Telemedicine’s pivotal role in treating covid-19 as an endemic disease
In the recent weeks, there has been more news and discussion about how we can transition from treating Covid-19 as a pandemic disease to an endemic disease in Singapore. One of the key initiatives is the home recovery scheme, where instead of getting treatment and recovering in the hospitals, individuals can do that from home.
A pilot test was started 2 weeks ago with 21 fully vaccinated individuals with mild symptoms and have enough room at home to self-isolate without being a risk to family members. They were given care packs to monitor their symptoms and have access to medical assistance via telemedicine whenever needed. The results are promising so far, with 9 “discharged” and the rest clinically well as of Sep 9.
This result is to be expected.
Based on data collected by MOH in the past month, 7/1000 infected patients require oxygen supplementation, with 0 death. Hence, instead of testing the efficacy of this mode of treatment in terms of recovery/death rate, it is more likely that the objectives of the pilot are to try out and fine tune the tools, processes and manpower required to enable the initiative, to gain some experience and confidence to roll and scale this up, and to demonstrate with success stories that it is possible for individuals to recover at home.
While I am glad that telemedicine is used to provide medical assistance to infected individuals, I hope video call is provided as an alternative option on top of a phone call.
Having spoken to a few friends about their experience doing quarantine, some mentioned it was really nice to receive calls from the hotel staff, even if it was a short exchange on how they were feeling, even when the call was not really needed. Extrapolating this to the home recovery scheme, regular check in communication with medical professionals can definitely improve the patient experience, letting the patient know that professional help is not just available to them, but is taking the initiative to reach out make sure everything is okay. There is a huge difference between knowing you can ask for help and having help extended to you.
Apart from frequency, the mode of communication also matters, and in the case of a video call, there are a couple benefits.
Firstly, aside from the identity of a person, we get detailed insights into someone’s emotional state and level of engagement when we see the person’s face. Through a video call, within the first few seconds, we can get a sense of how well or terrible the person is feeling, if they are coping well with the treatment plan or they are distracted or worried about something. With visual confirmation, we can be a bit more confident about the impression we are forming.
This is especially important to a medical professional who is used to meeting patients in person and may not be as acute and familiar in gathering such information over just a phone call. It is these little observations of facial expressions, eye contact and body language that can better inform about the state of the person, and enable the medical professional to better ascertain the well being of the patient holistically.
Secondly, telemedicine via video call as an alternative care can give infected individuals greater confidence and peace of mind to recover themselves. For the past 1.5 years, we’ve been living with fear of a disease that we knew nothing about and with constant anxiousness of getting infected and infecting the people around us. Possibly, the only fact that we find comfort in is the excellent healthcare services provided by our medical professionals. To a population who has been expecting all-rounded care in the hospital, it is extremely intimidating to have to manage treatment and recovery from Covid-19 independently.
To overcome that, having regular video calls with medical professionals emulates the check-in in the wards. It gives infected individuals a platform to ask questions and show the progression of symptoms. Seeing a friendly, familiar face, getting support, assurance and a peace of mind also goes a long way on the road to recovery.
As a side thought, another crucial area to the success of encouraging and enabling Singaporeans to recover at home confidently is to share as much information on the recovery journey as possible, so that we know what to expect, when (not if) it happens. What is included in the care pack to monitor the symptoms? What are the different stages and timeline of recovery? How do I know I am on track with recovery? What kind of medical assistance will I get? What happens when my situation worsens? How do I make sure I don’t infect my family?
The covid-19 situation has made many of us more anxious and paranoid. In such uncertain and unfamiliar times, oversharing of information coupled with going beyond to provider better patient experience are critical to nudge everyone in the direction of treating covid-19 as an endemic disease.
Not at all a professor in public health, I am just someone who likes to think about problems and come up with solutions, so I’d love to hear your perspectives on the value of telemedicine.
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