Turning Adversity and Deprivation into Improvements in Medicine - The COVID Opportunity.

As the medical world braces itself to deal with the ongoing disastrous effects of corona virus (COVID-19), this global effort should be seen as an opportunity to use the experience to redefine the practice of medicine and surgery. Historically adversity, mainly conflict, has resulted in advances in medicine; infectious diseases [1], blood transfusion [2], or the development of mobile hospitals [3], which are currently being rapidly employed worldwide to deal with the demands of this unprecedented pandemic.

A simpler and frugal approach to medicine has to be adopted by less resource rich countries by necessity. Currently, with such an overwhelming pressure on medical resources, the developed world finds themselves in similar predicament, which could benefit the future of medicine. The pressure of overwhelming demand will force medical systems to work more efficiently, maximising what is achieved with disproportionately small and potentially diminishing resources.

The necessity to self–isolate in order to minimise the risk of cross contamination and rapid spread of the COVID-19 has changed radically our practice. The technical ability to undertaken virtual consultations, potentially reducing the need for clinician support staff, transport staff and costs have be available for almost a decade but only recently has work been started on exploring the use of technology [4], [5], [6]. Virtual clinics are rapidly being adopted in light of international locked downs. In response to the need to free up resources, sub specialities within medicine are being forced to radically re-think current practices. An example is The British Orthopaedic Association (BOA) [7] guidance advocating a more conservative approach to orthopaedic acute conditions. It recognises “Surgeons will need to consider alternative ways to manage many aspects of urgent orthopaedic conditions and trauma. Changes to standard management plans may be required to minimise patient exposure to disease and overall impact on resources.” Once the pandemic has passed, the same BOA guidance could be re-framed to address the urgent need to develop the practice of medicine in a more efficient manner that achieves the same or superior clinical outcomes at less cost. Furthermore, the quest over the last decade for those surgical procedures that promote early weight bearing, becomes even more pertinent [8]. Rehabilitation pathways are forced to swiftly evolve incorporating virtual reality and telecommunication platforms. Remote interdisciplinary communication and virtual clinical forums have received within weeks an impressive boost highlighting the inexplicable inertia of this readily available technology. The clarity of thought forcing changes in how medicine is practiced internationally at this time should be harnessed going forward.

During the course of the pandemic, there will be eureka moments, when doctors or other health care professionals ponder why this was not done before. These moments should be captured in a simplistic manner, through the following web keepitsimplesurgeon.com or using the Twitter #keepitsimplesurgeon or #keepitsimpledoctor. These seeds of thought could form the basis of more complex analysis going forward [9,10], with a clinical outcome, patient experience and wider health economic approach.

It is currently unknown how long the COVID-19 crisis is going to last. By the time this threat to humanity would be over, many lives would have been lost. Joining our thoughts and resources together, we must not allow this ‘COVID Opportunity’ to bypass us without collating the knowledge and experience acquired to transform our future. We ought this to the lives lost already and to the ones that will be lost.

Declaration of Competing Interest

None