Question

The correlation between responding to epidemics and the need of rationing medications and services

Answer 1

Epidemics always put the healthcare infrastructure under tremendous pressure. Healthcare resources are often built over a period of time to cater for the needs of the population under its service. When epidemics occur in a seasonal manner or are fairly anticipated, it is likely that the resources required are in place to tackle the sudden increase in healthcare needs. But unanticipated epidemics often put the healthcare system under tremendous pressure.

For example, in an area that is known for outbreaks of epidemics like hepatitis A or cholera or dengue fever, the healthcare system would have put protocols in place to address any sudden increase in requirements. This is often by recruiting points of primary care to provide a protocol based care, conserving the resources of the higher center for complicated cases.

But unanticipated epidemics often have no protocols in place and put extreme stress in the system. For example, the recent Corona outbreak. An epidemic if it's proportion is unprecedented in modern history. It took time to at least partially understand the course of illness and the population at higher risks. The infectivity was underestimated. As a result of sudden increase in the number of patients and patients requiring mechanical ventilation, countries known for excellent healthcare systems were under strain. For example, the European countries of Spain and Italy were totally unprepared for the crisis. The hospital's were not ready in terms of infrastructure if staff to face the epidemic. As a result, the number of deaths increased . The requirement for ventilators increased and could not be met. This also affected patients with other comorbidities who could not get routine care as most of the hospital's were catering to the needs of COVID. Such a situation has shown the need for rational healthcare services and medicines.

A lot of patients were on hydroxychloroquine for rheumatoid arthritis and other conditions. There was sudden misinformation that the medicine is a cure for COVID 19 and now countries don't have enough stock to provide for these patients or the healthcare workers.

Times of epidemics neccesiate rationing healthcare services so that the most deserving get the services and the healthcare system is not exhausted. Conditions which can be home treated should be managed at home so that hospital based care can be provided for the truly needy. Facilities like telemedicine should be used. Since epidemics often put a strain on the supply chain of medicines, medications should also be rationed.

Rationing will ensure that the critically ill and the patient's at highest risk will benefit from necessary care.