Checklist for Addressing a Health Crisis

December 05, 2022

The pandemic caused by the SARS CoV-2 virus, which causes COVID-19, seems to be taking its last breaths; however, it is still—or should be—cause for concern, due to its ability to mutate and its potential to cause harm, particularly among at-risk groups. On the other hand, its organic impact mechanisms are still being deciphered.

The wake of the pandemic is evident and has marked, the hard way, the hearts of many—especially those who lost loved ones, sometimes more than one. In this connection, almost 20% of people who suffered from COVID-19—i.e., about one hundred million people—experience long COVID symptoms, which compromise their quality of life.

The world is rapidly returning to business as usual, with its problems and conflicts, and the daily struggle to survive for the vast majority of the population becomes increasingly imperative. This recovered “normal” feels very pre-2020, so much so that it seems that the pandemic never happened and it was just a nightmare from which we have already awaken.

Sometimes, memory is selective and suppresses traumatic experiences, perhaps as a defense mechanism.

The “new normal” was a popular catchphrase especially in 2021, which described a new way of facing our everyday lives, applying some sanitary measures, but it was merely said in passing.

But reality, or at least an approximation to it, is still there, and cannot be concealed. As of mid-November 2021, the Latin American and Caribbean region had about 14% of the nearly 630 million cumulative and laboratory-confirmed cases worldwide and 27% of the approximately 6.6 million deaths.

Data on excess mortality in recent years, based on pre-pandemic mortality patterns, show temporary surges that easily exceed 100%, especially in lower-middle-income countries.

One of the indicators that probably reflects the quality of response of countries to this event is the coverage of anti-COVID-19 vaccination. Although there are countries that stood out for high coverage as a result of a series of effective actions, others barely exceeded 50% of vaccination rate with full doses of the initial schedule, and 20% coverage for the booster dose.

Not to go into much detail, but rather, emphasize some specific issues related to the health system, the following checklist could be useful for decision makers in countries to reflect on what happened, and to be better prepared for the next health crisis.

Ítem

Training and development of human resources for health and stability of public officials

(for healthcare, promotion, management and communication)

Update of the epidemiological surveillance system

(early warnings, use of ICTs, optimized responsiveness)

Adequacy of health information systems

(towards a nominal and interoperable information system)

Healthcare Financing

(at least 6% of GDP and extraordinary budget items for identified emergencies)

Functionality of healthcare networks
(infrastructure and equipment, communication, functionality and resolution capacity to ensure continuity of care)

Functional laboratory network

(qualified staff, modern equipment, accredited reference laboratory)

Risk information, education and communication strategies

(social participation for health promotion, disease prevention and healthy practices)

Telehealth

(Internet for the network, staff training, equipment, monitoring)

Mechanisms to ensure access to vaccines, essential supplies and equipment

(revolving fund, strategic fund, etc.)

Revised social protection policies and mechanisms

(ensuring that basic, healthcare, nutrition and education services are maintained during emergencies)

These sectoral actions require continuous advocacy and coordination with other sectors and with technical resources available in the country.

Social protection policies and mechanisms should be discussed broadly and based on evidence, cognizant of the relevance of the health sector’s role.

Decision-makers could greatly benefit from pausing, reviewing and systematically reflecting on the lessons of the pandemic, taking into account its different dimensions. We cannot make the same mistakes, we must be better prepared, being aware that humanity is at one of the moments of greatest risk in case of health crises, as a result of our own actions.