One of the key factors to living with epidemics is a strong health system.
In Trinidad and Tobago, our health care system can be described as anything else but strong… some might say mediocre, subpar, or just okay.
However in order to mitigate the impact of epidemics, countries need to protect the health workforce and ensure continuity of health services during and after them.
Epidemics and pandemics put these systems under great pressure and stress. The sudden influx of large numbers of sick individuals to health facilities stretches the systems’ capacity and resources, even more so and more noticeably where resources are already scarce.
According to the World Health Organisation, when an epidemic emerges and spreads, it inevitably draws most of health responders’ attention and monopolizes most of the health system’s human and financial resources, as well as medical products and technologies.
People, efforts, and medical supplies all shift to respond to the emergency. This often leads to the neglect of basic and regular essential health services. People with health problems unrelated to the epidemic find it harder to get access to health care services. Some may die as a result, if the disruption overwhelms the health system. Mortality rates of other diseases for which people could not get treatment may rise.
Furthermore, health care settings, and especially emergency rooms, can become hubs of transmission.
Many people get infected there, (as we have learnt recently from the spread at the Port of Spain General Hospital) if prevention and control measures are not properly implemented. This is particularly true for unknown and emerging pathogens (for instance, MERS).
A delay in the recognition of the disease will lead to delay in applying the right protection measures. Infected patients will be able to transmit the disease because health care workers, family members and other patients will not know how to protect themselves. Because health care settings and emergency rooms are usually crowded, the lack of appropriate infection prevention and control for example through triage, isolation, and other precautions can be very significant.
Health systems resilience after epidemics may be challenging for unprepared health systems.
Indeed, if the health system is ill-prepared to cope with epidemics of infectious diseases, health care workers, at the frontline of the response, may themselves become infected and die. Tragic as such cases are, they have wider consequences.
In countries where there are health staff shortages, the loss of several more health
workers further weakens the health system.
It takes years to train new medical staff and rebuild the health workforce. In the meantime,
other constraints are burdening the health system that still has to provide the usual and
Long-term substantial investments should therefore be made to strengthen health
systems so they are able to provide safe, effective and qualitative health services before,
during and after epidemics. Critical elements include an appropriate health financing system
and a fit-for-purpose workforce that is trained, safe and provided with personal protective
equipment. In addition, access to essential medical products and technologies and a business continuity plan are essential to ensure that health systems are strong enough to withstand the increased needs and to mitigate the impacts of very disruptive epidemics.