2020-03-31 08:48:29
This timely webinar to hear representatives from medical travel programs at top hospitals around the globe share their perspectives, strategies and tactics for managing through the COVID-19 crisis.
As the number of COVID-19 cases across the globe soars, governments and international health authorities are struggling to contain the spread of the virus. Governments have taken extreme measures including closing borders, instituting travel bans, and cancelling classes, sporting events and public gatherings. In countries with a high number of COVID-19 cases, healthcare providers are facing capacity challenges to adequately treat patients, while in certain countries, travel bans, or the fear of travel has significantly reduced the number of medical travelers seeking cross border care.Join us on this timely webinar to hear representatives from medical travel programs at top hospitals around the globe share their perspectives, strategies and tactics for managing through the COVID-19 crisis.
SPEAKERS
- Dr. John Louis Lucas
Chief Executive Officer
City International Hospital - Ms. Karen Timmons
Chief Executive Officer
Global Healthcare Accreditation
Ms. Karen Timmons:
It is now my pleasure to welcome and introduce Dr. John Louis Lucas who is Chief Executive Officer of City International Hospital in Ho Chi Minh City Vietnam. Dr. Lucas perhaps you can begin by providing an overview of the mitigating strategies Vietnam initiated to minimize the spread and impact of COVID-19 as well as actions that you have implemented within City International Hospital.
Dr. John Louis Lucas:
Thank you for that introduction. Just talk about Vietnam, we Vietnam have a lot of experiences with SARS 15 years ago, so they have quite a robust public health structure and they have been extremely proactive. Now their main focus has been containment, so that involves the tracing contacts. All of our cases so far have been formed, we have not had a community transmission that’s been at least validated through testing. So it appears that the containment strategy has been working. Although we are starting to see more cases I think it will hit the tipping point where we will get community transmission and have to change from containment to mitigation. But the containment has been cancelling flights, closing the border with china, now not granting visas to foreigners coming to the country. The use of quarantine and the mitigation’s focus is social-distancing and closing public areas, closing bars and restaurants, closing schools and really emphasize personal hygiene. In Asia, they are very emphasizing in wearing masks even though in the US, that’s been controversial and ask people to not to wear masks unless they are infected. Where here, it’s mandatory everybody to wear masks.
Ms. Karen Timmons:
That’s impressive. Very interesting.
Dr. John Louis Lucas:
I have heard that many epidemics in the past, it’s very much of a culture whenever there is an epidemic, and everybody is going to wearing masks. The population seems to so isolated and stop to going into stores and facilities. Six weeks ago, well before we had 15 to 16 cases, no more cases for three weeks. But it started up throwing again 10 days ago. I think the level of containment in mitigation is hitting more aggressive now. But so far, I not only have 60 cases. The one thing with this problematic is that we don’t have much testing. So it’s similar to the US experiences, there is very tight control of tests so most of us are in clinics and facilities can’t do many tests it all have to refer back to a limited number of laboratories. If people are tested positive, currently again, with very few cases. They have to go to the public facilities. Private hospitals really are not allowed to take in COVID cases. If we happen to have somebody that we put on investigation and they test positive on the screening. Even though testing is pending with the PCR test, we still have to transfer them to a number of very specific hospitals. Quarantine is very aggressively used. There have not home-quarantine yet. In Korea, for examples, because they have a lot of cases, they put people on with mild diseases. They did it in China as well. They have them at home instead of putting them in quarantine camps. But still, unfortunately, there are thousands of people in them. They’re tending to fill up, so I think there must be a change in strategy, to probably home-isolation. That’s problematic for medical travelers or tourists. They would have to do that in hotels, so that’s going to be challenging. If you’re a tourist and a part in this situation you don’t have a place to shelter that’s very accessible to you. There’s probably going to be a number of hotels designated as quarantine centers where people can go, so like we will need to have that expansion very quickly here because the current centers are all full. There are 10 of them here in Ho Chi Minh City and they’re at peak in capacity now.
Ms. Karen Timmons:
And those for who have tested positive, but there are mild cases or?
Dr. John Louis Lucas:
Court quarantine is anybody, so you have something called F1, and then you have F2, and then F3 and F4. So it’s classic epidemiology the F1s are the people that either have COVID-positive or they have been in intimate contact with somebody that’s COVID- positive, let’s say a family member. They all go into mandatory quarantine, they go into a hospital those people who’re the F1s. The F2s are more distant contacts, and as you branch down as secondary, tertiary, quaternary contacts, so they go to the quarantine camp facility which really isn’t medical service oriented. It’s purely separating those people who are asymptomatic.
Ms. Karen Timmons:
I see what you are saying. Thank you for that explanation. Would you anticipate for a private hospital if Vietnam does need capacity other than the public hospitals that private hospitals such as City International Hospital would be step in and be a provider for COVID-19 patients?
