Impact of COVID-19 within Chinese Healthcare Industry

 Background

The new coronavirus 2019-nCoV emerged in the Chinese city of Wuhan has caused one of the biggest health crises in recent years. What follows are the certainties and open questions about the episode. The declaration of a public health emergency of international importance is adopted before an outbreak a situation "serious, sudden, unusual and unexpected" with health consequences whose impact extends beyond the affected country. The declaration begins the process that makes possible an immediate and coordinated international action. WHO has taken this decision five times: for influenza A in 2009, against polio in 2014, against Ebola in West Africa in 2014, against Zika in 2016 and last July against Ebola in the Democratic Republic of Congo (Tam et al., 2020).

Since March 14, the coronavirus epidemic has been in stage 3. Many questions are asked of caregivers, in particular in town consultations. The Covid-19 epidemic has been considered a pandemic by the World Health Organization since March 11. The epidemic now affects the whole world, where the virus is actively and rapidly circulating. The objective is no longer to curb the spread, but to mitigate the effects of the epidemic (Anzai et al., 2020). The increase in the number of infections causes a risk of saturation of the health system, which implies its necessary global adaptation. The containment measures almost total population is in place since March 16.

All over the world, due to Corona virus, transports suspended. Classes in schools, canceled until further notice. The shops, closed. Wuhan's coronavirus, which has already killed many people, threatens to leave, at least in the short term, profound effects on Chinese economy, which already faced its lowest growth in decades, 6.1 % (Anzai et al., 2020). The GDP growth in the first quarter of this year could be reduced by one percentage point and stand at 5% or even less, due to the break due to the virus.

These days, different cities of the world, including China, look like huge deserts. Cinemas, museums, and tourist attractions have canceled their operations. Most stores remain closed; those that have opened - with dependents well covered by a mask - barely register activity, except those that sell food. Many restaurants have not bothered to reopen even though, under normal conditions, these would be cashier days: now the public avoids crowded places. 

Problem Statement

All stakeholders in the Chinese health system must therefore be ready and mobilized! The epidemic phase of Covid-19 aims to specify the intervention framework for the three sectors of healthcare provision as well as the coordination links between actors in the healthcare system to ensure the care of patients infected with this virus. In particular, this involves defining the strategy for organizing ambulatory care for the least serious cases and the organization of health establishments, which will mainly be mobilized for the care of patients with signs of severity or severity (Fouchier et al., 2016). 

Chinese healthcare industry is operating at its maximum capacity. For healthcare workers, terms like "contact tracing" and "quarantine" are becoming everyday lingo. People are seeing healthcare facilities stretch to their limits, and healthcare professionals knowingly expose themselves to an increased risk of contracting the virus. China has demonstrated an incredible ability to mobilize both people and capital (including building a completely new hospital in a matter of days) (Dai et al., 2019). Now, the rest of the world must do its part to help tackle the shortage of necessary resources and equipment.

This research study will explore the exact impact of Corona virus on the healthcare industry of China. 

Research Objectives

·      To find the role of Chinese healthcare sector in fighting against Corona Virus

·      To determine the impact of Corona virus on society of China

·      To investigate the effect of Corona Virus on healthcare sector of China

Research Design

Ethnography and phenomenology research designs are two qualitative research designs. The ethnographic research design is an effective technique to explore the experiences of individual’s belonging to a specific cultural group.  Creswell (2014) defined ethnographic research design as a technique for exploring human attitude from the point of the individuals to understand their knowledge about the cultural norms. This technique mainly involves using observations to study the healthcare sector. 

Observation technique is not easy and requires a focused approach (Steen and Roberts, 2011) to understand the impact of Corona virus on healthcare sector from the point of view of the person belonging to healthcare sector. This research design was rejected, as it does not suit the aim of the study. Therefore, phenomenological research design is chosen for this research project.

Data Collection

Phenomenological approach and the in-depth interviews will allow the researcher to understand human experiences in-depth and get hold of the meanings behind these experiences (Reiners, 2012).  Thus, this research study will use semi-structured interviews to collect data. Interviews will be face to face and the participants will be told about the topic and purpose of the research study (Taylor et al., 2015). 

The researcher will recruit the participants by using purposive sampling (Ritchie et al., 2013). It means that the participants will not be recruited on random but they have to fulfil some basic inclusion criteria (Levy and Lemeshow, 2013). 

Data Analysis

Critically assessing the substance transmitted by a given content is arraigning the interest, pertinence or significance of the thoughts that the content passes on to the reader a bland reader and specifically, clarifying the reasons why the content is intriguing to readers (Elo et al., 2014). The researcher will analyse the content, by using content analysis and then discuss the analysis of the research. 

Ethical Considerations

The researcher will first describe the purpose of the research to the potential participants and then ask them whether they are ready to participate in this study or not. If the participant will show the affirmation to participate then she will have to fill a consent form (Creswell, 2014). The researcher will make it clear to the participants that their anonymity will be ensured and their identity or personal data will not be revealed to anyone (Marshall and Rossman, 2014). The participants will also be ensured that their data will not be used for any other purpose. 

