Welcome to Coronavirus Government Global Briefing, Mandarin Premium’s morning update on everything in local and global government responses to the COVID-19 outbreak.
Rehabilitation neglected as an essential service: WHO survey
The World Health organisation has released preliminary results of a rapid assessment survey of noncommunicable disease services (NCDs) throughout COVID-19. The survey was conducted between 1-25 May among 194 ministries of health, with 155 ministries (80%) responding in time for these results.
As the graph below demonstrates, ‘rehabilitation’ was the most commonly disrupted service, in part because it was — at least relative to other NCDs — neglected as an essential service within national COVID-19 plans.
The report, which also unpacks how people with NCDs are more vulnerable to becoming severely ill or die from COVID-19, found that:
- the three most common causes for service disruption has been a decrease in inpatient volume due to cancellation of elective care (63% of countries), closure of population-level screening programmes (45%) and government or public transport lockdowns hindering access to the health facilities (43%);
- the more severe the transmission phase of the COVID-19 pandemic, the more NCDs services are disrupted;
- most counties that have included NCD services in national COVID-19 plans have prioritised services for the four major NCDs (in order, cardiovascular diseases, diabetes, cancer services, chronic respiratory diseases); and
- rehabilitation was the most commonly disrupted service, which WHO found is because “rehabilitation continues being wrongly perceived as a non-essential health service for patients, when for many patients it is essential.”
On the apparent neglect of rehabilitation, WHO found that the most commonly disrupted services include “acute rehabilitation (premature discharge after COVID-19 but also e.g. after heart disease, stroke and surgery), post-acute rehabilitation (e.g. cardiovascular disease and amputations) and outpatient rehabilitation (e.g. people in need of physiotherapy)”.
This, in turn, could lead to compromised health outcomes; future increased demand, including longer inpatient stays; and preventable hospital admissions due to complications, and the body recommends:
“When rehabilitation services are temporarily ceased, decreased or diverted, clear guidance needs to be adopted to identify priority patients who should continue rehabilitation (e.g. surgery, stroke, cardiovascular emergencies and NCDs multi-morbidity). Wherever appropriate and feasible, tele-rehabilitation services should be used.”
The report notes four major guidance requests from participating countries, before offering some recommendations for building NCDs “back better”:
- Guidance on how to provide continuity for NCD programs (i.e. “How to provide ambulatory essential NCD services during lockdown”
- Communication materials (i.e. risk communication campaigns targeting people living with or affected by NCDs)
- Better data (i.e. “How to assess rehabilitation and palliative care services during COVID-19 response”)
- Country support (i.e. Provide training for policy makers on how to include NCDs into national COVID-19 plans)
- In ‘What past epidemics tell us about public trust in science — and scientists‘, economists writing for the London School of Economics and Political Science explain how their report, ‘Revenge of the Experts: Will COVID-19 Renew or Diminish Public Trust in Science?‘, found that people aged between 18-to-25, “whose core beliefs are still being formed,” are likely to suffer the strongest impact of COVID-19 “on their faith in scientists, but not in science”.
- Following two separate multi-centre investigations that found no evidence of interactions between anticancer treatments and COVID-19 morbidity or mortality, writers at The Lancet explain why standard oncological care should be offered to cancer patients with COVID-19 if feasible, including chemotherapy administration.
- Croakey founder Melissa Sweet has unpacked some of the consequences of Donald Trump’s plan to withdraw America from the World Health Organization.
- In ‘Covid-19 Is History’s Biggest Translation Challenge’, WIRED’s resident linguist, Gretchen McCulloch, unpacks the multifaceted communication challenges posted by the pandemic i.e. how services such as Google Translate, which only supports about 100 languages, exclude “thousands of other languages — spoken by people just as vulnerable to this crisis.”
- Researchers at Science have proposed a phased model for ramping up academic research during COVID-19, shown below, as well as a safety checklist (i.e. “Does the institution have the ability to track symptoms, conduct testing, and/or trace and inform contacts?”).