Dr. John Louis Lucas:
We have to go through a process to be certified to provide to these COVID patients. The Department of Health of HCMC has a list of hospitals and they’re starting to add private hospitals and international hospitals but we have to go through a process, we have to be inspected to make sure you know that we have the confidence to take care of this type of patients that’s highly infectious patients. You know, we have to make sure our staff can protect themselves and are familiar with procedures and PPE, so we expect we will be evaluated next week for that.
We have a 20 beds unit. But we need to have it licensed to take these patients in. The reason why they are doing this is to create more potential capacities should they need it.
Ms. Karen Timmons:
Currently what is happening to those patients who might need critical care such as special surgeries, cardiac, oncology is that going on as normal?
Dr. John Louis Lucas:
It is going on as normal. But when you hear the story in Italy in particular. You have to appropriate a lot of the technology for example you turn your OT use the anesthesia machines as respirators. So in Italy, they created a 20% additional ventilator capacity by using other sources such as anesthesia machines and other parts of the hospital like the PACU in the operating theater recovery areas, so there are ways to add more ventilators. So we expect that in order to do that, you would have to (if you’re running a hospital) cancel all your elective surgeries. However, in Vietnam, there is no need to do that because the patients do that themselves starting February 1st our volume drops in half. So without any directive, the patients started not coming in, they’re fearful of coming to the hospitals right now. So they are not following through the procedures as much. There are certain population obstetrics where they still have to get the care so they’re coming in. But our elective procedures have pretty much dried up. We’re doing very little right now. It seems like the patients want to defer all that care until the epidemic is over.
Ms. Karen Timmons:
Yes, I can understand that fear, we’re seeing that likewise here in United States and what about communication with payers or suppliers have you had to do any anticipatory proactive outreach to these.
Dr. John Louis Lucas:
Certainly supply chain is critical, so we’re reaching out to the vendor community and really trying to lock up as much as we can for our needs. Our goal is to have at least a month of consumables available. And having contingencies if we run through them quickly. The same thing with pharmaceutical supplies. Yes, we’re working very diligently to assure that we don’t get cut off from anything. The risk in private hospitals is we have to use the same supply source as the public hospitals. The public hospitals will be given preferences, so we will be a second tier for receiving resources. So that’s going to be a challenge. So that is a part of why we want to be certified as a treatment facility, so we don’t get locked out of the supply chain.
Ms. Karen Timmons:
Yes, I can understand that. And moving forwards, thinking hopefully in the not-too-distant future where this crisis might be dissipated. Do you vision special communications to medical travelers, how do you envision possibly your marketing or communication strategy as a way to reach to patients, who might be interested in coming to your facility who might be foreign visitors obviously they can’t travel to Vietnam right now or might need to get a visa.
Dr. John Louis Lucas:
There is a short-term aspect of that, then the longer-term. In the short term, we’re compelled, using website and interacting with people on Facebook and social media. But we know we need to have a telehealth platform, where we can provide consultation, so we’re partnering with a company to do that. Then I’m enlisting our doctors to provide those services. I would say that in Asia, there is not the same comfortable level with telehealth as you’d find in the US. People are reluctant, they really want live visits. But I think with the epidemic now, people may shift because they are afraid to come in if they can get care online or in the information they need online. I think they will shift to that. We’ll offer some free services and we will offer some fee services. We have it in English and Vietnamese. So that you know most of the expat community is about 200,000 in people in Vietnam. English is their lingua-franca. So they will gravitate to an English language site like that. So we think that’s a way to keep in communication with them and spend as much time as it’s needed to help people. But the purpose of the website is also to do facilitate care coordination. Now how to do the linkage with the insurance is the other question. So we need to reach out to them and have a partnership in Vietnam. Most of the insurance companies will not cover COVID, so it’s maybe 5% of them. So, that’s a big problem right now. They view it as a force majeure, they won’t cover in the contracts. So that’s going to be a very interesting challenge to deal with. Whether that applies to the type of insurance, international travelers, have you know that they have Blue-cross a net none. We see exactly the large international insurance company are willing to do, to see how they will want to deal the claim that devolves from this. It’s unclear but we need to reach out to them and start talking to them, try to get some sense of what we can advise to do, what their payers have agreed to pay their claims.
Ms. Karen Timmons:
We certainly appreciate your participation in this webinar Dr. Lucas. And your perceptions and insights are necessary in order to mitigate, contain and hope.
Dr. John Louis Lucas:
Well in additional comment, I think the group health framework is excellent, so we’re looking longer terms, hoping that we can build credibility and trust in a short term. But we think the challenge, business sustainability is going to be a big issue because of the drop-off in business, so we hope longer term that will emerge on the other side of this as a stronger organization. They should use more technology and you know the formal act of participants in medical travel program and you know we’re eager to work with you to develop that.
Ms. Karen Timmons:
So in finally, please everyone join me. Thank you our esteemed panelists, who did a great job and we certainly appreciate your sharing. Wish everyone to stay well and be well.
Meet our CEO - Dr. John Louis Lucas (City International Hospital, Ho Chi Minh City, Vietnam)
Should you have any questions, please do not hesitate to contact us:
City International Hospital
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