Will Patients Come To Your Medical Travel Destination, Post COVID-19?

The natural reaction for countries, healthcare providers and medical tourism businesses is to wait out events, until they return to normal.

But expecting the flow of medical travellers to return to where it was before may be a major strategic and tactical mistake.

How much your country was affected, what your government did or did not do, and the post COVID-19 view of risk may heavily influence the potential medical tourist’s view of your country for the next few years.

For example, will people still want to fly long distances or will they prefer shorter trips? Will they want to leave their country at all?

Plan for the future now

This is now the time to plan for the future. You could do nothing and lock down the hatches and when things get back to normal, carry on as before. Or you could take time out, away from daily life, to make plans for how you can encourage your country, organisation, agency, or healthcare provider to get medical travellers to come to you in 2021/22, both new and existing customers.

WTTC proposals

Coronavirus puts up to 50 million tourism jobs at risk says the World Travel & Tourism Council (WTTC). When the time is right, WTTC and the global private sector will be ready to help and support governments and countries to recover.

WTTC is calling for a series of measures to be taken, to enable the swift recovery of the sector once COVID-19 is under control. It will offer its support to all governments, and has made some suggestions:

  1. Improve travel facilitation. Remove or simplify visas wherever possible, reduce the cost and improve processing times where practical, accept other visas when appropriate and introduce more efficient technologies for seamless and secure travel.
  2. Remove barriers.  Ensure that unnecessary barriers are removed or relaxed to alleviate pressure at ports and airports and implement flexible working visas for the industry in some countries with existing limitations, especially in hospitality and tour operation. 
  3. Ease fiscal policies. Reduce and remove travellers’ taxes, which increase the cost of travel, e.g. air passenger duty and airport, port, and hospitality taxes around the world.
  4. Introduce incentives. Introduce relief and incentives to support business continuity for companies, which have been most negatively impacted by the virus. SMEs, in particular, will take longer to recover. 
  5. Support destinations. Increase budgets and assign resources for promotion, marketing and product development purposes in destinations when they are ready to welcome visitors again.

WTTC reinforces the importance of strong public-private partnerships and greater international cooperation to respond and overcome the challenges faced by the sector during the recovery from COVID-19.

The tourism sector has a proven track record of resilience in the face of crises and this ability to bounce back has improved significantly in recent years.

Medical tourism planning

Unlike the more short-term problems for travel caused by politics, terrorism, weather events or strikes, the COVID-19 problem is a medical one. It will be harder for medical tourism to recover than other tourism sectors.

Hospitals, clinics and agents may be able to use modern marketing techniques to help encourage new and returning customers. But they can only do that if customers feel safe travelling to the country.

Governments and national/regional medical tourism promotional organisations will have to work hard and spend money on tackling the following issues:

  • Smaller global market :  The medical travel market is expected to be smaller in 2020 and 2021 , so what medical tourism customers there are will have a wide choice of destination. Organisations will need to work out how to maximise the effect of their marketing spend to make sure they get a share of the medical tourism ‘cake’.
  • A permanent change? The big unknown is if any change in the behaviour of medical tourism customers will be permanent or temporary. Will they look to travel domestically or to nearby countries rather than go on long-haul flights?  Any plan you make must include allowances for different longer-term results.
  • Maximise spend : The medical tourism industry has many examples of spending marketing money in the wrong places (e.g. scatter-gun promotion tactics ; exhibition stands or attending unknown “international health” conferences ). But is that spending reaching the end consumer? Are you still using outdated websites and printed brochures, when most of the world has moved to different online options to research treatments?  Are you still blogging, when competitors have apps, Instagram pictures and remote tele-consultations?
  • Target market : Are the target markets you selected in your 2020 plan the right targets now? It is easy to get locked into a habit of targeting what was the best market five years ago, rather than looking towards what will be the best markets in a year’s time. Check out opportunities by country, location, age, and a range of other factors.  
  • Your offer : Is your offer targeted, logical and realistic, or more the equivalent of trying to hit a small target with a shotgun? Is the offer now right for you and potential customers?
  • Keep informed : As well as reading IMTJ, are you using up to date research produced by your country and others? There are many ‘copy-and-paste reports’ in the market that use historic figures but offer little or no analysis for the future.
  • Accreditation : Some medical tourism accreditation organisations suggest that accreditation is the answer to attracting international patients and some governments look like they are controlling rogue medical tourism agents by bringing in accreditation.  While accreditation may help improve the standard of hospitals and clinics, there is however no proof that accreditation alone brings in international business. It is likely that the average medical traveller is less concerned about whether  their medical travel agent has or does not have a certificate, and more interested in whether they are cheap and efficient.

