220.

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4. Deogade SC, Naitam D. COVID-19 and dental aerosols: The infection connection. Avicenna J Med 2021; 11:107.

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5. Li G, Chang B, Li H, et al. Precautions in dentistry against the outbreak of corona virus disease 2019. J Infect Public Health 2020; 13:1805-1810.

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