For years, Israel's health care system has been a global example of excellence. The citizens of Israel enjoy one of the longest average life spans in the world, excellent doctors, and modern treatment, all at low cost compared to other advanced nations.
Despite all this, for some years the public health care system has been neglected and subjected to budget cuts that affect its ability to provide the best treatment. Over the years, the effect of budget cuts, staff cuts, and a lack of hospital beds could have been mitigated through proper use of existing resources.
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During the COVID pandemic, we have watched the concept of providing the best treatment with limited resources collapse. The lack of beds on regular wards and intensive care units, as well as the lack of trained staff – especially doctors and nurses in internal medical and ICU units – has led us into a total lockdown for the second time in six months, at an enormous cost to Israelis' mental health and the economy.
It takes many years to train internists who care capable of providing high-quality treatment to intensive care patients, and these patients cannot be handed off to doctors from other specialties. Even though we don't expect to see scenarios of patients who cannot be put on ventilators or thousands of dead, and we are not expected the hospitals to collapse entirely, it is almost certain that thousands more will fall ill and die because vital treatments are being postponed, and diagnoses are being delayed.
To limit the harm to the health of Israel's citizens, we must bolster hospital capacity on internal wards as well as ICUs. The solution to the shortage of staff and hospital beds must be dual: first, we need to reduce the burden on internal medicine departments and ICUs. We can staff internal medicine departments with administrators, physician assistants, phlebotomists, and paramedics, who will help cut down the burden on medical teams and allow the rest of the patients to be treated. We can enlist high-quality manpower from the IDF reserves and among students, and train them to carry out these procedures now ahead of the difficult winter we are expecting.
After that, it is vital to realize that internal medicine and ICU comprise the foundations on which we build treatment for patients in intensive care. These specialties are neglected and poorly paid in comparison to other fields of medicine, so are less attractive to young doctors. As the population ages, we can expect a greater burden on the internal medicine departments. To strengthen them, we must pay the doctors and nurses who choose that difficult field appropriately. Without bringing in good staff and adding more beds, we will not be able to avoid the disgraceful sights of elderly patients hospitalized in hallways and certainly not be able to improve the quality of their treatment.
But there are bright points in our battle against COVID. The health care system is managing to use limited resources appropriately to prevent a lack of beds in areas where the epidemic is raging. The Sheba Medical Center at Tel Hashomer, the largest hospital in Israel, has taken a lead role the battle as is preparing to open units for children with COVID, for COVID patients who require dialysis, and psychiatric patients who contract COVID. The complex cases demand a combination of infectious disease knowledge as well as the ability to balance their underlying conditions with additional areas of expertise, which is not always available everywhere in Israel.
Wise use of global centers of excellence like Sheba can help our national fight against COVID. Support in the departments that are already on the front lines will give the public health care system the time it needs to contain community spread. That is the only way we can beat COVID and get back to our normal lives.
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