Professor, Department of Healthcare and Pharmaceutical Management Jamia Hamdard New Delhi, India

Corresponding author email: shibu.john14@gmail.com

Article Publishing History

INTRODUCTION

The malady which stemmed from China’s Wuhan in late 2019 has continued well into 2020 with no indications of ending anytime soon. With over 36 million cases of the infection and more than one million deaths, the disease has morphed into a global crisis. Governments worldwide have formulated and executed quarantine measures along with other interventions, such as lockdowns, to suppress the transmission. According to the data provided by the Indian government, levying an early lockdown prevented 1.4 to 2.9 million infections and around 37,000 to 78,000 deaths. (The Economic Times, 2020) Such drastic measures, although necessary, gravely impacted all social orders and elements of practicality.

During a pandemic, like COVID-19, it is common that there is a substantial level of panic buying, which increases the demand of certain items such as toilet papers, kitchen towels, and canned food. (El-Terk, 2020) There was an apparent change in buying behaviour in the FMCG market, which laid bare the shortcomings of global supply chains. Pertaining to quarantine measures, a major concern was the delivery of essential items in severely affected zones. ( Singh et al, 2020) Along with disruptions in the economic landscape and livelihoods, the catastrophe has even disrupted essential health services delivery leading to adverse public health outcomes.

This article is based on a meticulous review of literature aiming to deduce the impact of the pandemic on the public health landscape, the system and process of health care service delivery and also on the business and behavioral practices which seem probable to be imposed upon us in the future, as put forth by many experts. Adopting precautionary regulations such as social isolation, increasing sanitation, and employing strict quarantine measures have proved to be beneficial in containing the virus. (Khachfe et al 2020) Implementation of these interventions have become a major part of our day-to-day lives, and consequently many ponder that which of these pandemic-induced modifications will become a part of the post-COVID era.

Repercussions for Public Health and Associated Sectors: With no regard for out-patient services and hike in self-treatment or self-medication, the struggling health care providing facilities and poor health status  of the people are a testament to the aftermath of the pandemic being more precarious than the outbreak itself. There have been changes in the health seeking behavior of the people, especially in case of major treatments such as surgeries, scheduled therapies, chronic treatments and others. The fear of the virus has also given rise to non-institutional deliveries, which further poses the burden of increased maternal and infant morbidity and mortality.

It was estimated that this loss of service will likely result in an additional 38 million unintended pregnancies, 679,864 child births, 1.45 million abortions (including 834,042 unsafe abortions), and 1,743 maternal deaths. (Mohitar, 2020) An expansion of vagrancy and in the frequency of different ailments is likely to be observed, attributed to the breakdown in immunization administration programs for polio, measles, cholera, human papillomavirus (HPV), yellow fever and meningitis, affecting at least 13.5 million people in 13 of the world’s least-developed countries. (COVID-19: Massive impact on lower income countries threatens more disease outbreaks, 2020).

For assessing the impact of coronavirus on Chinese population conclusively summarized that the virus has mild to moderate impact on the mental health and quality of life among residents. (Zhang and Ma 2020). However, this study needs to be conducted on the wider section of the society before reaching a conclusive answer.  An upsurge of over 21% was seen in crimes against women during the COVID-19 lockdown in India. Pertaining to unfit living conditions, many people have been subjected to unsurmountable mental strain and pressure – women due to increased household responsibilities, children due to changes in their lifestyle, young people due to job insecurity and loneliness, the elderly because of being a high-risk group and loneliness, migrant workers due to loss of livelihoods, frontline health care workers due to fear of contracting the virus and unbearable job pressures, and sexual minorities due to exclusion from government’s policies and changes in their lifestyle. With more than 50% of its population under the age of 25 years, the country reports around 28 suicides each day, as per the data from the National Crime Records Bureau. Nearly 197 million Indians are known to suffer from some sort of mental disorder and COVID-19 has adversely affected the mental health of these individuals. (Sagar et al, 2020).

The virus has also invariably altered the definition of normally accepted social behavior standards. Most of us prefer shaking hands or hugging our acquaintances to greet them, but in the health emergency that COVID-19 has caused, it may be considered as an act of ignorance. (Colive 2020) In the wake of ‘social distancing’ measures to prevent person-to-person transmission, infected people are being advised to self-isolate or quarantine, which is especially difficult for people with extraverted or outgoing personalities.

