health system responses to covid-19 in...
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HEALTH SYSTEM RESPONSES TO
COVID-19 IN OECD COUNTRIESWebinar: COVID-19 MANAGEMENT STRATEGY IN LITHUANIAWednesday 3rd June
Frederico GuanaisDeputy Head of the OECD Health Division
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The evolution of the reproduction number (Rt),
or why we all need to remain vigilant
Real-Time Estimates of the Effective Reproduction Rate (Rt) of COVID-19
0
1
2
3
4
5
6
7
8
21-Feb 28-Feb 6-Mar 13-Mar 20-Mar 27-Mar 3-Apr 10-Apr 17-Apr 24-Apr 1-May 8-May 15-May 22-May 29-May
Lithuania South Korea Italy Mexico
Source: Data from Arroyo Marioli et al (2020), Tracking R of COVID-19: A New Real-Time Estimation Using the Kalman Filter. http://trackingr-env.eba-9muars8y.us-east-2.elasticbeanstalk.com/ Accessed 3 June 2020
1.751.260.880.58
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AUS
AUT
BEL
CAN
CHL
CZE
DNK
EST
FIN
FRA
DEU
GRC
HUN
ISL
IRL
ISRITA
JPN
KOR
LVA
LTU
LUX
MEX
NLDNZL
NOR
POL
PRT
SVK
SVN
ESP
SWE
CHE
TUR
GBR
USA
0
2
4
6
8
10
12
14
16
18
1,5 2,0 2,5 3,0 3,5 4,0 4,5 5,0 5,5 6,0 6,5Practising doctors per 1 000 population
OECD
Practising nurses per 1 000 population
Doctors low
Nurses low
Doctors low
Nurses highDoctors high
Nurses high
Doctors high
Nurses lowOECD average: 3.5
OECD average: 8.8
Lithuania was well-placed to respond to COVID-19:
More doctors, slightly fewer nurses than most countries
Source: OECD (2020). Beyond containment: Health systems responses to COVID-19 in the OECD. https://oe.cd/31K
Number of doctors and nurses in OECD countries, 2017 (or nearest year)
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Lithuania was well-placed to respond to COVID-19:
4th highest availability of acute care hospital beds in OECD
7,8
7,1
6,0
5,5
5,5
5,0
4,9
4,9
4,3
4,2
4,1
3,8
3,7
3,6
3,6
3,5
3,3
3,3
3,2
3,1
2,9
2,8
2,8
2,8
2,7
2,6
2,5
2,5
2,4
2,4
2,2
2,0
2,0
2,0
1
2
3
4
5
6
7
8
Per 1 000 population
94.9
93.3
91.6
84.3
82.0
81.8
80.7
79.8
79.1
78.9
75.6
75.5
75.3
75.2
74.0
73.8
73.2
71.1
70.7
70.4
70.1
69.5
68.0
67.8
66.8
65.5
65.4
64.0
61.6
50
60
70
80
90
1002000 2017
%
Acute care hospital beds in OECD countries,
2017 (or nearest year)
Occupancy rate of acute care beds in OECD countries,
2000 and 2017 (or nearest year)
Source: OECD (2020). Beyond containment: Health systems responses to COVID-19 in the OECD. https://oe.cd/31K
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Lithuania’s effective test, track, and trace response:
Extensive and consistent testing
Notes: 1. People or cases tested. 2. Tests performed or samples tested. 3. Units of test unclear or inconsistent. Differences exist as to whether figures include tests, or individuals tested; whether they include all lab tests (public and
private) or not; on how regularly data is updated by each country; and other aspects. Date of testing data shown in the graph varies between 20 May and 1 June2020. Source: Our World in Data. https://ourworldindata.org/covid-testing
accessed 2 June 2020.
1,8
2,3 6,
517
,518
,019
,520
,4 23,7
24,6
24,6 31
,331
,631
,633
,4 38,0 41
,4 44,8
45,3
46,1
47,2
49,3
50,2
51,2 54
,2 57,0
58,2
58,3
60,3
60,7 63
,464
,766
,078
,091
,311
2,0 12
0,5 17
9,0
0
20
40
60
80
100
120
140Tests per 1 000 population
0,02
1
0,02
5 0,18
0
0,23
6
0,23
7
0,24
2
0,27
0
0,28
6
0,33
7
0,35
7
0,36
4
0,41
0
0,42
0
0,42
1
0,47
5
0,49
4
0,49
8
0,51
1
0,58
8
0,61
4
0,64
2
0,64
8
0,70
8
0,70
9
0,79
9
0,85
4
0,86
5
0,87
3
0,91
9
0,95
8
0,96
2 1,13
9 1,31
8
1,40
6
1,41
8
1,62
2 1,80
5
2,30
8
0,0
1,0
2,0
3,0Tests per 1 000 population
Diagnostic testing for COVID-19 in OECD
countries, cumulative total
Diagnostic testing for COVID-19 in OECD countries, daily
(3-day rolling average)
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The things to watch closely: COVID-19 imposes a double
burden on people with chronic conditions12
.1
15.6
23.2
23.6
23.7
25.2
25.9
27.0
27.5
27.7
29.2
29.4
30.0
30.3
30.7
30.8
31.3
33.2
33.6
34.5
36.7
37.0
38.5
40.5
40.9
42.2
48.1
49.4
0
10
20
30
40
50
60
70
80
%
Total 15-64 65+
1/3 of the population live
with 2 or more chronic
conditions
People living with 2 or more chronic diseases, 2014
Source: EHIS-2 2014 and other national health surveys.
