The ‘covidization’ of health care

The attention on COVID-19 is certainly warranted, given its grave human toll and its continued potential to kill far more people than it has already victimized. Even if it does not lead to death, COVID-19 can cause prolonged hospitalization and unbearable strain on health care systems around the world.

But what about other medical conditions and health concerns? Governments have poured resources on public health, but if we are to be precise, what we see right now is a dramatic escalation of COVID-19-specific care in particular, not health care in general. However unintentional, this “covidization” of health care is taking attention away from other health concerns, many of which are likewise a matter of life and death.

Consider, for instance, the conversion of many health facilities into dedicated COVID-19 facilities, and the suspension of other essential health services, including outpatient care and surgeries. Even though hospitals are opening, many individuals today would rather deal with their health conditions on their own for fear of contracting the disease. When combined with a history of neglect of public health systems, cases of patients with poor health access tragically add to the disaster.

Consider also the impacts of pandemic-related policies on health. Quarantine measures may be necessary, but the restrictions are limiting the ability and mobility of people to avail themselves of preventive and therapeutic measures, from doing exercise to availing themselves of medicines and basic needs, as well as vaccination.

Related to the above, the economic impacts of the pandemic are leading to, and worsening, food insecurity, and consequently poor nutrition and dire health outcomes. How are families coping as an increasing number of children’s “first 1,000 days” are spent in this situation? Alas, it will take years for the full impact of malnutrition to manifest, though developmental and mental concerns will be seen earlier.

Physical distancing, for all its intentions to prevent the spread of disease, also has a polarizing effect in highly stratified societies. The gap between the rich and poor becomes highlighted, especially in terms of health access and sustainability during quarantine. More layers of structural violence are added in the way COVID-19 disproportionately affects the poor and the marginalized.

Finally, academic research and funding are being channeled to the pandemic, potentially taking away resources from other vital areas of research. The fact that close to 2 million people will die this year of tuberculosis should serve as a sobering reminder that public health is broader than pandemics, and scholarship (and funding) should reflect this full picture.

Of course, the sooner the pandemic is over, the sooner we can turn our attention back to other health conditions; the sooner testing gets scaled up, the sooner health care workers can return to work and health facilities can reopen. This is why, in many ways, proactively addressing COVID-19 is key to ending the covidization of health care.

Even as we are still in the midst of the pandemic, however, we do not have to make the false choice between COVID-19 and other medical conditions. Telemedicine, for instance, is experiencing explosive growth and can help bring health to Filipinos during the pandemic and beyond—provided that we deal with issues of privacy, digital competency, and equity. Enabling primary care, especially community health workers, can also bridge the gaps.

Government should also make sure that quarantine rules—often unevenly and unreasonably implemented—do not get in the way of access to medicines and provision of essential services.

Any talk of a “new normal” should be about better funding and appreciation for public health and preventive care. As we move into less stringent quarantine measures, the fight against COVID-19 is no longer merely in the hospitals, but also in the communities, workplaces, and schools. Improving health centers in communities, as well as occupational and school health, must be among the priorities alongside testing, tracing, and treatment.

What we need is not just COVID-19 care for all, but health for all.

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Gideon Lasco and Joshua San Pedro are both physicians and anthropologists.