The situation bound up with Covid-19 will have not only an impact during the current crisis or the near future. Its effect on the future of health systems is something that will need to be followed closely as it may have a negative impact towards achieving the Sustainable Development Goal (SDG) number 3, with the draining of resources from other sectors to tackle the current pandemic affecting the rest of the SDGs
By Francisco Becerra-Posada MD, MPH, DrPH
Public Health Consultant, Mexico
Implications of Covid-19 Pandemic on Health Systems
Once the Covid-19 epidemic in China started moving to other countries, it was clear that at some point the WHO would declare a pandemic  once it had initially been declared a Public Health Emergency of International Concern (PHEIC) in January of this year . Given the rapid dispersion and high contagion rate, the world has come to adopt drastic measures as we all have seen globally, cities or country-wide lockdowns, mobilization restrictions, etc.
The amount of all sorts of resources devoted to tackle the pandemic, and the global economic implications of the lockdown and border closing, is unprecedented, with many countries moving fast to authorize specific emergency and budgetary measures to confront the problem, , while other have been slow to react. Decisions by governments to prohibit exports of health goods for national consumption, will too, place extra pressure to dependent countries on imports. The pressures of SARS-Cov2 virus on health services and systems is and will continue to be overwhelming. The world has seen patient crowded hospitals, exhausted medical and paramedical staff, and health services devoted to the pandemic.
The risks of all health resources devoted to Covid-19 are necessary, but health services can’t and should not forget about those patients with chronic ailments, such as diabetes, hypertension, HIV, TB, or in need of cancer treatment or that had received a transplant and who are in need of their medication or medical control. Countries and the world are closely following Covid-19 related deaths; however, we don’t know about deaths of other diseases not linked to Covid-19 that due to lack of access to medication or supportive health care are occurring.
Good things also come from these kind of global health events. Science advances faster and international collaboration is enhanced, barriers are down, and a common goal is being sought. Seeking a medical treatment, performing genomic mapping and sharing the SARS-Cov2 genome, working on a vaccine, and developing rapid tests for faster diagnosis and epidemiological control are examples of it.
As the numbers of positive cases increases globally, we can only have a glimpse of the costs and demands to health systems and services the pandemic is causing. From testing, consultations, hospitalizations, patients in ICU and all their needs, etc., plus demand of equipment, personal protection equipment, medications and many other resources that were not budgeted for and are now needed in order of taking care of the demand.
Resilient health systems are important to sustain the strains these situations can bring. If norther countries with good infrastructure and important budget allocated to health are suffering from the over demand, we just can imagine what will this demand cause to low- and middle-income countries’ health systems, systems that might be weaker that those of rich countries, and that may not have enough resources to finance the unexpected demand.
This situation will have not only an impact during the current crisis or the near future. Its effect on the future of health systems is something that will need to be followed closely as it may have a negative impact towards achieving the Sustainable Development Goal (SDG) number 3, with the draining of resources from other sectors to tackle the current pandemic affecting the rest of the SDGs. Even more, if the global economy will suffer in the years to come as many predict, SDGs will be seriously jeopardized and the people living in a state of vulnerability might be the ones most suffering.
Social determinants will widen and people in those groups might take longer to come back to the level of lives -even difficult ones- they were living before the crisis. Those who survive on a daily income, work as informal vendors, or day to day workers, if cities and countries shut down their income will also shut down. Their livelihood will be affected, as well as the ones of small businesses and starts ups that have been forced to close and nevertheless their expenses still have to be taken care of, such as rent, electricity, etc.
This is the moment countries’ governments have to take and move forward social support to sustain their vulnerable groups, as well as to support the productive sector with financial incentives and emergency measures. How countries cope and invest for their future after Covid-19, will determine the recovering and coming back to what we used to know as “our normal lives”.