COVID-19 management in ferment

Lindsay Edouard


The dire circumstances of the COVID-19 pandemic have demonstrated1 the importance of a community, as opposed to hospital approach2, the value of prevention compared to treatment3, the need for objective information4, and the crucial role of access to services and commodities. Faced with a new disease, decision-makers often lacked reliable information on its natural history and value of proposed treatment modalities.  Navigating in unchartered waters, service purveyors introduced interventions that were often challenged and sometimes proven to be inappropriate.  Parallels can be drawn with the changing scenario of reproductive health over the last half-century.

During the 1970s, developments in technology were at the forefront of public interest in health to the detriment of a community perspective that emphasised the Benthamite principle of the best for the greatest number1.  Prominence was then given to clinical advances such as medical imaging in outpatient departments, microsurgical techniques in the operating theatre, and the development of synthetic drugs in laboratories.  Success in the control of infectious diseases had led to that specialty being far from appealing for a career by 1980.

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