Key Points

• 155,000 COVID-19 Winter numbers have overtaken the 2021 figures for the same period.
• A seven-day average of 2260 deaths due to COVID-19 is being witnessed in the US.
• Significance must be given to the strain on the healthcare system and the number of deaths that the variant has caused.

As the omicron variant pushes cases and hospitalizations to a record high, Dr. Rochelle Walensky, Director at the Centre for Disease Control and Prevention, has warned against taking a casual approach towards COVID-19 even if the infection is milder than the previous strains.

According to her, milder by no means should be taken as mild and the strain cannot be allowed to dwarf the health system and the number of deaths it can cause. She adds that there is still a threat of a high overall disease burden that everyone is facing. She has asked people to remain vigilant, wear masks at all times, and get inoculated.

The Department of Health and Human Service Data says that US hospitals account for around 155,000 COVID-19 patients, which is above the numbers from 2021 winters. As per compiled data by John Hopkins University, the country is reporting an average of 2260 COVID-19 deaths every day.

Most importantly, what these numbers are doing is adding more stress to the health care industry. The healthcare industry has already seen innumerable resignations in 2021 and those who are still a part of it have been facing contraction through inbound cases, forcing them to spend days in isolation off from work.

Walensky says that she knows there are many people tired, but hospitals are also facing the brunt of overcapacity. In a recent step taken by the CDC, the isolation time for healthcare workers was cut, and in addition to that, the Biden administration has already put in place military doctors to help the already overwhelmed hospitals. However, from what is witnessed, the health workers are still struggling.

Anthony Fauci had earlier in the last week of January said that the end of omicron may be approaching soon. Most of the states, according to him, will be peaking in mid February and, in fact, in some cases, have already started to see a decline as well. Even

though the curve goes down, there are still many thousands of infections per day on the other side of the peak. Walensky is of the strict opinion that American citizens must adhere to COVID protocols and also get boosted.

Royal Philips, a global leader in health technology, announced the introduction of the industry’s first full-service, at-home, 12-lead electrocardiogram (ECG) solution for use in decentralized clinical trials. The clinical-grade solution is the most advanced patient-centric ECG offering within the company’s cardiac monitoring portfolio, pairing data readings comparable to clinical, site-based ECGs with Philips leading cloud-based data collection and analysis services. This latest addition to Philips’ digitally enabled suite of monitoring solutions helps to drive innovation across the care continuum and support the decentralized clinical trial space.

Patient attrition is one of the biggest issues faced by clinical trial sponsors seeking regulatory approval for new therapies. Attrition over the course of a study can reduce the quality of its findings and can lead to longer, more expensive trials that require higher than optimal recruiting rates to compensate. Voluntary patient withdrawal is often tied to disease progression or the prolonged inconvenience of adhering to protocol regimens and repetitive site visits [1]. By offering the consistent and reliable standards of a 12-lead ECG in the comfort and convenience of a patient’s home, Philips at-home ECG solution aims to improve trial recruitment, compliance and patient retention by reducing the need for and burden of site visits.

Our growing portfolio of remote monitoring solutions help to curb patient attrition by reducing the amount of site visits required during the trial period, helping to improve both the quality of the outcome and the patient experience overall.

“Our customers are seeking solutions that will help them to address key challenges that can stand in the way of extracting meaningful insights from their clinical trials,” said Andy Broadway, General Manager of Ambulatory Monitoring and Diagnostics at Philips. “Our growing portfolio of remote monitoring solutions help to curb patient attrition by reducing the amount of site visits required during the trial period, helping to improve both the quality of the outcome and the patient experience overall.”

Leveraging PCA 500 ECG patch data recording technology, the at-home solution allows clinical trial participants to record data with quality comparable to site-based ECGs at home. The solution’s innovative body-worn patch ensures compliant 12-lead ECG placement and near real-time, highly secure data transmission without the need for recurring site visits, onsite technician, or home nurses.

Philips offers a complete range of clinically validated ambulatory cardiac diagnostics and monitoring services and associated expertise to its cardiac care portfolio, including its BioTel Research capabilities that have already supported more than 2,000 clinical trials in 72 countries. These comprehensive offerings provide industry-leading technology and data management that streamlines the clinical trials process and ensures optimal performance. The at-home, 12-lead ECG solution is now available in select markets across North America, Europe and Asia.

