American systems face global challenges in response to COVID-19

Nurses greeted patients in front of the clinic to take their temperature and asked if they had been exposed. There was a hand washing station. Patients were safely placed in the waiting room. Hand sanitizers and masks were readily available.

Sanford Health clinics in Ghana looked and operated like those in the United States But surrounding communities lacked reliable internet service, a consistent vaccination schedule and adequate distribution channels, said Tracy Bieber, clinical services for Sanford World Clinics, who has just returned from Ghana on Sunday.

“Telemedicine is not as popular as in New Zealand or the United States, because when it enters rural areas, they don’t have very reliable internet,” he said, adding that some clinics experience “downtime” when connections fall intermittently. “It’s been a big hurdle.”

Sioux Falls, Sanford, based in SD, can still connect to the centralized communication system in Ghana to transmit as best warehousing and distribution COVID-19 vaccines, Bieber said. But connection problems illustrate how difficult it is to coordinate a global response to COVID-19 as many countries struggle with outbreaks.

Health systems in the United States, including Sanford, Cleveland Clinic, UPMC and Mass General, have tried to help their counterparts around the world in safety and distribution of vaccines, source personal protective equipment, Find supplies and guide public health security measures But they have been limited by the respective health and bureaucracy ministers of each country who slow or stop exports.

Without a coordinated, holistic global response to COVID-19, outbreaks in places like India and Nepal could soon become everyone’s problem, and should be treated that way, experts said.

“It can be a needle movement for us to engage our own leaders, whether here in the United States, Europe or other rich countries where we’ve piled up the global vaccine supply and we haven’t really advanced, and we say we have a global movement in solidarity here, ”said Louise Ivers, executive director of the Massachusetts General Hospital Center for Global Health, on a recent webinar coordinated by the Harvard TH Chan School of Public Health. “For us to look at it and say it’s someone else’s problem – it’s not, that’s our whole problem.”

Only about 800,000 of the approximately 31 million inhabitants in Ghana have been vaccinated. About 11% are they would be vaccinated in Costa Rica, where Sanford helped implement the first drive-through vaccination site in the country. But positivity rates are still very high, executives say.

“They’ve had some problems with government nurses pretending to give vaccines and sell them on the black market. People are so desperate that they’re willing to pay a little bit,” said Karoliina Slack, senior director of operations for Sanford World Clinics. , who has traveled frequently to Costa Rica. There’s a big concern about that – we have no way of knowing how many people have actually been vaccinated. ”

Costa Rica, which is heavily dependent on tourism, has been cautious in implementing rigid public health guidelines, Slack said, adding that the unemployment rate is about 25 percent. The Biden administration is trying to get vaccines in some countries, even though India has about 1 billion people eclipsing countries like Costa Rica, he said.

“If they get vaccinated, we have the protocol in place to help them operate quickly,” Slack said. “But that’s if they can get it.”

Even though vaccines were readily available, only 82% of Indian residents said they would get a vaccine if it was available at no cost to them, according to a recent Gallup poll. More than 1 billion people worldwide have said they were unwilling to take the vaccine.

“The more people who don’t take the necessary precautions, the more the virus will evolve,” said Julie Ray, managing director of global information at Gallup. “Here’s the worst case scenario.”

After India overcame its first wave, there was a false narrative that India had overtaken COVID-19, said Dr. Krutika Kuppalli, a fellow at the Society of Infectious Diseases of America.

“When you have the relaxation of public health measures with population density and socioeconomic issues, it was really mature for the development of the spread of these infections and the development of these variants, which is now leading to the high cases we see in city, ”he said in a May 12 webinar. “We’ve seen this spread in rural areas, which is really challenging.”

Mass General has partnered with Indian organization Mission Oxygen, which helps hospitals procure oxygen concentrators. But there is also a shortage of vaccines and supplies in India.

“Rich countries are 25 times faster at vaccinating people than poorer countries,” Ivers said, noting that less than 1% of the world’s vaccine supply has gone to Africa. “It’s a moral catastrophe. We have to do something about it.”

Cleveland Clinic Abu Dhabi offers vaccinations to caregivers and the general public, in coordination with Mubadala Health and the Abu Dhabi Department of Health. Cleveland Clinic caregivers have also volunteered with the National Health Service to help vaccinate the British public, a Cleveland Clinic spokesman said.

Clinical staff at the University of Pittsburgh Medical Center in Italy and Ireland have been vaccinated, a UPMC spokesman said, adding that the ISMETT transplant hospital run by UPMC in Palermo, Italy, has partnered with the government to increase vaccination efforts.

By mid-April, 2,000 elderly and 600 transplant patients had been vaccinated in ISMETT, with another 800 patients expected.

“I took this opportunity immediately, and looked forward to it,” said Angela Zaffuto, 80, of Palermo, who was the first person to receive the vaccine at ISMETT. “Now, I feel safer.”

It has been difficult for Sanford to help its international affiliates secure vaccination because each government has contracts with pharmaceutical manufacturers, which take precedence, Bieber said.

But Sanford has been able to leverage its skills and resources in terms of education, supply chain management, infection control, regulations and human resources, he said.

“There are so many resources at our fingertips. Sometimes we take that for granted,” Bieber said. “But this is something that most health systems can offer to our younger partners in different countries.”

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