Corona devastation 2019, 2020 Journey of corona virus (covid 19

Corona devastation 2019, 2020

 Journey of corona virus (covid 19)

 Corona :

The acute crisis with the coronavirus disease of 2019 (COVID-19) caused by the novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) is the largest biomedical catastrophe of our lifetimes. Like so many other disasters in the past, such as war, famine, social unrest and economic calamities, this too shall pass, but it will undoubtedly leave the world changed. Some of the changes are already evident, but some are inevitable once we get over this pandemic. In this perspective, I provide examples of how the virus is already inducing change in the practice of medicine at large and for nephrology in particular.

The fight against COVID-19 was not just against the virus. The deliberate actions taken by large healthcare systems to fight the virus created another problem. In the face of the pandemic, most routine medical services were suspended. Because of the lack of access to routine medical care, patients with chronic illnesses were now exposed to potential harm. COVID-19 was pushing all other diseases by the wayside, and telemedicine rapidly emerged. Many of the rules that would have taken years to be approved were passed almost overnight. Visits to patients using cameras next to the dialysis machine or by phone were rapidly adopted. Many practices started seeing patients by telehealth visits.

COVID-19, being a droplet-borne viral infection, necessitated social distancing and required patients to be dialyzed in a manner that reduced the risk of viral transmission to other dialysis patients in the same unit. One option was to dialyze such patients at home. Thus home-based systems—instead of in-center dialysis requiring centralized water delivery systems—may emerge. Receiving self-care dialysis during catastrophes may make more sense for our patients and may enter the lexicon when planning care for patients reaching end-stage renal disease. Patients may therefore lean toward home therapies such as peritoneal dialysis or home hemodialysis, instead of in-center dialysis.

Some changes are already evident. For example, the Food and Drug Administration issued new guidance for research during the pandemic and approved diagnostic tests in a matter of days. It also approved within a matter of days emergency use authorization for the use of imported anesthesia gas machines modified for use as ventilators. Trials of vaccines and drugs were fast-tracked. But the future of research is moot.

In a 2015 Ted Talk, 'The next outbreak? We’re not ready', Bill Gates speculated rather accurately that it is not a nuclear disaster but a virus that will kill more of humanity [16]. Yet globally, the allocation of national budgets to healthcare is often a fraction of defense budgets. If our society recognizes that a more realistic enemy we face is an infection—and not a nuclear war—it may dedicate more resources to healthcare as a deterrent to this calamity.