The Covid Experience, Gain Not Just Pain for Human Healthspan

There was nothing expected about Covid itself, nor the consequences of its aftermath.? There was plenty of bad, but perhaps surprisingly, also good.? In the short term, the mortality threat drove distorted healthcare utilization, affecting preventative services (cancer screening plummeted), elective surgery (ie: hip replacements), and creating chaos within most inpatient service settings.? The full effects from two years with deficient preventative services has yet to be seen.?The effect on hospitals and nursing homes was immediate and often devastating with occupancy rates wildly distorted.? ?Raising the stakes, the strain of Covid on health workers led to burn out, while the inability to study in hospitals limited the supply of new fully trained staff.? Inflation in wages for experienced health workers soared as a result.? Just to add insult to injury, interest rates then rose, burdening the cost of infrastructure.

Nursing homes represent an extreme, with approximately 10% of residents dying during Covid, highlighting the inpatient risk.? Mortality (and the threat of it) led to plummeting census while costs for operators soared.? Seemingly a terrible business, supply of new nursing homes has continuously fallen since, with new starts now hovering at about 50% of their peak during the 2018-2020 period. This now seems like folly given the demographic boom is upon us and will drive the number of nursing home aged people from roughly 2.5 million last year to over 4 million in 2028.? With fears calmed and staffing beginning to normalize, demand is resurging.?It is not clear that there will be enough beds.

Cutting the other way, prior to Covid, telemedicine was illegal across some state lines, and it was poorly reimbursed.? That all changed as the imperative for out-of-hospital care exploded.? In a post-Covid era, as a result of new policies and developed technology, we now possess a greatly elevated potential to provide homecare for seniors in addition to lower touch prevention for younger populations.? Given that nearly 80% of people over 75 own a home, a lower cost homecare solution, particularly for the 30% who are not in need of long-term services and support, is possible.? The potential to restructure our bricks and mortar heavy, sick care-oriented system to bring better care at lower cost is clearly visible on the horizon.?Advances in remote monitoring and care coordination are still necessary for this to be a reality, but the data, technology and software to do it has come of age. Without the necessity of responding to Covid, it is unclear how long it would have otherwise taken for our political, regulatory and industrial complexes to make way for the advances now possible.