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Things to watch closely: Opportunities for improvements in
primary health care
42
43 45 52 59 62 66
73
74 77 78 79
96 96 98 102
108
117
119
119
129
139
144
148
151
156
162
165
170 20
9
210
218
219
222 24
5
249
0
50
100
150
200
250
300
350
400
2012 2017Age-sex standardised rates per 100 000 population
Diabetes hospital admissions in adults, 2012
and 2017 (or nearest year)
Trends in hospital admission in adults, selected countries 2007-2017 (or nearest year)
Source: OECD (2019) Health at a Glance 2019. OECD indicators.
→ http://oe.cd/PHC
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• France: online bookings for GPs fell 44% and specialist care by 71%
• United Kingdom: emergency rooms visits decreased by 29%
• United States: visits to ambulatory care declined nearly 60% in mid-March(Source: https://sante.lefigaro.fr/article/coronavirus-l-inquietante-baisse-des-consultations-medicales-en-ville/; ; https://www.commonwealthfund.org/publications/2020/apr/impact-covid-19-outpatient-visits‘https://www.bmj.com/content/369/bmj.m1607)
• Scaled-up Telemedicine
• Scaled-up non-resource-intensive interventions that encourage self-management
• Developed guidelines to protect vulnerable populations (France)
• Expanded ‘hospital at home programs’ (Australia, Italy, New Zealand and UK)
Across the OECD, COVID-19 has disrupted the
continuity of care prompting countries to react
In response, countries have:
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How are countries using telemedicine now?
Expanded provider payment
e.g. Estonia, Slovak Republic, Poland, Japan,
Belgium, US, Ireland, France, Australia
New guidelines and regulations
e.g. Belgium, France, US, Japan
New services and platforms
e.g. Slovak Republic, Greece, Israel,
Turkey, Luxembourg, Brazil, Chile, Spain
New legislation allowing use
e.g. Costa Rica, Peru, Estonia, Poland
High-level political encouragement
e.g. Switzerland, UK, France, US
Image of coronavirus: Alissa Eckert, Dan Higgins/CDC
SARS-CoV-2
See http://www.oecd.org/health/COVID19-OECD-Health-System-Response-Tracker.xlsx for more
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The impact of COVID-19 on mental health and
wellbeing
COVID-19 presents a risk to mental health and
wellbeing for:
• Front line workers
• Mental health service users
• General population
• Phone and online support services for the
general population (10 OECD countries)
• Dedicated psychosocial support for
healthcare workers over the phone, online
or in person (e.g. FRA, IRE, UK)
Source: Sciencano (2020), ENQUÊTE DE SANTÉ COVID-19 : QUELQUES RÉSULTATS PRÉLIMINAIRES, Sciensano, Brussels, https://www.sciensano.be/sites/www.wiv-isp.be/files/report_final_fr.pdf (accessed on 30 April 2020).
The impact has been more significant for those with
less secure employment and who are less-able to continue working
In response, countries are offering:
Education
Status
Employment
Status
Working during
confinement
Teleworking
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Secondaryor less
Highereducation
Employed Unemployed Disability Continuedworking
Temporarysuspension
Able totelework
Not able totelework
Prevalence of anxiety Prevalence of depression
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Thank you
@fredguanais
www.oecd.org/coronavirus/en/#policy-responses
• Testing for COVID-19: A way to lift confinement
restrictions
• Beyond Containment: Health systems responses to
COVID-19 in the OECD
• Supporting livelihoods during the COVID-19 crisis
• Supporting people and companies to deal with the
COVID-19 virus
• Migrant doctors and nurses in COVID-19 crisis
• VET in a time of crisis:
• Public employment services on the frontline for
jobseekers, workers and employers
• Children and COVID-19
• Women at the core of the fight against COVID-19 crisis