 

 

Literature Review

According to Phelan et al. (2020), the pressure on the health system facing the Hubei province and its capital, Wuhan, due to the coronavirus epidemic, shows the challenges of China in this sector. The most important impact of Corona virus on Chinese healthcare, as mentioned by Lai et al. (2020), is the deficit of human resource - although two hospitals were erected in record time and funds, equipment and supplies were moved from there to other locations. 

Schwartz et al. (2020) state that nurses are the backbone of the medical system of China and act as the first line of patient medical care and nursing quality is one of the most important factors determining medical service performance. It can be seen that the effects of job related stress occurs in nursing should not be just confined to individual level.

Zeng (2019) with different descriptions about occupational stress and job related stress in nursing some important ideas can be concluded. First job related stress in nursing, due to Corona virus, is very commonplace currently, considered as unpleasant and could possess many negative impacts on doctors and nurses’ physiological and psychological status. Second, stress can arise from different sources that related to different natures. Usually the demands that healthcare professionals of China perceive exceed their ability to cope and the ability of individuals coping with the stress can greatly vary.

You et al. (2018) regret that during 2008-17, the number of patients visiting hospitals, in China, almost doubled, but the number of doctors for every thousand individuals only grew from 1.58 to 2.44 percent. Thus, China has to strengthen health infrastructure in the near future, particularly in remote and rural areas. The Covid-19 coronavirus epidemic shows that medical facilities in some places are obsolete and cannot meet the demands of the local population.

In this regard, Phelan et al. (2020) urge that the number of hospitals grow at the same rate as other projects such as highways, after expressing confidence that local governments accelerate investments in the necessary healthcare services in each territory of the country. As a result of the contingency, the state strengthened the doctors and nurses in Wuhan with the military and more than 10,000 professionals, who have been providing care for an increasing number of patients with the coronavirus for weeks.

According to Munster et al. (2020), faced with the high demand for tapabocas in China, pharmacies have taken the opportunity to raise their prices in an excessive way. Beijing municipal authorities announced on January 29, a fine of three million yuan (393,000 euros) to a city pharmacy for having multiplied by six the sale price of the caps used to protect themselves from the coronavirus. The establishment was selling boxes of ten units for 850 yuan (111 euros), when its price on the Internet is around 143 yuan (19 euros). Given the almost imminent negative impact of the virus on the Chinese economy, the manufacturers of these accessories are among the few benefited since in some provinces the use of capbocas is mandatory.

Results

In replying to the question, all the participants unanimously said that in the epidemic phase, as during the flu, patients with a simple or moderate form must be taken care of using the medical and paramedical resources of the territory and by mobilizing all the actors. This outpatient care is intended to be organized by the health professionals usually concerned and according to the guidelines and recommendations given by city doctors of symptomatic patients in the epidemic phase of Covid-19". The teleconsultation should be preferred. When this is not possible, consultations must be done by appointment with time slots without appointment dedicated to patients with respiratory signs.

According to all the participants of the study, the healthcare industry is operating at its maximum capacity. For healthcare workers, terms like "contact tracing" and "quarantine" are becoming everyday lingo. The participants said that we are seeing healthcare facilities stretch to their limits, and healthcare professionals knowingly expose themselves to an increased risk of contracting the virus. China has demonstrated an incredible ability to mobilize both people and capital (including building a completely new hospital in a matter of days). Now, the rest of the world must do its part to help tackle the shortage of necessary resources and equipment.

Majority of the health professionals, who took part in this study, are of the opinion that China has to strengthen health infrastructure in the near future, particularly in remote and rural areas. The Covid-19 coronavirus epidemic shows that medical facilities in some places are obsolete and cannot meet the demands of the local population. All the participants urged that the number of hospitals grow at the same rate as other projects such as highways, after expressing confidence that local governments accelerate investments in the necessary healthcare services in each territory of the country.

All the participants agreed on the issue that the health professionals, due to this health emergency, face stress which yields consequences that impact imminent deterioration of  health, in all Bio-psychosocial spheres, and thus job performance degradation. Under all the above, it is necessary to raise the need to determine the stress of nursing staff manifested by the presence of physiological symptoms such as high blood pressure, palpitations, headache, abdominal pain, gastric ulcers, nausea, bloating, pain in the neck and back, involuntary movements of the hands or feet, poor or excessive appetite, tiredness, fatigue, exhaustion, excessive sweating, changes in breathing rate, etc., and / or psychological symptoms such as anxiety, decreased ability to concentrate , memory lapses, irritability, self-doubt, inability to accept criticism, indecision, sadness, lack of interest in what he does, smoking and other foods or drugs to calm down, among other symptoms.