Beware one size fits all solutions

There is no off-the-shelf simple plan for recovery that you can follow post COVID-19. Bespoke solutions for medical travel destinations are now vital. COVID-19 will move medical tourism into the next phase, where what works and makes money for Country A, will be irrelevant for Country B to adopt.

If you want to plan for 2021 and commission your own research or specialist strategy, you must set aside enough time to work out, in detail, what you want from it.  It will then take more time for a good analyst to work out the best action plan for your destination.

Source : www.imtj.com

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How Will COVID-19 Shape Medical Tourism Development?

COVID-19, an unknown term six months ago, has become the greatest fear of individuals and companies. And while much coverage in the media has tended to spread panic, some posts and articles, like Reuters, are now taking a more pragmatic approach.

How might COVID-19 change the shape of the medical travel market?

Like most sectors, the medical travel market includes providers of many different sizes.  Here’s how they might be affected: 

  • The small and market-sensitive: Mainly medical travel consultants, startups and small agencies (facilitators). These individuals tend to have limited budgets and cash flow, and are most sensitive to fluctuations in medical travel flow due to ‘COVpanic’. They are likely to cut back on marketing and customer services immediately, dismiss personnel (if they have any) and potentially even disappear from the market. It may also be difficult for them to restart their business after the COVID-19 crisis.
  • The medium size medical travel providers: these professionals, mainly average size clinics or agencies, are in a better position. They might consider the COVpanic just as another crisis, possibly downsize their staff, reduce their spending, and cancel their participation in events. They will be more committed to maintaining their business through the crisis.
  • The large and well-established businesses in medical travel: these professionals, mainly large clinics, hospitals, hospital groups and the largest agencies have heavily invested in an international patient business which has, pre-COVID-19, generated high revenues. They are the most resilient to a business downturn due to COVpanic. It is likely they will continue to invest in this business, and will take a pragmatic approach to foreign patient cancellations. For them, this is just another crisis that will pass. 

There is one other provider group within the medical travel sector, who could be any sized, whom I call the “wise ones”.  They will use their time when there are fewer customer interactions, for preparation and reorganisation. They will update themselves about what is currently changing in the international patient market, train their people, rewrite their business plan,  apply healthcare protocols, and search for new markets. They will also try to identify the ‘where and when’ of future opportunities once the COVpanic subsides. 

Impact on medical travel events

Event organisers are as sensitive to the impact of COVID-19 as tourism providers. Many medical travel events, especially the ones that were scheduled during the first six months of 2020 have been cancelled or moved to a future date. 

This has been influenced by the personal choice of people not wanting to travel, but also in several countries there are now national restrictions on public gatherings.

Seasoned event organisers have downsized their events (and expenses) by booking smaller halls and anticipating fewer delegates, rather than stepping out of the market entirely. Medical travel exhibitions have proved even more sensitive than conferences, as they need a high number of anticipated visitors in order to be sustained. 

In this space, we might see live streaming and use of technology to facilitate knowledge sharing and networking by remote delegates, take a more central role in medical travel events in the future.

Planning recovery after COVID-19: it’s about patient perception 

The more pragmatic media articles predict that, like other flu, health or political crises, COVID-19 will pass.  We just don’t know when. 

Some physicians believe that it will peak soon, then decrease during the summer months.

To attract international travellers as tourism picks up again, flights and accommodation costs may be very competitively priced. Treatment costs will possibly follow, along with the other related services in medical travel. The first medical travellers after COVID-19 are likely to enjoy their treatment journey at very affordable prices and with no waiting time at all.

The established medical travel destinations, whose governments and health bodies have best managed to contain COVID-19 may be seen as ‘safer’ countries for patients looking at healthcare options abroad.  Medical travel providers in these countries who have survived the COVpanic are the ones who are likely to enjoy the first fruits of the post COVID-19 era.

Finally, lessons from COVID-19 are an opportunity for accreditation companies. Healthcare quality assurance is now an even hotter topic and so far, many hospitals with certifications from high quality accreditation companies have been well prepared to handle the crisis. A line of protocols that was applied to hospitals (mainly private) has played a significant role in identifying this virus early, so protecting the rest of the hospital patients. With other hospitals, maybe COVID-19 will be the motivation  for providers to improve and become safer for the patient.

