COVID-19 and resilience of healthcare systems in ten countries

Using administrative and RHIS data from ten countries, we assessed the effect of the COVID-19 pandemic on a spectrum of health services. We estimated the immediate effect after the declaration of the pandemic on 11 March 2020 and assessed whether services had returned to pre-pandemic levels by the last quarter of 2020. We found declines of varying magnitude and duration in every country. Effects were heterogeneous across countries, and we found no clear patterns in disruptions by country income group or according to the severity of COVID-19 epidemics. The health systems most affected included those in Chile, Haiti, Mexico, Nepal and South Africa. By contrast, Ethiopia and South Korea, which represent the poorest and richest countries, respectively, in our analysis, were among the least affected by health service disruptions.

The magnitude of health service disruptions at national levels also did not appear to be directly driven by COVID-19 severity. Of the ten countries included, six reported fewer than 2,000 cumulative cases per million in 2020 and even fewer deaths (Supplementary Table 3). Only 41 total cases were reported in Laos in 2020. Chile, Mexico, Nepal and South Africa faced higher COVID-19 caseloads, with peaks in June or July (or late October in Nepal). However, health service disruptions were largest in April and May 2020 in all countries, suggesting that they were not caused by overburdened health systems but rather by a combination of policy responses and demand-side factors. Several reasons for reduced healthcare use appeared common across countries: fear of contagion, inability to pay for healthcare due to loss of employment or remuneration, intentional suspension of routine care to leave room for patients with COVID-19, the redeployment of health workers or hospitals to COVID-19 care and prevention and the barriers imposed by COVID-19 lockdowns. Whether the type of COVID-19 response (for example, elimination versus steady-state strategies) or the stringency and length of COVID-19-related lockdowns were associated with the magnitude of disruptions remains unclear and should be investigated further.

On the other hand, we found patterns in disruptions according to the type of health service. Outpatient visits and hospital-based services (including emergency room visits, inpatient admissions, trauma care, accidents and surgeries) declined in every country reporting them, and these disruptions often persisted throughout the period analyzed. Other studies also reported declining inpatient admissions during the COVID-19 pandemic16,24. These declines may be explained, in part, by a reduction in need.

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General public library invests grant into wellness and conditioning systems

LAWTON, Okla. (KSWO) – The Lawton General public Library has made a decision to spend their yearly wellness literacy grant toward a plan that focuses on a balanced lifestyle.

Our library is one of the 36 public libraries that received this a long time grant, awarded by the Oklahoma Section of Libraries.

All 36 grants totaled around 220 thousand dollars, courtesy of the Institute of Museum and Library Providers.

Local community Engagement Librarian Tanya Organ reported they made a decision to commit the 9 thousand greenback grant into plans that will motivate the community to get lively.

”This year we acquired some library of items, individuals can look at out to use whether they want to use it 1 time or see if it’s some thing they want to buy for their dwelling,” Organ explained. “We ordered some bike mend stations. And we are heading to host some Thai Chi Lessons through OHAI.

Organ stated the Library of Points plan allows everyone who is about the age of 18, and has a library move, to look at out balanced living things for 2 weeks.

The objects variety from, weights, leap ropes, headphones, and even a metal detector.

The grant gave them the option to incorporate mild therapy packing containers and weighted hula hoops as very well to persuade movement and exercising.

”Some of these matters are products that if they are at the park participating in with their children, they may well not have the accessibility to get their tire aired up or everything,” Organ explained. “So it’s critical for us to get the information out there so individuals can use them.”

Apart from the overall health constructive assortment of goods, they also selected to develop 3 bike fix stations all all over city.

At the library, Elmer Thomas Park and Greer Park, which several of us know as Kid Zone.

”Our group being so sturdy in the bicycling, we having 2 substantial bicycle races, just one of them becoming the Tour of the Wichitas,” Organ said. “It’s just a good way to present an opportunity, if they’re out there schooling, they have a position to stop if some thing breaks on their bicycle.”

They hope to get these bike stations finished by February of this calendar year.

And and finally, they are likely to get started a cost-free Thai Chi class, starting off January 24, that focuses on harmony

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Labor shortage being felt at hospitals, healthcare systems

Almost every industry across the state over the past 18 months has been affected by a labor shortage.

Included in the labor shortage situation are health care staff, who are needed now more than ever as daily COVID-19 infections continue to surge across the state and in Northern Michigan.

Dr. Christine Nefcy, chief medical officer with Munson Healthcare, said Munson Healthcare — like many health care systems across the State of Michigan — is suffering from staffing issues for a variety of reasons.

Munson Healthcare, like other Michigan health systems including Ascension, Beaumont, Bronson, Henry Ford, Spectrum and University of Michigan, announced last month policies for staff to require COVID-19 vaccinations.

Munson Healthcare officials said the decision is a proactive move in anticipation of a federal requirement.

Specific details regarding a plan to require vaccinations for any business which employs 100 or more workers have not been released yet, but are expected to come soon.

John Karasinski, communications director for the MichiganHealth and Hospital Association, said it still remains to be seen what the actual policy details will be.

“However, our biggest concern is the potential impact on staffing,” Karasinski said. “While it creates a national standard for healthcare providers and facilities, it could result in employees in non-clinical positions leaving hospitals for other industries and smaller workplaces not impacted by the employer mandate.”

Other systems including McLaren have yet to make the COVID shot mandatory, but rather strongly encourage all employees to get vaccinated.

“Everybody is quite busy with non-COVID related issues as well as COVID, so all of (health care systems) are seeing the same thing,” Nefcy said. “What we have noticed here in Northern Michigan is our ability to transfer some of our sickest patients out of the system to other entities which would have traditionally taken them is taking much longer.

Christine Nefcy

“We are having much longer waits in our emergency departments for people who need to be hospitalized,” Nefcy added. “The pressure is really everywhere across the state and our ICU beds continue to increase in occupancy.” 

A story published recently in Bridge Michigan mentioned emergency department visits are up 43% in the last year in Michigan.

Additionally, studies have repeatedly shown emergency department overcrowding increases the risk of a patient to get sicker, or even die.

“Across our system we often see single digits in terms of critical care beds we have available and we

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