The participants suggested that for proper intervention and fight against Covid-19 complete coordination between all the sectors of healthcare as well as the coordination links between actors in the healthcare system is required to ensure the care of patients infected with this virus. In particular, this involves defining the strategy for organizing ambulatory care for the least serious cases and the organization of health establishments, which will mainly be mobilized for the care of patients. 

 

 

 

 

 

 

Discussion

The current episode is indeed an opportunity to become aware of the weaknesses of Chinese healthcare systems. It could lead to questioning the "efficiency logics" to which they obey. In other words, seek to achieve a maximum objective, whatever the cost, rather than aiming at a goal, at the lowest cost because, the pandemic shows the extreme economic cost to cope with a shortage of beds. The logic of efficiency over time recalls that of ecological transition. Better to make "a significant investment" today in order to avoid "a colossal cost" tomorrow. One of the lessons from the current crisis is therefore the need to "over- invest in the health sector because, on the front line facing the pandemic, health infrastructure will be at the heart of China.

Initial flaws in reports and diagnoses show that Chinese encounter-based care model, one in which medical care waits for sick patients to arrive when they think they are sick, must change. The country must find a treatment and / or a vaccine. But because of the need for more research, more clinical trials, and mandatory safety protocols, China is one year away from a solution like this being readily available (Wang et al., 2020). Chinese healthcare needs to focus more than ever on coordination, across borders, with authorities, with research, academia, and the clinical community, and ensuring that the pursuit of public health outcomes goes beyond politics.

2020 has brought natural risks for China such as public health. From this point of view, it must plan and prepare for resilience as companies and as a society. Chinese healthcare must focus more than ever on cross-border coordination with authorities, with research, academia, and the clinical community, and ensuring that the pursuit of public health outcomes goes beyond politics. It must think more systematically about risks and preparedness: a viral outbreak is no longer a "black swan" but an anticipated event. As individuals, it must avoid the exaggeration of the end of the world that fuels unnecessary fear and seek facts from reputable sources and authorities.

A collective and measured response is key. Future reactions should be relative to risk. China should focus on diligence, safety and balance, while maintaining the highest possible normality. Despite the uncertainty and unknown resistance of the coronavirus outbreak, there will be recovery. China should evaluate and take stock of the lessons learned (Zheng et al., 2020). It should implement future measures for preparedness. What has become clear amid uncertainty is that global crises will persist and continue to recur. Chinese healthcare must look to the past and present to understand our future, not act as situations unfold.

The effects produced by the health emergency should instead be considered from the point of view and with the awareness that strategic choices do not always go in the right direction. But as often happens, this time too, the consequences were paid by the people who died, the doctors and the operators in the health sector to the extreme and the entire production system (Wang  et al., 2020) now lacking the necessary liquidity to get their businesses back on their feet and to cope with the payment of wages to employees.

Given the high number of deaths and those infected, as well as the organizational and structural deficiencies registered across the country ranging from: 1) failure to train health workers; 2) failure to comply with the provisions dictated by the modern world; 3) insufficiency of number of beds for intensive care; 4) lack of equipment in healthcare facilities due to lack of resources, up to the waste of public money for the construction of unfinished hospital works still abandoned and never put into operation today (Zhang and Liu, 2020). There is no doubt that the unexpected health emergency that has brought China, and the whole world, to its knees, should make the whole political class reflect on the choices made regarding current economic policies to re-organize a more efficient and advanced health model that already in the past had been counted among the best in the world.

The health companies of China are of the opinion that if Chinese healthcare continue to quarantine more and more places in China, they will start to break the normal interaction of society. This includes the normal movement of goods and people, medical supplies, food and medicine. At the macro level, this probably seems more harmful than useful for controlling the epidemic (Zhang and Liu, 2020). The Lancet endorsed the Chinese government, praising it for its speed of response and sharing of data with the international community. They also applauded the World Health Organization for not giving in to pressure to declare an international emergency without good reason.

Conclusion

The Chinese said they could have the vaccine ready in a record 41 days. However, healthcare professionals fear that Chinese scientists' efforts to accelerate vaccine development could pose major health risks and complications, and could worsen the disease if people are exposed to the coronavirus after receiving the vaccine. Such reactions have already been reported for vaccines against coronaviruses. 

What is most needed now is an international response to provide the necessary aid and medical supplies that local authorities continue to request. Given the exponential increase in infection rates, preliminary experience indicates that about 20 percent of those affected will require significant medical care - oxygen, monitoring of vital signs, possibly respiratory assistance, or even in some cases, case admission to intensive care. These resources are not easy to obtain and, even in large centers, access will soon be exhausted. Potentially, mild to moderate symptoms that can be managed conservatively can turn into a disaster for patients whose access to care is limited by a lack of resources.

Although the real impact of Coronavirus on Chinese healthcare is still unknown, however, depending on the impact that the coronavirus generates within the country, it will be what affects Chinese economy, without forgetting that pharmaceutical companies and hospital supplies providers will be the big winners.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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