Source : www.imtj.com

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The Third Eye Medical Services advice on Coronavirus

For the most up-to-date response to the situation, The Third Eye Medical Services advises clients to refer to the World Health Organisation (WHO) for any queries they may have. The current sentiment is to be alert, not afraid. 

Archana Gupta, Head of International for The Third Eye Medical Services says, ‘As with any potential health outbreak or emergency, we would urge employers to seek advice from reputable sources such as the World Health Organisation, The Foreign and Commonwealth Office (FCO), their healthcare provider or specialist adviser. Such organisations will be monitoring the situation and have the most up-to-date advice.’

If individuals are concerned about symptoms they are experiencing, such as respiratory problems (fever, cough, shortness of breath and breathing difficulties) that has been linked to the virus, they are advised to seek medical advice and speak to their healthcare provider.  

At present, The Third Eye Medical Services understands that the novel coronavirus originated from Huanan seafood wholesale market, in Wuhan City, Hubei Province of China.  There have also been cases in Japan, Thailand, the US, Australia the Republic of Korea, and a handful of cases recently confirmed in France and Australia.

So far (at time of writing, 05th Feb.) there have been 24,558 confirmed cases and 493 deaths.  The case fatality rate is quite low so far (less than 3%) and mainly in elderly persons or those with co-morbid conditions.

Chinese authorities have imposed travel restrictions to prevent people travelling in and out of Hubei to reduce the spread of the disease, and the UK Foreign Office has advised against all travel to Hubei.

What to expect next :

  • Authorities are stepping up screening of air passengers from China. Temperature screening is already taking place in Australia, Singapore, Hong Kong, Taiwan, the US, Russia and Japan. The UK is expected to begin screening passengers arriving from China.
  • The UK Government has stated it is reviewing options for the return of the 200 UK nationals currently still in Wuhan, given the travel restrictions imposed by the Chinese authorities.
  • The head of the UN health agency, WHO declared on Thursday 23 January that the respiratory disease Novel Coronavirus, is not yet an official Public Health Emergency of International Concern (PHEIC), but warned that is an emergency in China.

Current advice :

  • Don’t travel to Hubei Province .
  • The FCO has advised British citizens to leave Hubei Province after the chief medical officer issued new advice recommending vulnerable people should immediately evacuate the area at the centre of the coronavirus outbreak.
  • In Shanghai, the government has stopped businesses from returning to work until 10 February.
  • Avoid crowds and minimize public gatherings if you are in the province.
  • Do not touch animals or eat game meat and avoid visiting wet markets, live poultry markets or farms, if travelling in China.
  • Seek medical advice immediately if you’re concerned about cold or flu-like symptoms and have recently visited China, or have been in direct contact with someone who has recently visited China, and inform your medical practitioner of your travel or contact history.
  • Basic hygiene measures such as washing hands is sensible.

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Bangalore Doctors Perform a Rare Bloodless Liver Transplant on a Nigerian Patient

Doctors at the Aster CMI Hospital in Bangalore have performed India’s first bloodless liver transplant on Jehovah’s Witnesses from Nigeria. The surgery was challenging compared to a normal liver transplant due to patient’s religious beliefs. The doctors could not use blood or blood products such as platelets, fresh frozen plasma, Cryoprecipitate and more. Few such surgeries have been conducted worldwide and were successful.

The patient named – Jehozadak from Nigeria was suffering from end-stage liver disease. Without a liver transplant, his chances of survival were less than 10% in the next 2 years.

The team of liver specialists – Dr. Rajiv Lochan, Dr. Sonal Asthana, Dr. Mallikarjun Sakpal, Dr. Arun V – Anesthesiologist and Dr. Prakash Doraiswamy – Intensivist, reviewed the patient’s medical history before recommending surgery and charted out a feasible pathway.

“During a liver surgery, patients lose a lot of blood which needs to be replaced for the patient’s survival. Generally, doctors keep 3-4 units of blood and a similar quantity of platelets/plasma on reserve for the patient. In this case, we had to figure out and alternative,” said Dr. Mallikarjun Sakpal, Hepatologist at Aster CMI.

The doctors used ‘Normo-volemic hemodilution’ technique where doctors took two units each of both patient and donor’s blood and were connected to the system throughout the surgery using special equipment so there is no break in the blood circulation loop. This procedure was discussed with the patient before surgery and it was in line with their beliefs.

During the surgery, the patient lost about 2 units of blood which were compensated with the use of ‘cell-salvage’ technique to collect and reuse the blood. The surgery lasts for 12-hours and two teams of specialists with close to 25 doctors were involved in this surgery.