Jeddah, in the Kingdom of Saudi Arabia, is set to become home to a 150 bed world-class multi-specialty hospital, which will be fully integrated with King’s College Hospital’s facilities in London.

Building on the success of King’s College Hospital Dubai, which in a short period of time has become one of the best hospitals in UAE, Ashmore Group, a specialist emerging markets investment manager, in partnership with King’s College Hospital London and Saudi Bugshan Group, is pleased to announce the start of construction of King’s College Hospital Jeddah (“KCHJ”). The hospital is scheduled to open its doors to patients in the second half of 2023, and this is expected to be the first of many similar projects providing Ashmore and King’s the platform for further growth in KSA.

KCHJ will be the country’s first truly integrated hospital bringing the full benefits of King’s College Hospital London to KSA, and playing its role in achieving the Kingdom’s 2030 vision in the healthcare sector. The London-based tertiary hospital is part of the world leading UK National Health Service, with a 180 year history of successfully caring for patients with complex conditions. King’s is also one of the largest teaching hospitals in the UK. The hospital’s 13,000+ staff in London treat over one million patients every year.

Scheduled to open in 2023, the state-of-the-art King’s College Hospital Jeddah, located on King Abdulaziz Road, will cover an area of over 32000 square meters, with a capacity of 150 beds in the first phase. The hospital will be staffed with over 1000 leading healthcare professionals, sourced from London, KSA and wider region, delivering care in line with the tested clinical pathways of King’s College Hospital London. Clinical innovation and smart technologies will be a prominent feature at the hospital, with 40 medical and surgical specialties and four Centres of Excellence in the following Institutes: Women’s Health, Metabolic Diseases & Bariatric Surgery, Orthopaedics and Heart & Vascular. The patient-centred care model, staffing and services will all be fully integrated with King’s College Hospital London, designed to address a range of complex and critical care requirements unique to the residents and communities of the Kingdom of Saudi Arabia.

Ahsan Ali, Head of Healthcare Private Equity at Ashmore commented, “We stand true to our ambition and commitment to bringing the best of British healthcare to the region in partnership with King’s College Hospital London. Following the success of King’s hospital and clinics in Dubai, entering Saudi Arabia marks a new chapter for King’s and Ashmore, with the first project being a landmark hospital in Jeddah. We expect to follow this with the establishment of similar King’s branded facilities, including specialized centres, in other parts of the Kingdom.”

The London and Jeddah hospitals will share knowledge from established King’s research centres in the UK. Utilizing King’s world-leading expertise in healthcare will ensure the very best quality of evidence-based care is accessible to patients in Jeddah, will encourage further collaborations between physicians in both countries, and enable seamless patient journeys between the Jeddah and London hospitals, reducing the need for patients to travel to the UK.

Sir Hugh Taylor, Chairman of King’s College Hospital, London said, ‘’We are delighted that King’s, in partnership with Ashmore, is expanding its footprint to Saudi Arabia, following on from the success of our hospital and clinics in the UAE. King’s College Hospital has a long history of providing outstanding patient care in London and as part of our “Strong roots, Global reach” strategy we remain committed to delivering outstanding care for patients in Saudi Arabia”

Mark Coombs, Chief Executive Officer of Ashmore Group plc, added, “Ashmore Group remains committed to supporting KSA’s continued development across multiple areas. We have been active in KSA over the last two decades and were the first international fund manager to establish local operations with a dedicated team in Riyadh, and we are now excited about playing our role in the development of KSA’s healthcare sector by bringing King’s to the country.”

UK Government’s Department for International Trade (DIT) has been supporting Ashmore and King’s College Hospital with this project in Jeddah and added, “The proposed Jeddah development will greatly benefit from having an NHS partner – King’s College Hospital – which will support the Kingdom’s Healthcare transformation and allow for valuable expertise and knowledge transfer to help shape the healthcare provision. This will be the first hospital in The Kingdom to partner with the National Health Service”.

The South African Society of Obstetricians and Gynecologists wishes to clarify its position on COVID-19 vaccines in light of a newly published study on the association between menstrual cycle length and the COVID-19 vaccination, titled “Association Between Menstrual Cycle Length and Coronavirus Disease 2019 (COVID-19) Vaccination” and the subsequent media release by the Commission for Gender Equality (CGE), “Warning against imposing mandatory COVID-19 vaccination on employees and students” dated 16 January 2022. (See attachments below for reference.)

