Driving evidence-based healthcare decision making in the wake of COVID-19

The COVID-19 pandemic continues to reverberate around the world. Some countries have already come out of lockdown, while others are still to experience the full impact of this new coronavirus. Many healthcare systems โ€“ especially in low- and middle-income countries (LMICs)โ€“ have struggled to contain the virus. Even where public health authorities have succeeded, their efforts often diverted resources from the fight against other diseases. Worryingly during lockdown, in some parts of South-East Asia for example, we have seen an uptick in cases of dengue fever and tuberculosis and a drop in vaccination rates.

We have also seen a global trend against science-based decision making. Medical professionals had to battle on two fronts โ€“ not only a pandemic, but also an infodemic of fake coronavirus news.

While we are still a way from containing this crisis, I believe there are clear and useful guidance for countries gleaned from the COVID-19 experience that will help us to drive more innovation and evidence-based decision making that will help us to futureproof healthcare systems.

1. The Health of Healthcare Workers Must Come First

This is a lesson that we should already have learned during the recent Ebola crisis in West Africa, but COVID-19 has reminded us of its importance: the personal protection of doctors, nurses and other medical support staff on the frontline has to be given top priority by governments. If many of them fall ill or even die, already stretched healthcare systems โ€“ particularly those in LMICs โ€“ are bound to collapse.

2. Leverage Big Data to Fast-track Policy

Thereโ€™s a traditional way of approving drugs and vaccinations; it relies on years if not decades of peer-reviewed trials and systematic reviews of all data available. During a pandemic we canโ€™t afford to wait that long. However, I believe there is a viable solution: we are now capturing much more and better data than ever before. Combined with powerful algorithms to analyse them, we can use a Big Data approach to model disease spread and treatment success to inform smarter and quicker policy making. My NUS colleague Alex Cook has been spot-on with predictions around COVID-19 spread in Singaporeโ€™s migrant worker population using this approach. In future, we should use Big Data analytics much more - not to replace traditional evidence-based research, but to complement it.

3. Build Capacity to Develop Treatment Guidelines โ€“ but donโ€™t reinvent the wheel

Developing treatment guidelines may not seem the most obvious priority when fighting a pandemic, but COVID-19 has shown that every country must fight disease in a way that is both standardised and tailored to its healthcare system. Many LMICs have struggled to develop treatment guidelines for COVID-19, because they donโ€™t have that legacy skillset. But there is often no need to reinvent the wheel โ€“ where guidance from places like WHO already exists. Given the mismatch between limited resources and competing priorities, we must help these countries to build capacity and streamline development processes while doing so.

4. Improve Data Collection and Sharing

Let me be frank: many LMICs donโ€™t know what their people are dying of. One of the main reasons is poor quality data collection: diseases are still tracked using pen and paper, and medical professionals on the ground have not been taught what data to collect. We must make a concerted effort to train medical workers even in the most remote locations to use a standardised approach to tracking what is happening on the ground and securely share the data with public health authorities. Beyond that, when we do have data, we need mechanisms to better facilitate open and timely data sharing and explore how countries can lend each other technical assistance.

5. Support a Health Policy Mindset Shift

No policy maker wants to make bad policies. But they are dealing with competing priorities and limited resources. COVID-19 has shown countries that they have to invest more in their healthcare systems. Healthcare should be seen as a development priority, with direct economic impact that benefits all of society. Good healthcare systems are about nation building, and โ€“ as the pandemic has shown โ€“ economic survival. I hope other countries will follow the example set by Indonesia whose leaders have been purposeful in making health one of three major policy priorities. 

Iโ€™m optimistic that together we can futureproof our healthcare systems. Thatโ€™s partly because of the dramatic difference that better data and data analytics will make in the years to come. And as I reflect on what I found most encouraging during the current crisis, it is the positive attitude of our younger generations, especially across the APAC nations, to realise a healthier world. They have shown huge creativity and potential especially in emerging technologies, and it is both for them and with them that weโ€™re going to build the healthcare systems of the future. 

Professor Tikki Pangestu is a member of the expert advisory panel for Rochel's FutureProofing Healthcare initiative. The views expressed here are his own.

Join the next live panel discussion on the future of health systems beyond the COVID-19 pandemic, with a focus on data-driven solutions for resilient healthcare systems.

When: Wednesday, 10th June 2020

Time: 15:00 CET

Click here to register: Building Resilient Health Systems: Data-driven solutions for a post-COVID world

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