Being cut off from society can frustrate them and contribute to social incompetency, leading to a hike in the cases of mental and emotional episodes ranging from anxiety disorders to various forms of depression. Being virtually connected through telephone, video chat, or social media has become a coping mechanism. Telemedicine mental health visits, group visits, and delivery of care via technology platforms will be important components of stepped care for both acute crisis management and more routine communication and support. (Galea et al 2020)

The impact of the virus, disease-spread and its prevention measures has been drastic and multi-faceted. Individuals and corporations alike are participating in quarantine practices and evolving safer work structures and workforce redistribution, and compromising their operational activities to curb transmission rates and protect and safeguard the health of the public. However, COVID-19 disruptions do not affect all businesses equally. Some are deemed essential and remained open, while others were forcibly shut down. (https://www.hbs.edu/faculty/Publication%20Files/20-102_1c8a5b54-d400-4a8d-b136-d6890cf876dd.pdf). Essential services and businesses like clinical stores, centers, and emergency clinics remained open to support and strengthen the public health framework in the battle against this ensuing virus novelty.

Other activities vital to the civilization such as education, travelling, social engagements and businesses have also faced the brunt of the repercussions that COVID-19 entails. It has emerged as the biggest disruption in the education sector in history, making over 1.6 billion students staying out of school each day and demolishing opportunities, more so for the vulnerable groups, making them more prone to domestic abuse, lack of nutrition and mental strain. United Nations latest reports that closures of schools and other learning spaces have impacted 94 per cent of the world’s student population, up to 99 per cent in low and lower-middle-income countries. (United Nations, 2020) Young and adolescent children have been confronted with immense strain with regards to their well-being and security pertaining to school closures, changes in lifestyle and increased prevalence of nourishment uncertainty.

With most economies expecting a contraction in their GDP till FY-2021, and negative growth rates reported for the first quarter of FY-2020, various speculations state that the efforts to curb hunger and poverty worldwide will be gravely pushed back. The World Bank estimates that 40 to 60 million more people will be living in extreme poverty in coming months, depending on the scale of the economic shock Due to evident changes in worldwide markets and consequently, lesser flow of money into the economy, the chances of an economic revival seem bleak for the short-term. (Pangetsu, 2020) This indicates that the public health systems of all countries are bound to be impacted to some extent attributed to shrinking economies and negative GDPs and vice versa.

As the health care workers continue to fall sick, people continue to succumb to the virus and economies continue to crash, it has become crucial for institutions and individuals around the world to come forward and present a united front to mitigate this ‘external shock’ to the global health care system. Researchers, scientists and health care professionals from the world over have joined hands to seek treatments, or develop vaccines, or curate mechanisms for early detection of the disease. Companies and businesses have come forward to aid the frontline healthcare workers, keep the supply chains moving and providing financial and/or material aids to the vulnerable groups. Various communities, faiths, religions and people from all walks of life, have done and are doing in helping curb the spread of this virus novelty. As the COVID-19 keeps endangering the global community, various innovative initiatives have been put forth with multi-faceted collaborations between diverse stakeholders.

Some of these initiatives include WHO Solidarity Call to Action, UN Call for Technology Solutions, Coalition for Epidemic Preparedness Innovations Urgent Call for Vaccine Preparation. WHO Global Research and Innovation Forum towards a research roadmap, Global COVID-Zero Initiative, followed by tons of other undertakings. These efforts range from fund-raising for COVID-response to finding a vaccine to contemplating digital health or technology-based solutions to tackle the virus. World Economic Outlook Update states that the global community must act now to avoid a repeat of this catastrophe by building global stockpiles of essential supplies and protective equipment, funding research and supporting public health systems, and putting in place effective modalities for delivering relief to the neediest. (World Economic Outlook Update, 2020)

CONCLUSION            

Drawing on recorded evidence from the past outbreaks and the current scenario as it unfolds, analysts contend that the far-reaching effects of COVID-19 will leave a profound and seemingly irrevocable impact on the global community. As the health care systems worldwide stand on the verge of or have undergone a collapse, reinforcement of robust and pro-active public health measures emphasizing on healthcare promotion and prevention is crucial. These mechanisms will act as pillars upholding the trust of the population looking forward to experiencing normalcy. Surfacing, spreading and even re-surfacing of COVID-19 have made the world realize the value of building a resilient public health care system, that can withstand any crisis or external challenges. The repercussions of not acting now, will give rise to a challenging ‘Domino’ effect, not only on the health care delivery process, but also on public distribution system, economy and education. Multilateral foundations such as the WHO, UNICEF, UNESCO, and many more serve as role models in evaluating and implementing appropriate strategies.

The current arrangements have necessitated the formulation of migration laws, emergency preparedness, risk assessment and better monitoring and evaluation mechanisms in our existing health systems, processes for which are underway in many nations. The disease has travelled from one small region to around 213 countries and territories and is bound to resurface again, as evident by second waves in China, France, Singapore, Norway, Spain and regions of Australia. For the short term, the focus should be on saving lives and livelihoods by devising appropriate and sustainable containment strategies, followed by phased reopening and resumption of normal life. For the long term, the region should opt for a GDP-centric growth rebound by resetting and reprioritizing its healthcare policies. The economies should collaborate and move towards a more prepared, more sustainable and more resilient healthcare and business landscape, which would facilitate the attainment of desired growth while focusing on capacity building.

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