The most important findings of the study are:

• An increase in cycle length of less than 1 day in the vaccinated cohort compared to the unvaccinated cohort. Although this increase was found to be statistically significant it is not clinically significant (clinically significant change in cycle length is defined as a change of 8 days or more).
• Furthermore, this increase in cycle length was temporary with no difference in cycle length between the two cohorts by the third cycle after vaccination.
• Vaccination had no effect on duration of menses.

The findings of this study and the conclusions drawn by the authors that there is no clinically meaningful change in menstrual cycle length associated with COVID-19 vaccination is very reassuring.

SASOG urges new mothers and mothers-to-be to be, to consider the results of numerous studies and monitoring programmes (both completed and ongoing), that reveal no significant risk associated with COVID-19 vaccinations during both pregnancy and breastfeeding.

As such, SASOG urges both new mothers and mothers-to-be to be vaccinated. Studies show that the risk for critical illness due to COVID-19 is higher for pregnant than non-pregnant women, particularly in the 3rd trimester.

It has been found that pregnant women who experience COVID-19 symptoms have a higher risk of being admitted to ICU, needing mechanical ventilation and dying, than non-pregnant women of the same age.

We therefore find it surprising that the CGE brought out a statement warning against mandatory vaccination of women. Not only is their interpretation of the study flawed, but they also chose to ignore the proven benefits of vaccination of women of reproductive age as pointed out above.

It is our opinion that their statement is irresponsible and has the potential to increase vaccine hesitancy amongst women.

As a society of South African OBGYN professionals, we are committed to excellence and equity in women’s health.

We strongly recommend to women who might be uncertain about the risks associated with COVID-19 vaccination, to consult their doctor or clinic who will be able to provide them with the most up to date and reliable information to assist in making their decision.

Hospitals in the US are getting battered by the day due to the onslaught of the pandemic. The major concern that has raised the alarm is workforce shortages as well as the rise in the cost of labour.

Almost 31% of the total hospitals in the country, nearly 1400 to be precise, have started facing critical shortage when it comes to staffing as per the AHA- American Hospital Association. In about 12 states, more than 40% of hospitals are reeling under workforce limitations. As a matter of fact, many hospitals have stalled performing specific procedures, have been forced to shutdown care units, and have diverted patients to certain other facilities.

Detroit’s Henry Ford Health System having 75 beds, is shut due to the unavailability of enough health care workers. According to Wright Lassiter, systems president and CEO, this number went to almost 150 beds 30 days back. What this peculiar concern of staffing shortage has done is increase labor costs for hospitals, particularly when systems related to health are forced to move towards contract labor firms such as nurse staffing agencies to bridge the consistently occurring gap.

There have been instances where in some areas the pay rates for temporary nurses have been a whopping $240 per hour or even more. This has prompted the hospital association to seek help from the federal government as far as the price inflation is concerned. As per Rick Pollack, President and CEO, AHA, they have been consistently urging the federal trade commission to analyze and dig deep into the nursing staff agencies conduct which are being criticized for anti-competitive behavior. He adds that these agencies have gone on to exploit the critical shortage of healthcare personnel in times of the pandemic as they have practiced charging exorbitantly.

That said, job postings when it comes to nurses and other clinical staff have seen a surge of 45% and 41% respectively, between January of 2020 to January 22. It is also expected that 500,000 nurses will be leaving their positions in 2022 alone, which will further bring down the national shortage to 1.1 million nurses as per Bureau of Labor Statistics. As expected, it is the fatigue caused due to COVID-19 which has led to the talent drain. Lassiter further adds that there has been an increase of 600% in staff who have requested support for dealing with emotional issues or even personal stress.

Bruce Flanz, President and CEO, MediSys Health Network, says that the staff is understandably worn out. This is despite the wellness support that has been given to them. The pandemic as per him has caused many to retire early or even resign from their positions. Besides, the mandate for vaccines has led to the loss of a few workers, too.

According to him, they had to filter 78 from their 6500 employees, which itself meant that 99% of their workforce was already inoculated. This helped their organization tremendously during the current wave they are experiencing as they still had another 3% of their workforce out due to contracting COVID. As per the hospital association patients are put up in the hospital longer with an 8.8% increase in the average stay as compared to the levels found before the pandemic hit.

