Post-COVID healthcare in Latin America

The first and most intriguing question we can ask about post-COVID is whether we are already there or not. Is the temporary drop in cases we see in LatAm a trend? Or should we expect to see the same as in some other parts of the world - repeated waves and the spread of new virus variants in the region? 

The answer is not easy and in fact there is no unified front when asking LatAm doctors.  The return of severe waves of Covid is the most likely scenario for HCPs in Colombia and Mexico, while a relative majority of Brazilian doctors are more confident that severe waves are unlikely to return. 

Beyond the varied perspectives, it is noticeable that physicians present a more cautious vision than their own patients, who are mostly confident that serious waves are in the past and even, for many, that the pandemic is already completely over in their country. 

Worsening of health conditions 

The sharp plunge in visits to doctors during the most intense phase of the pandemic was a strong regional trend all over Latin America. In May 2020, we identified a 61% drop in the number of patients seen in relation to pre-pandemic levels, affecting treatment adherence to all kind of diseases such as diabetes, cancer, HIV, autoimmune or heart diseases. 

Doctors also reported a significant drop in preventive medicine. The number of breast or prostate cancer screenings in October 2020 fell by more than 60% from pre-pandemic levels, according to data previously released by Fine. 

By November 2021, the context changed, COVID-19 cases have tended to decline, and face-to-face care is almost reestablished, being only 16% below pre-COVID levels. However, the worsening of many diseases is still reflected in clinical practice. 

In addition, physicians still describe most of their patients as having a more sedentary lifestyle, a worsening of eating habits with many living with increased economic restrictions which impact on the quality of healthcare access. 

Will this worrying scenario worsen further over time? Not necessarily, and the good news is that physicians estimate that in 12 months these effects would tend to be mitigated by the current normalization of patient care. 

Emotional impact 

It will take longer, however, to reverse the emotional aftermath of the pandemic. Increased anxiety, resulting from increased mental health vulnerability, is affecting 2 out of 3 of their patients, as reported by professionals. 

The latter is valid for patients but also for physicians, and 9 out of 10 doctors acknowledge being emotionally affected. More than a quarter of the doctors surveyed in November 2021 report not sleeping as well as before the pandemic; a third feel more pressured and anxious. 

There are, however, positive trends for physicians. In a population where vaccination has advanced rapidly, doctors consistently report less concerns about personal and family infection, experience less uncertainty, and have also overcome the isolation experienced at the peak of the pandemic. 

However, physicians are experiencing fatigue and the proportion of professionals who recognize that they are more easily irritated is also higher compared to the data we collected in May 2020. 

Consequently, the higher level of risk of burn-out in the profession should not come as a surprise. And indeed, 9 out of 10 doctors believe it has increased and will remain relevant in the foreseeable future. 

Virtual fatigue and the craving for in-person connections 

Today, 82% of consultations in the region are face-to-face and two thirds of physicians say that they would only use telemedicine in a few cases or that it is not applicable to them at all. However, 3 out of 10 imagine a hybrid model where they will switch between face-to-face and virtual healthcare. 

In our opinion, the data suggests that telemedicine will accelerate much more slowly than the dizzying pace it showed during the pandemic, but it is far from disappearing. Rather it has become a permanent niche in medical care for some specialties, types of patients or methods of consultation organized by healthcare organizations. Regardless, any use of telemedicine will coexist with a strong preference for face-to-face relationships. We have seen a consistent fatigue with excessive virtual communication and an appetite for the return to face-to-face relationships at all levels. For example, 3 out of 10 doctors would like to receive more invitations to webinars, while a similar proportion would prefer to receive fewer or none. 

This contrasts with the interest in in-person medical conferences where 6 out of 10 would like to receive more invitations and only 1 out of 10 would like to receive fewer or none. Likewise, 70% of the doctors are quite or very interested in receiving visits from pharmaceutical representatives.

Half of physicians are looking for a return to a format based primarily on face-to-face relationships and an almost similar proportion favor a format that combines face-to-face and virtual formats. But only 6% choose a future made exclusively of virtual connections. 

Takeaways 

In summary, the pandemic has profoundly modified the landscape of the healthcare system and the current challenge is how best to integrate hybrid relationship models that can take advantage of the benefits of technology with the face-to-face approaches generally preferred by healthcare professionals all over Latin America. 

The evidence provided by this survey strongly supports the need for policies aimed at mitigating the multiple consequences of the pandemic on the population health. 

This goes beyond the efforts – very necessary but also insufficient – of COVID vaccination and treatment to include support to the healthcare system in order to deal with low adherence, late diagnosis, post-COVID syndrome, increased restrictions to healthcare access and emotional vulnerabilities of both doctors and patients. 

*This article is based on a tracking study that Fine Research has been developing since March 2020 and which has involved over 16,000 interviews from LatAm doctors. The last wave took place in November 2021, and includes responses from 2,521 medical professionals from Brazil, Mexico, Argentina, Colombia and Chile.