COVID-19: An International Perspective

There has been a vast amount of corroboration behind the scenes between health care professionals from around the world. This is often unseen yet has played a vital role in the response to the pandemic. Lectures are often given with international guest speakers sharing learning and experience from the last 15 months.

Last week the World Health Organisations and the Royal College of General Practitioners (RCGP) gave a joint talk. Professor Marshall spoke from the UK, Dr Lui from China, and Dr Lola-Dare from Nigeria.

Professor Marshall is currently the president of the RCGP.

This is his update.

UK COVID-19: The Facts:

1.        75% of 10 million vaccines given in the UK have been given by NHS GPs. This has been an unprecedented effort.

2.      Of the total deaths in the UK from COVID-19, 11% are health care workers.

3.      In the UK, cases are currently around 600-800 per million. In Europe, it is around 200-400 per million.

General Practice Moving Forward

There have been some important changes to General Practice that have occurred due to the pandemic.

The main alteration is the use of technology. Pre-pandemic face-to-face consultations accounted for 80% of consultations. During the pandemic that fell to just 10%.

Now 45% of consultations are face-to-face and 55% are via e-consultation, tele-consultation, or text.

Population Health Management

When looking at the health of the nation, we can break down the relative influences on a person’s health into the following categories:

 ·        38% - Behaviour: smoking, drinking, drugs, high-risk behaviours.

·         23% - Social circumstances: food poverty, homeless.

·         21% - Genetics.

·         11% - Health intervention from medical professionals.

·         7% - Physical environment: pollution.

This shows that a person’s health destiny is largely down to themselves, their choices in life have a 38% influence on wellbeing.  

As well as personal life choices health screening can be an essential part of maintaining good health. It is important that the approach to preventative care is targeted and evidence-based. This topic will be covered in an upcoming blog.

What are medical professionals saying internationally?

Dr Yuanli Lui: Professor and Dean, School of Public Health, Peking Union Medical College in Beijing speaking from Peking.

Dr Yuanli Lui is the Professor and Dean at the School of Public Health, Peking Union Medical College in Beijing.  He oversaw the Chinese response to COVID-19 in China in 2020.

This is his review of events and an update on his view on how to move forward.

China’s population is five times that of the US population. US GDP is five times that of China’s GDP per person. The opposite has occurred in the ability to prevent illness. Why has that happened?

China 2020

Within 2 weeks of Covid-19 being formally identified on 31st December 2019, the gene sequence was released by China. On the 10th of January 2020, the gene sequence was shared with the world allowing every laboratory around the globe to start work on developing a vaccine against this virus and to study it. This is the fastest a virus has ever been sequenced.

China used the following five tools to control the pandemic:

The Five Tools:

1.      Science: Genetic sequencing.

2.     Technology: Identify and isolate people who are infected.

3.     Basic Infection Control:

On 23rd January 2020, for the first time ever in history, a city was placed in quarantine.

This affected 11 million people and was organised when there were only 444 cases.

It was visionary and courageous.

The decision was made because the 24th of January was the lunar New Year’s Eve and there was about to be a mass movement of people. It is estimated the number of cases prevented was between 500k and 3 million. The estimated lives saved were between 18k and 70,000.

China built 16 shelter hospitals within weeks to isolate people who had COVID-19 and to stop the spread of the virus.

Dr Lui used information from the UK studies which showed isolating cases and social distancing will reduce cases by two thirds.

4.      Leadership: Using evidence-based policies, holding stakeholders responsible, and mobilisation.

5.      Solidarity: The importance of everyone being in this together. Help from outside Wuhan was mobilised. Dr Lui mobilised 340 medical teams, 42,000 doctors and nurses were mobilised across China to Wuhan. Wuhan reopened on 8th April 2020 after around 3 months. 60,000 people had been treated. That is 60% of total cases so far in China.

Dr Lui said he feels currently one of the biggest problems is the social virus:

·         Misinformation

·         Discrimination – pitting one group against another.

·         Dirty politics.

Dr Lui’s view on how to move forward and the major issues he sees are:

1.       How to encourage detection?

2.      How to make the UN and WHO more effective?

3.      How to mobilise bilateral co-operation?

4.      Balance trade needs/anti-epidemic policies?

Dr Lola-Dare spoke from Nigeria.

The pandemic has not affected Africa as predicted.

Africa has dealt with Ebola and several other disease outbreaks in recent years and had systems in place for disease control across the whole population.

Had things been as bad as predicted Africa would not have been able to cope but in reality, so far, the health care system is coping.

Health care workers around the world are coming together and there is a vast amount of corroboration to try and both save lives and to get lives back to some sort of normal.

Conclusion

At Sloane Square Medical we have followed the advice from the Royal College of General practitioners and invested in technology to allow easy access for remote consultations.

It is important to maintain an effective relationship with patients and remote consultation should not become transactional medicine. This is our ethos at Sloane Square Medical and in line with advice from the Royal College of General practitioners.

At SSM we are incredibly proud to pioneer the use of new technologies to provide a world-class GP service. This approach allows us to keep our patients at the heart of everything we do, building long-term doctor and patient relationships based on the needs of each individual.

My very best wishes to everyone.

Dr Victoria Owen