#EAPM – Rollbacks, tackling underlying disease risks and the need for a new social contract?

| May 11, 2020

More differing messages are emerging from EU member states in respect of rolling back the lockdowns across the bloc – with Germany perhaps coming unstuck by moving too quickly (we’ll see) and the UK still struggling to keep up. Meanwhile, the likes of Sweden, Denmark, Spain and Italy are going their own way to all intents and purposes and it’s fair to say that Europe looks on somewhat nervously, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.

Either way, it is clear that we do have to look at both the various exit strategies and, of course, the new normal that will constitute life, post-COVID. From an ‘expert stakeholder’ viewpoint, the coronavirus outbreak is certainly providing those in the health arena with an unparalleled opportunity to examine and emphasise the importance of resilient health systems, now and going forward. In fact, this formed much of the content of a recent EAPM co-organized virtual conference on future proofing, geared towards both Europe and Asia which, of course, share many of the same problems, and all connected topics will be revisited in a further event on 30 June. More of that below and a report to follow in the coming days.

Given the current global attention to the demands of an adequate healthcare system and the heightened interest in public health in general, it’s clearly time to address what can be done to ensure that the health systems of the future are resilient enough to not only handle shocks such as a global pandemic, but also respond those underlying forces that are shaping future healthcare needs. Going forward, there is a need to a great extent focus on how countries are using health data and digital health solutions in responding to the pandemic with a view to identifying some best practices.

On top of this, it’s time to look at the implications for digital health, and how such solutions can be used to manage public health, diagnose and treat (and now track) diseases as well as predict ill-health. And, yes, it’s certainly time to explore how governments can allocate resources between competing public health demands, and how available technologies can help – and how much more the EU should get involved directly in the health of its hundreds of millions of citizens.

These were key discussion points in the international virtual conference on futurproofing health care last Friday, 8 May.

Prevention and underlying disease risks

We all know, in the context of today’s crisis, that prevention could have played a bigger part than it actually did, has and is. In many cases (it’s hard not to highlight Britain once again) lockdowns were late, piece-meal, inadequate and testing was the same, despite many on the science side saying that testing and tracing is absolutely vital to an ultimate victory over the virus. Let’s not even mention the waffle over masks…

Of clear yet not-often mentioned import is the fact that, of the six WHO regions, Europe is the most affected by non-communicable disease-related morbidity and mortality. These, such as cardiovascular diseases, cancers, chronic respiratory diseases, obesity and diabetes are also major risk factors for patients with the novel coronavirus. Other methods to fight the virus – not least isolation – can also have a negative impact on sufferers by limiting the activity, and access to preventive or health promotion services among those with non-communicable diseases. It follows that, above the disaster that it represents all by itself, the pandemic has and will have broader and widespread health impacts, specifically among the vulnerable already mentioned.

A recent report from Italy – a country which has been particularly hard hit – shows that more than 96% of patients who have died in hospital from the virus already had comorbidities, and these were primarily non-communicable diseases. Therefore the prevention and control of such diseases have an important role to play in our response to the coronavirus, not least in order not to underestimate the danger, numerical and otherwise, to high-risk groups. The underlying issue of the risk of non-communicable diseases in the COVID-19 scenario must not be ignored.

So, we need to ensure that the response to the virus is adapted to encompass prevention and management of large non-communicable disease risks. This is a clear policy matter and lies at the heart of what EAPM’s members, partners and stakeholders strive for – to improve healthcare options for all.

Social contract – time for a rebuild

Never before, in most of our lifetimes, have the citizens of Europe en masse been asked and, in many cases directed, to make huge sacrifices to help in the battle against the coronavirus crisis. From working from home, teaching the kids in the house, to restricting exercise, even for the dogs, and trips to the shops, it’s been particularly hard for those without gardens and certainly those with cramped housing and, often, underlying other illnesses and vulnerabilities due, perhaps, to age.

We’ve become used to most of it, even wearing masks to many people’s surprise, but it cannot last forever – especially with the economy in free-fall and many of those making the major sacrifices with no guarantee of having their job back at the end of it all. Which would spell further disaster and, of course, has already raised fears of those seemingly always imposed ‘austerity measures’ coming into effect again.

Yes, it could be viewed that the public which is already suffering is being lined up to suffer yet again. So where’s the deal? What do we get back from our governments as we move through the maze of this pandemic? We’ve had around one-third of the global population under some form of lockdown lately – so it’s a long way off merely being Europe (just think of America, for instance, which is suffering hugely from infections and deaths yet nonetheless panicking about the economy and eager to reopen).

As it stands, most members of the European public seem to be riding the storm and ‘keeping the faith’, yet there will come a time – not too long off – when citizens begin to question whether their governments did enough to start with, are doing enough now, and crucially can be trusted to do so in the future. And this without serious extra impingements on our lives that we may, by then, deem either excessive, unnecessary or a blatant power grab. Let’s face it, governments are not traditionally big on transparency until they think their people can handle it, and even then perhaps not as transparent as they could or should be. Does nanny always know best? It’s a big question…

Core values challenged

Clearly, the circumstances surrounding COVID-19 have overturned our core values and societal rules (whether enforced or traditional) that we in the West are used to. Just for a little perspective, one analysis found that, by the last week of April, no less than 151 countries had planned, introduced, or adapted a total of 684 social protection measures in response to the pandemic.


Prepare for more change. AI expansion, and the greater use of tracking apps (they won’t just disappear, one way or another that’s for sure) are just obvious examples. Looking further down the line, what will surely begin to emerge (if it hasn’t already) is a wobbling of confidence in the social contract that we all sign up for but that, in the end, only works if those signing up get something of equal value back. This is at the bedrock of society. All the above topics will be discussed at EAPM’s next major video conferencing event on 30 June. Registration will be open this week for that upcoming Croatia-Germany EU Presidency bridging conference on the 30th of that month, just before the Croatia presidency moves in to Germany’s six months stint at the helm.

The conference is entitled ‘Maintaining public trust in the use of Digital Health for health science in a COVID and post-COVID world’, which certainly covers a multitude of topics, and we genuinely hope you can join us and lend your voice to these vital topics.


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Category: A Frontpage, coronavirus, Coronavirus face masks, Coronavirus Global Response, COVID-19, EU, European Alliance for Personalised Medicine, European Commission, Health, Personalised medicine, PPE

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