Authored by Luisetto M*,
Abstract
Related actual covid -19 pandemia it is possible to verify that not all countries in the world choose the same strategy to reduce health and economic severe consequences. Following the more effectives strategy make possible a rapid and useful come back to the situation pre-pandemia. Some management instrument make possible to avoid worse situations.In this work some instrument are analisyed to produce a global conclusion related the topics related.
Keywords: Business; Coronavirus; Covid -19; Viruses; Economy; Financial; Management; Pandemia; Risk Management; Strategy; What If Analysis
Introduction
In article: 09 April 2020 “If the world fails to protect the economy, COVID-19 will damage health not just now but also in the future” by Martin McKee & David Stuckler.“The COVID-19 pandemic is, first and foremost, a health crisis. However, it is rapidly becoming an economic one too. This is not, of course, the first global economic crisis. However, this time it is different”. And according OXFORD ECONOMICS website “We now expect global industrial production to fall sharply in H1 2020 and to contract by 2% for the year” April 2020. During the last period (in covid -19 Pandemia) many research and article was published related the various aspect of this severe infectious disease.
The public institution of the various countries in the world adopted different strategies
Form social distancing to lockdown, quarantine, isolation, to Heard immunity, diagnostics like nasopharyngeal swab, body temperature, serology DPI like musk and gloves, disinfectants use, sanification procedure and many other Epidemiological data helped l in this approach but whit is interesting is the various mortality rate Showed by different world region : from about 18% to 8% and also less related the diffusion of the viruses. Many factors seem to be implied but not clearly identified until today.In example it is interesting to verify TAIWAN situation : whit 6 death (at this date) vs the total HIGH mortality seen in china or in other world region: in TAIWAN government provided musk to population since first time and this seem to contribute in this result. (see interview of Prof. M. Brunori 17 april 2020). Relevant in this the diagnostic availability, ICU beds, right number of pulmonary ventilator, availability of DRUGS (also experimental trial) and DPI, disinfectants, oxygen and other.
The way of transmission of the virus make possible to verify and control the diffusion person to person but other fact must be take in consideration: air pollution. Some literature show that the region with high mortality rate seem related to the high air pollution in and indirect way. Many respiratory disease are worsened by exposition( year) in real polluted air [1,2]. Other theory seem to show that the virus diffusion follow the great high way of track transport: North Italy, very industrialize, Belgium and other. According https://www. scienzainrete.it/articolo/coronavirus-ha-viaggiato-autostrada/ giovanni-sebastiani/2020-04-09
An hypotesys of work is related some characteristic of Italian relevant way of travel communication.“La diffusione è maggiore vicino ai grandi nodi autostradali».The same wu -han is a real industrialized area with high air pollution .According other scientist ( Isaac ben Israel ) lockdown is not so useful because the time of duration of this pandemia was the same in the various countries about 70 days and then reduce itself (Recent article).
Material and Methods
Whit and observations method some relevant literature is analyzed to produce a global conclusion related to the topics of this work. All literature, and reference presented gives a global image of the hypothesys of work.
Results
From literature: only few example: According Peterson K Ozili, Thankom Arun Spillover of COVID-19: Impact on the Global Economy 2020. “How did a health crisis translate to an economic crisis? Why did the spread of the coronavirus bring the global economy to its knees? The answer lies in two methods by which coronavirus stifled economic activities. First, the spread of the virus encouraged social distancing which led to the shutdown of financial markets, corporate offices, businesses and events. Second, the exponential rate at which the virus was spreading, and the heightened uncertainty about how bad the situation could get, led to flight to safety in consumption and investment among consumers, investors and international trade partners” [3]. And by Jaime S. King : “the Covid-19 pandemic has brought into sharp focus the need for health care reforms that promote universal access to affordable care” [4].
Discussion
Starting from the observation that the mortality rate and the number of patient whit disease active vary a lot form a region of the world to other (In similar condition of latitude) it mean that the various strategy adopted make possible to get the best or the worst strategy. Translate in business- economic field this imply to exit first or not from this global crisis and so this is an really useful instrument: a Management Instrument. Applied in this crisis in various world nation was created specific TASK FORCES, was applied TIME MANAGEMENT , and RISK ANALISYS methods added to the concept of epidemiology, statistics, and Infectious disease , environmental toxicologist and other scientific discipline.
Politics ask to scientist and other expert to help in choosing the really efficacy strategy. Many management tool help in this situation : from scenario analysis to what if analysis to Risk management , strategic plan ,strategic management , problem solving ,DATA analysis ,Time management, to MBO, to HR management, ICT management but, logistic management , supply chain and many many other .In this situation rapid availability of data, decision making system, ICT make the differences.