Costa Rica, WHO launch COVID-19 Technology Access Pool
Last weekend, president Carlos Alvarado of Costa Rica joined WHO director-general Dr Tedros Adhanom Ghebreyesus in launching the COVID-19 Technology Access Pool (C-TAP), a policy initiative aimed at making vaccines, tests, treatments and other health technologies to fight COVID-19 accessible to all.
Thirty countries and multiple international partners and institutions have signed onto C-TAP, which was first proposed by Alvarado in March as a means of voluntarily sharing global knowledge, intellectual property and data with the goal of accelerating the discovery of vaccines, medicines and other technologies as well as fast-tracking product development by mobilising additional manufacturing capacity.
The initiative has five priority areas, outlined below with some corresponding initiatives:
- Public disclosure of gene sequences and data — through publicly accessible databases such as the Global Initiative on Sharing All Influenza Data (GISAID);
- Transparency around the publication of all clinical trial results — i.e. publication through open license initiatives, such as the FAIR Guiding Principles for scientific data management and stewardship, and registration in line with WHO’s Joint statement on public disclosure of results from clinical trials;
- Governments and other funders are encouraged to include clauses in funding agreements with pharmaceutical companies and other innovators about equitable distribution, affordability and the publication of trial data;
- Licensing any potential treatment, diagnostic, vaccine or other health technology to the Medicines Patent Pool — a United Nations-backed public health body that works to increase access to, and facilitate the development of, life-saving medicines for low-and-middle-income countries; and
- Promotion of open innovation models and technology transfer that increase local manufacturing and supply capacity, including through joining the Open Covid Pledge and the Technology Access Partnership (TAP).
C-TAP will serve as a sister initiative to the WHO COVID-19 Strategic Preparedness and Response Plan and the Access to COVID-19 Tools (ACT) Accelerator.
To date, the project has received support from the following countries: Argentina, Bangladesh, Barbados, Belgium, Belize, Bhutan, Brazil, Chile, Dominican Republic, Ecuador, Egypt, El Salvador, Honduras, Indonesia, Lebanon, Luxembourg, Malaysia, Maldives, Mexico, Mozambique, Norway, Oman, Pakistan, Palau, Panama, Peru, Portugal, Saint Vincent and Grenadines, South Africa, Sri Lanka, Sudan, The Netherlands, Timor-Leste, Uruguay, Zimbabwe.
Note the absence, as least thus far, of much richer countries like the US, UK, China and Australia.
WHO, Costa Rica and all the co-sponsor countries have also issued a ‘Solidarity Call to Action‘ asking relevant stakeholders to join and support the initiative, with recommended actions for key groups, such as governments, research and development funders, researchers, industry and civil society:
“The COVID-19 pandemic has revealed the fallibility of traditional ways of working when it comes to equitable access to essential health technologies. This initiative sets out an alternative, in line with WHO’s efforts to promote global public health goods, based on equity, strong science, open collaboration and global solidarity.”
State wrap: VIC to reopen cultural institutions, NT defers games, and WA launches ‘Wander out Yonder’ campaign
- Yesterday, the Victorian government announced that the National Gallery of Victoria, the Melbourne Museum, Scienceworks, State Library Victoria and parts of Arts Centre Melbourne will re-open to the public on Saturday, 27 June.
- The NT has deferred the Alice Springs Masters Games and Arafura Games until 2022 and 2023 respectively.
- After the majority of Western Australia’s regional travel restrictions were lifted on Friday, May 29, the state government has launched the ‘Wander out Yonder’ tourism campaign. The government has also written to the federal government to permit travel into the Kimberley region from Friday, June 5.
- Finally, the Tasmanian government has announced a Treasury review into increasing the state’s ‘buy local’ policy, currently set at a goal to award 90 percent of all government contracts to state businesses by 2022.