Beyond the Pandemic

COVID-19 is currently the top priority for Australia’s healthcare system. Whilst there is uncertainty about how the pandemic will unfold, the implications for our healthcare system could be long felt. We all owe a massive debt of thanks to our health sector leaders, health professionals and health and aged care workers for all they are doing right now in this response. There have been huge efforts put in across the sector (following so soon after the bushfires over summer) with lots of positive actions.

Actions taken so far include establishing clear protocols and pandemic response teams; allotting $2.4 billion in funding including paying for telehealth; conducting more than 633,107 tests (by 3 May 2020) and contact tracing; fast-tracking increases in capacity of the workforce, beds, equipment and diagnostics; and much more. It is likely that it will take some time post pandemic to achieve what could be considered ‘business as usual’. In addition to getting things back to working normally, it will be important to use the experience of this pandemic to help us be better prepared for the next one and use the experience of dealing with this crisis as a way to also consider other sustained improvements to our healthcare system.

Australia is currently in a propagation phase of the coronavirus. In mid-April, it appeared possible that Australia could be in a post peak period and will in coming months settle into a post pandemic period. Specialist epidemiology and pandemic response will be required to help Australia successfully make this transition, which may only be possible with a vaccine. The impacts, however, will be broad across these phases.

Post peak

We hope it’s not long before there is confirmation Australia is in a post peak period. New cases of COVID-19 will still emerge, but the most critical period of health system pressure would be over. At this stage, there will be a number of areas requiring attention.

Preparation for possible future waves

It is possible that actions taken now could move Australia into a post peak period, but additional waves of virus transmission could occur.

Actively preparing for this possibility will be important, particularly as social distancing requirements are reduced.

Viability of services

Small businesses are vulnerable to economic shocks like a pandemic. A range of allied health, aged care and community health services may experience significant issues with their viability, as could private hospitals if non- critical elective surgery demand remains significantly less than pre-pandemic.

Private heath insurance

It is unclear how post-peak the COVID-19 pandemic will affect the demand for private health services, including extras. It is possible that insured Australians will make less use of their insurance for a period of time, but that there will then be a returning demand post peak of the virus.

Elective surgery ramp-up

As capacity is returned to the health system, it will be important to have a clear understanding of elective surgery demand and make strategic decisions on whether there are particular priorities that should apply. Utilisation of private hospital capacity may help address built- up demand for public system care.

Address fatigue and mental toll

There is likely to be a significant physical and mental toll on clinicians and administrators through the pandemic period. A range of support may be required, including a critical need to allow a break. Proactive measures should also be taken to understand what other needs may exist.

Post pandemic

Once Australia (and the world) has achieved a post pandemic state, attention can turn to some of the consequences of the virus. These are potentially broad-ranging, and some will only emerge in coming weeks and months.

Mental health

Australia’s national resilience has been tested recently – significant regional bushfires and now nationwide virus risks. For some on the frontline, significant mental health issues could arise requiring support. More broadly in the community, proactive action may mitigate mental health issues emerging in the Australian population, particularly if some parts have experienced significant social isolation.

Telehealth

Australia is experimenting with new funding for telehealth, supporting use of this technology in ways that have not previously been supported through government funding. It may be that this experience can help provide a pathway to fund ongoing use for specific circumstances, improving Australia’s ability to deal with communicable disease.

Collaboration

The connections established or modified across the health system to better govern, manage and deliver during the pandemic are ones that could be useful to continue to a modified form, particularly as Australia prepares for any future crisis.

Health funding implications

Beyond the agreements around funding and emergency assistance, annual price determinations are likely to be impacted by the activity changes from COVID-19 treatment.

Opportunities from the lessons learnt

Whilst it may be difficult to prioritise supplementary data collection during a pandemic, where data is not normally captured, it is vital that there is objective information available for use when we achieve a post pandemic phase. This will help examine issues such as:

• • Optimal ways to manage initial diagnosis of those affected, and those with whom they may have had
• • Treatment pathways, and how best to manage the impact upon non- pandemic related healthcare.
• • Whether there were particular parts of the community disproportionately impacted compared to what the epidemiology would indicate – for example, related to social determinants of health.
• • Preparedness for next time – across all aspects of coordination, governance, supply chain, stockpiles, etc. This could also extend to fully understanding the reasons for and nature of transmission, and what actions could better mitigate these in future.

Written by Stuart Babbage, Health Practice Partner, PwC Australia.

This article has been adapted from the original article, first published on PwC’s website.

The original version can be found here.