Conclusion
Related the various MORTALITY RATE and diffusion velocity of the covid -19 disease Is possible to Conclude that not all the strategy adopted by different countries present the same results. So it is needed by the international and national institution to observe the really best practice .This pandemia is an health and social crisis but with high involvement in business and economic field. Recession and economic crisis is a real scenario if public administrator not choose the really best solution to the pandemic situation. And a more rapid control make possible to come back to business – economic cicle pre virus diffusion. Some measure like lockdown , that help in the acute phases of diffusion of the virus , can cause stop in many economic field whit great social implication. So the right choose by politics and public institution in re- start after lockdown is real crucial and science .Help. (Research work, article, publication, theory et other).
A real balances between health and economy must be followed but according science principle and not under fear emotion. Organization , scientific evidence , best practice and The management science surely help in this process.A clear evidence of the pathogenetic process that can explain the various phases of the disease since from first phases to pulmonary phases to cytokine explosion and related phenomena can help in choosing the really best therapy in the right time as well as using the best imaging strategies to stratify the patient risk in objective way [5]. The right therapy in the right phases of the disease ( first phases) seem by literature to avoid the most severe consequences.
“Huang et al. reported the clinical features and cytokine profile of critically ill patients with COVID-19 in Wuhan, China, and suggested that a cytokine storm (i.e. higher concentrations of granulocyte-colony stimulating factor, interferon gamma-induced protein 10, monocyte chemoattractant protein 1, macrophage inflammatory protein 1α and tumour necrosis factor α) could be associated with the severity of disease “[6].
Also the strategy followed by an Italian famous oncologist Prof. CAVANNA in this epidemic situation is a real innovation with result: the physician and his equips goes directly at home of the most fragile patient to verify clinical condition before recovery in ICU of ospital: this produce 2 results : patient health monitoring in early stage, avoiding ICU bed use, reduce in diffusion of virus in hospital settings. (inversion of paradigm) .
As reported in articled “The Italian Doctor Flattening the Curve by Treating COVID-19 Patients in Their Homes” TIME 9 april 2020.
Accordin an article of 8/5/2020 “I work in oncology and hematology, departments accustomed to dealing with suffering and death - Cavanna says - Main these days I had the impression that we were facing something that had been seen before. It was so scary there were many sick people in those makeshift beds. Ambulances came in line to bring other patients, I looked around, I crossed the eyes of my colleagues. We had the perception of not being able to. “ It is in that state of impotence that the idea of changing your approach blossoms. “At meetings we always tried to increase the places in emergencies and resuscitations, but then we understood that this is a viral infection that leaves you time to intervene. It is not a stroke, a heart attack or a cardiac arrest that strike in a few minutes or in seconds: it leaves you a week or even 10-15 days “. There is therefore room to act before the clinical picture worsens. The reasoning is logical: if the patient is treated in an hospital based on an antiviral and hydroxychloroquine (an antimalarial), all drugs - which are taken orally, what prevents us from starting treatment at onset of early symptoms? “We said to ourselves: we try to go - to the houses, not only for the simple visit to the sick, but with everything we need to cure the disease - on time”. The “early” and “at home” care is immediately effective. “People don’t get worse, they heal first and above all they don’t die.” Soon the results of the studies on the “Piacenza method” will be published in a magazine to give information to the scientific community. But the analyzes that Cavanna anticipates at Giornale.it at the end of April are- extraordinary: “Out of 250 patients treated at home, I can tell you that none of them died. Neither at home nor in the hospital. Of these, less was hospitalized than 5% and everyone returned home, half of which within a few days “. These are “true”, “relevant” and “heartening” data, on which it will be necessary to reflect. “For a long time there has been talk of increasing the places in intensive care, a strategy-criticizable - says Cavanna - But when a patient goes to resuscitation we have to see it as the failure of the treatment. It should be the last resort: the viral disease goes attacked early. “ Only in this way can Sars-Cov-2 be defeated, “reduce access to emergency rooms” and “block the natural history” of the disease. Avoiding a river of victims [7].
All this under an prospectic approach and not only related historic analysis [8] and under a great global rethinking of actual health care system as well as a global reorganization of social life from work to school
University, industry and other to reduce possibility of contacts.
Health organization, preventive measure, diasgnostics, clinical diagnosis, lockdown, quarantine, isolations of patients, therapy, vaccines , ICT technologies to trace positive patient, right institutional information , smart working and other will be the instrument but correctly managed by public and international institution.
In this kind of new catastrophic event, with rapid evolution also PRELIMINARY research can be useful
Instrument to give some direction to the physician: see the Tocilizumab, Remdesivir , heparin and other procedure under clinical trial by health authority in some countries [9].All this must be verified in large studies but in absence of data it can be a light in obscurity.
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