New Delhi: Doctors from Bergamo, the epicentre of the coronavirus pandemic in Italy, have made a plea to the world to urgently replace the “inadequate” patient-centered care with community-centred care.
In a paper, these medical professionals have advised that more patients should be treated from home to reduce the risk of transmission.
Citing the strain on Italy by the pandemic, these doctors reflect on how to prepare for the next outbreak.
Doctors from the Papa Giovanni XXIII Hospital in Bergamo suggest the need for a “long-term plan” for the next pandemic.
The coronavirus pandemic has claimed over 6,077 deaths in Italy alone. Over 63,927 cases have been reported in the country so far.
The doctors from Bergamo claim that their hospital is “highly contaminated”. They maintain their health care system is struggling to provide “regular services” such as pregnancy care and child delivery.
“Western health care systems have been built around the concept of patient-centered care, but an epidemic requires a change of perspective towards a concept of community-centered care,” write Mirco Nacoti, Luca Longhi and their colleagues in a paper titled ‘At the Epicentre of the Covid-19 Pandemic and Humanitarian Crises in Italy: Changing Perspectives on Preparation and Mitigation’.
This paper was published in NEJM Catalyst, a peer-reviewed journal from the New England Journal of Medicine.
The experience of doctors in Italy can be crucial for medical professionals across the globe.
According to Maurizio Cereda, co-director of the surgical ICU at Penn Medicine and co-author of the paper, this is “because some of the mistakes that happened in Italy can happen here (United States)”. The western health care system is patient centric and “the virus exploits this”, Cereda adds.
In the paper, Bergamo doctors claim that they are learning that hospitals may be the main COVID-19 carriers. “This disaster could be averted only by massive deployment of outreach services. Pandemic solutions are required for the entire population, not only for hospitals.”
To equip the world to handle a pandemic, the Bergamo doctors argue that a switch from patient-centered care to community-centered care is needed.
Community-centered care would entail “home care and mobile clinics to avoid unnecessary movements and release pressure from hospitals”.
Since health workers are prone to being “asymptomatic carriers”, treating patients from home will reduce the stress of those on the front line.
Moreover, the paper claims, “early oxygen therapy, pulse oximeters, and nutrition can be delivered to the homes of mildly ill and convalescent patents, setting up a broad surveillance system with adequate isolation and leveraging innovative telemedicine instruments”.
This move could limit the hospitalisation to a “focused target of disease severity”.