Social and health care safety during the COVID-19

Hanna Tiirinki,
Senior Specialist, PhD,
Finnish Institute for Health and Welfare,

When on March 11, 2020 the WHO declared the COVID-19 as a worldwide pandemic, we faced a global crisis which brought with it unprecedentedly large human, economic and systemic impacts on the whole society (Tiirinki et al. 2020). In particular, the pandemic has placed the capacity, resilience and safety of the social welfare and health care system to the test in all countries.

In any case, quality and safety need to be the highest priority of the social and health care services in all situations. However, the pandemic brought many critical phenomena that have affected multiple levels of service system.

It can be noted that the social welfare and health care system has not been adequately integrated. The roles within different authorities related service system can be fragmented. This makes information transfer and cooperation difficult e.g. in social and health care patient and client safety. In Finland, the Ministry of Social Affairs and Health is in charge of the planning, guidance and implementation of national social and health policy. The organization of social welfare and health care services is the responsibility of municipalities. The system consists of 20 hospital districts and five university hospitals. Currently, eight out of the 20 regions have social and health care under a regional joint authority. In addition, Regional State Administrative Agency operates steering and supervising social and health care services.

During the first wave of the pandemic non-urgent medical treatment was downscaled in many countries, which formed a significant obstacle for its part to the realisation of good and safe care. The restriction taken to contain the pandemic have had significant in the social safety as well. The realisation of the safety during the pandemic must also be assessed when analysing the causes behind infection chains, for example in care units for the elderly.

Availability problems of personal protective equipment (PPE) were an alarming safety risk in fighting a serious infectious disease. Different countries faced a situation, where there wasn’t enough PPE available for social and health care workers. There has been competition in the international vaccine market as well.

It needs to be analysed, how a competitive situation of this form has impacted the health and well-being of people in the end. Various research projects have already been launched and multidisciplinary dialogue can create a basis for new research approaches, also from the perspective of the safety of social and health system.

The operations of social and health care have been managed under unprecedented pressure during the pandemic. It has shown that extremely demanding situations require systematic management and coordination to ensure basic functions. However, new practices e.g. digital tools have been implemented simultaneously. It is time to start to analyse which new practices have worked, and which have not.

The common intention has been to ensure safe and good care, regardless of the exceptional circumstances. From managers of social and health care it has required continuous reassessment of the situation. The realisation of social and health system safety has required timely decision-making, measures and restrictions, and, for example, appropriate reorganisation of functions in the operational units of social and health care.

Understanding of the ways in which the pandemic can be controlled has grown significantly. When comparing internationally, it can be concluded that the preventative strategies which have been successful are made up of the timeliness of different actions, up-to-date and coordinated communications and the utilisation of various digital tools.

The organisation of social and health care services in exceptional circumstances has required large investments, as far as management, employees and financial resources are concerned. Analyses carried out in different countries have in common finding that an evaluation of the effects of the overall costs of the pandemic, from the economic and health care system perspectives, will take years.

In the future, the realisation of the success of the safety, capacity and operational reliability of social and health system will depend at least on the foresightedness of preparedness strategies and the ability to manage their implementation in practice. It is clear, in similar situations in the future, we will also face complex ethical and moral issues.

COVID-19 has tested drastically the components of safety in the social and health care system. However, we have already learnt a lot, and the social and health care will be increasingly better prepared for future crises.

Tiirinki H, Tynkkynen LK, Sovala M, Atkins S, Koivusalo M, Rautiainen P, Jormanainen V, Keskimäki I (2020) COVID-19 pandemic in Finland – Preliminary analysis on health system response and economic consequences. Health Policy Technol. 9(4):649-662. doi: 10.1016/j.hlpt.2020.08.005.

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