Prof. Eyal Leshem, Director of the Center for Travel Medicine and Tropical Diseases at Sheba, discusses how we can beat COVID by strengthening Israel’s internal medicine and ICUs.
Israel’s health care system has set a global example of excellence for years. Outstanding doctors, modern treatments at lower cost than other developed nations, and the fact that Israel’s citizens enjoy one of the longest lifespans in the world all contribute to this status.
However, even with all of these assets, the public healthcare system has been sorely neglected and impacted by budget cuts that have compromised its ability to provide optimal care. The effects of staff cuts, budget cuts and hospital bed shortages could have been allayed by the proper use of existing resources.
As the COVID pandemic continues, we are witnessing a collapse of the principle of providing the best treatment with limited resources. Doing more with less is no longer good enough.
As a result of the lack of beds in regular wards and ICUs, as well as a lack of trained staff (particularly in internal medicine and intensive care), Israel has now entered its second lockdown in six months. Unfortunately, this comes at an enormous cost to the mental and economic health of Israelis.
Training internists who are able to provide top-tier treatment to intensive care patients takes many years. These patients cannot simply be handed off to doctors from other specialties. Although we don’t anticipate scenarios of patients who have no access to ventilators or thousands of deaths, and we don’t expect a total collapse of our hospitals, we do realistically expect thousands more people to get sick and die because critical treatments and diagnoses had to be postponed.
For the sake of protecting the health of Israel’s citizens, it is necessary to fortify hospital capacity in both internal wards and ICUs. First, we need to reduce the overwhelming burden on internal medicine departments and ICUs, which can be done by staffing the departments with physician assistants, administrators, phlebotomists and paramedics – all of whom will help reduce the load on medical teams and help more patients to be treated. The workforce needed can be pulled from the IDF reserves and students, and they can be trained to carry out procedures that the upcoming difficult winter may mandate.
Internal medicine and intensive care make up the basis for treating patients in the ICU. Compared to other fields of medicine, these specialties have been neglected and poorly paid for a long while. Subsequently, they do not appeal to young doctors. But as our population ages, the burden on the internal medicine departments is growing. To bolster these hospital departments, we must pay the doctors and nurses who staff them more appropriately. Without adding quality staff and more beds, we won’t be able to avoid the disgraceful sight of elderly patients hospitalized in hallways – and we certainly won’t be able to upgrade their treatment.
In the midst of these tribulations, there are encouraging points in our fight against COVID. In areas where the epidemic is raging, the healthcare system is holding its own and managing to use limited resources to counter the lack of beds.
Sheba Medical Center is leading the battle against COVID-19, preparing to open specialized units for children with COVID, patients with COVID who require dialysis, and psychiatric patients who are infected with COVID. All of these complex cases demand that medical professionals have both a firm grasp on treating infectious disease and the ability to balance underlying conditions with additional expertise. This combination is not always available at every hospital in Israel.
The national fight against COVID is served well by the smart use of leading global centers, such as Sheba. By supporting the departments that are already on the front lines, we will be able to grant the public healthcare system enough time to contain community spread. That is that only effective way to beat COVID and return to normal life.
Based on an article written by Prof. Eyal Leshem, Director of the Center for Travel Medicine and Tropical Diseases, Sheba Medical Center.