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Economist: Chaos in health systems worldwide


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Today the health systems are on the verge of collapse and even more than at any other time since the outbreak of the pandemic.

An Economist article sheds light on the conditions prevailing in health systems worldwide and explains the reasons why most of them are in a state of chaos. The article initially refers to the “recent past” and how the recent pandemic has affected it. Governments imposed lockdowns to buy time to strengthen their hospitals in the interim. However, new units acquired or strengthened were ultimately left unused.

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For example, hospitals in both the UK and the US simply ended up closing down after admitting very few patients. Although today there are stories of hospitals in China being overwhelmed with patients, it is too early to tell whether these are isolated cases or a systemic weakness.

Today, however, health systems are on the brink of collapse, more so than at any other time since the outbreak of the pandemic. The Economist sought data and statistics from countries, regions and individual hospitals to identify the causes. So it seems that patients, doctors and nurses are experiencing the brutal consequences of the pandemic for the first time.

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High quality data are available in Britain. The National Health System is in a tragic state. Before the pandemic, a patient with a medical problem requiring emergency treatment (stroke or heart attack) waited an average of 20 minutes for an ambulance. Today he has been waiting for over an hour and a half.

In September, polling firm Ipsos published a global survey that included questions about the quality of the health system in 20 countries, all of them wealthy. Compared to 2021, the percentage of citizens who considered that they received “good” or “very good” services from their country’s health system decreased significantly. In Britain this percentage decreased by 5 percentage points. In Canada it decreased by 10 and in Italy by 12.

In Italy, the country that witnessed some of the most tragic images brought about by the pandemic, things look very bad again. For a breast ultrasound a woman may have to wait up to 2 years.

Dramatic stories have flooded the international media. Even in Australia, the time it takes to get a patient to the emergency room has skyrocketed compared to other years. The same is true for Canada where wait times have reached record levels for the country.

Even the richest countries are now under pressure. Today in Switzerland there are fewer ICU beds available than during the pandemic. Germany is also facing similar problems.

The US is doing better than most countries thanks to the huge sums it spends on its health care system. Again, however, for the first time the occupancy rate exceeded 80% for the first time.

Collapsed health systems lead to more deaths than the expected average per year. In many countries of the rich world, more deaths were recorded in 2022 than in 2021, the year marked by large waves of Covid. The number of deaths recorded today in Europe is 10% higher than expected. Germany is in the midst of a huge wave of deaths, with weekly deaths rising by at least 10% since September, with an increase of 23% in December.

What’s going on anyway?

The responsibility for the situation falls once again on the politicians without, however, always deserving it. The causes that have led to the chaos appear everywhere and are certainly related to the pandemic. And it may even be impossible for governments to deal with them.

It seems that the problem does not stem either from the financing of the health systems, nor from the number of professionals employed in the health sector. After all, today more people than ever are employed worldwide in health professions. In the EU alone, over 12 million people are employed in healthcare, while the number of healthcare workers in the US has reached a record high of 5.3 million workers.

The real problem is not the number of workers but how efficiently they work. Hospitals now do much less, having more workers. Even the protocols that are still in place about what a worker who has offered their services to a Covid patient is required to do is causing excruciating delays. While even the separation between patients suffering from Covid and all other patients creates additional problems.

Meanwhile, healthcare workers worldwide are literally exhausted, with metrics showing real levels of burnout. With the fatigue they carry from the period of the pandemic, it is completely normal that they now avoid giving the “something more” whether that means staying behind to fill out the bureaucratic forms or helping their colleague.

However, even this depletion of health system personnel is not capable of justifying the chaos that prevails. This, however, is explained by the boom in demand. Coming out of the pandemic, humanity needs more health services than ever. After all, we all went through two years in which we were hardly exposed to viruses at all. The result; Everyone you know has the flu today!

An equally important factor that explains the explosion in demand is the fact that for two years citizens stopped going to hospitals for diagnostic tests, either because they were afraid of getting infected or because those could not serve them. The result; In Italy, cancer diagnoses in 2020 fell by 40% compared to 2018 – 2019. At the same time, waiting lists in the UK NHS have increased, meaning that when patients are finally served they will absorb more resources.

With all the above facts and phenomena, today citizens feel that their countries are collapsing. Gradually the workload that the pandemic conditions brought to the hospitals will be dealt with. However, outbreaks of respiratory viruses in adults and children have peaked. The effort made by the health systems may have been enormous, but with the world’s population aging and the threat of the pandemic still present, the health systems we were used to in the past may now be the hallmarks of another, golden age.

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