To keep up with the scenario, around 95% of the country’s health care facilities have hired staff from contract labor organizations. Notably, it is respiratory therapists who are in huge demand in hospitals. Unfortunately, since supply is short and demand is at an all-time high, these contract firms have managed to squeeze out as much as they can from the healthcare firms pockets.

The surge in advertised pay rates for temporary nurses is 67% from January 2020 to January 2022, and hospitals often get billed 30% more by the staffing firms.

AHA has already sought Congress’ help in dealing with staffing and financial issues by way of pooling in $25 billion into Provider Relief Fund, setup during the pandemic. The fund had $178 billion for all providers in addition to the $8.5 billion which was specifically focused on rural providers. However, most of the funds were pooled in before the last two waves and no allocation has been done or even announced for omicron or the previous delta surge.

Moving abroad is a big decision that could leave you with a lot of questions. A big one might be what to do about health insurance. Do you need to be covered? How does it work? Can you even get an insurance policy as a foreigner?

These questions are all valid and should be considered before you even take the plunge and move abroad. You’ll need to ask questions specific to your destination, but here are a few important things to know if these questions are on your mind.

Your Regular Insurance Probably Won’t Cover You

First of all, you need to be aware that your regular policy in your home country probably won’t cover you internationally. Most private insurance plans are only designed to cover you in your home country, and may not even cover you on an international holiday.

If you’d prefer to stick with them, it’s worth having a discussion to find out their options for travel.

Otherwise, you’ll need to look into other options such as Worldwide Health Insurance to ensure that you’re covered in your new home, temporary or permanent.

You Definitely Need It

As much as you might be questioning whether all the hassle is worth it, you definitely need to get your international health insurance sorted out.

If your home country won’t cover you, and your destination country doesn’t offer healthcare to non-residents, you don’t want to be leaving yourself and your family uncovered and at risk in your new home.

Health insurance is a financial safety net and serves as a source of peace of mind when it comes to your and your family’s health. Failing to get health insurance leaves you at risk, and in the case of a medical emergency, you might struggle to pay for hospital fees, procedures, medicine and other medical expenses.

There Are Different Kinds

Choosing health insurance can be complicated even when you’re living in your own home country. Just like with a standard policy, people living abroad will have various different health insurance options to choose from.

You could have the option for employer-based insurance, private or public health plans, travel health insurance, global health insurance and others. Within these categories, there will be different policies with different costs and different benefits to choose from, and different companies that you could choose to sign up with.

The good news is that your options are wide open, and there will almost certainly be a policy out there that suits you and your family’s needs perfectly. The less good news is that it’s up to you to put in the hard work and effort to research your choices.

Your Residency Status Will Play a Role

Where you are in the world and who you are there will have an impact on your insurance situation. Different countries have different regulations (in some places it’s mandatory to be on health insurance after becoming a resident).

You may or may not have access to public health care. However, in some areas, you might even struggle to get private health insurance if you’re not a citizen or even a resident. It’s important that you do a little digging into the laws and regulations in your destination country to figure out whether or not you’ll qualify for government health plans and how you can get health insurance.

This might even play a role in your decision to move – your health is your wealth and not something to neglect.

It’s a Big Decision To Make

Planning and choosing your health insurance is not a decision to take lightly. Underinsuring could lead to issues in the case of a medical emergency and you may find yourself under financial pressure.

Take the decision seriously and be sure to put some effort into seeking out the best options. Do some research online, ask for recommendations and chat to other expats about their experience with health insurance.

You’ll also be able to receive professional help from someone who works in the industry, so if you’re willing to pay a fee for professional guidance, that might be your best option.

Final Thoughts

Overall, health insurance is a pretty big decision to factor into your moving abroad journey. Language barriers could make things more difficult, and not being a citizen in the country you live in is a tough thing to navigate when it comes to more than just insurance.

Be sure to ask as many questions as you can before firmly deciding on a policy: consider mental health benefits, dental and vision coverage, and any pre-existing chronic conditions that you or your family might have.

Everyone’s needs are vastly different when it comes to healthcare, and just because you’re moving internationally doesn’t mean that you should compromise on what’s important to you.