In a period of two weeks, the patient and his brother, who was a donor, were discharged from the hospital.   

Source : Gulfnews.com

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Apollo Doctors Save Life of 15-year-old Boy by Adapting Unique Technique

A 15-year-old boy was rushed to Apollo Hospital, Bangalore with a knife stab injury on the neck and voracious bleeding. He lost two liters of blood from the wound at the accident spot and the cut was deep at the critical position.

The injury was on the left side of his neck along with an injury in the nape of the neck and left forearm. He received an initial treatment i.e., wound suturing in another hospital and was later shifted to Apollo hospital. It was a huge challenge for doctors due to two reasons – a lot of blood loss and the location of the wound.

“The boy was brought to us in emergency and we did a quick CT Scan that showed that the cut was deep and through the blood vessels. It was difficult to save his life unless the bleeding was stopped. We removed the sutured wound and the bleeding increased profusely,” added Dr. Sunder Narasimhan.

“It wasn’t possible to perform angio-embolization of the vertebral artery because he had low blood pressure. As a result, we adopted a novel strategy, sutured his wound again and shifted him to cath lab”, he added further.

After the complex surgery, the patient is in good health and had no neurological complications.

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Underweight Baby from Saudi Arabia Undergoes a Rare Transplant Surgery

Doctors at Artemis Hospital, Gurgaon conducted a rare surgery of liver transplant on an underweight baby-girl, weighing 5.2 KG, using one segment of the liver donated by her mother. The baby, from Saudi Arabi, had an underdeveloped portal vein. This vein is a blood vessel that carries blood from gallbladder, gastrointestinal tract, spleen and pancreas to the liver.

A liver has eight segments. Generally, for a living donor transplant where the recipient is a small child and donor is an adult, two segments of the liver are used. Doctors at Artemis Hospital said this one-year-old girl was suffering from a congenital disorder – Biliary Atresia – transplanting two segments wasn’t possible. There was a risk of insufficient blood flow to revascularized the liver. To reduce this risk, surgeons replaced it with a bovine jugular vein.

To avoid this, surgeons separated segments II and III of the liver which has longer blood vessels and used segment III for the transplant.

Dr. Giriraj Bora, joint chief, gastrointestinal and hepatobiliary surgery at Artemis Hospital, said bovine graft vein is used in liver transplantation. The baby has recovered well from the surgery.

The child had prolonged and deep jaundice months after her birth. Doctors in Saudi Arabia diagnosed her with biliary atresia and conducted biliary bypass surgery but it was unsuccessful. The doctors then advised liver transplantation. However, taking her body weight and nutritional status in considerations, doctors in Saudi Arabia was reluctant to perform such a complex surgery and she was referred to India.

Source : Economic Times

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Delhi Hospital uses Novel Technique to Clear Calcified Blockage from Artery

A team of cardiologists at Fortis Escorts Heart Institute has performed a unique procedure to open a blocked artery of a 67-year-old patient. The hospital used a ‘novel technique’ called coronary shockwave lithotripsy.

According to the hospital, the patient had a 90 percent blocked artery and it wasn’t possible to open by standard technique of balloon angioplasty.

“A shockwave balloon was inserted inside the artery and sonic pulses were delivered to break the calcium blockage. After that, the blockage opened easily at even low pressure with stent implantation,” said Dr. Ashok Seth, Chairman of Fortis Escorts Heart Institute (FEHI).

“Hardened calcified blockage is a big challenge to treat using stents and angioplasty. Such blockage is opened with ease and safety with the novel procedure. This procedure brings hope for those suffering from an advanced form of Coronary artery disease,” added Dr. Ashok.

Hardened deposit of calcium happens in 20-25 percent of the patients, especially those who are diabetic, old, chronic kidney disease, long-standing blockages or who have undergone bypass surgery.

Source : Economic Times

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Iraqi Woman Undergoes 7-hour Surgery for Rare Tumor at Fortis Hospital

Doctors at Fortis Hospital, Vasant Kunj gave a new lease of life to a 27-year-old Iraqi woman by removing a “rare recurrent tumor” from the lower jawbone, thereby allowing her to eat properly after three years.

Rasha Mohammad was initially treated in her home country for the tumor. It was resected and a reconstruction plate was placed to bridge the gap in the lower jaw. However, this recurrent tumor – ameloblastoma, relapsed and the lower jaw got maligned due to which it was difficult to bite, chew and eat food.

The relapsed tumor also resulted in physical disfigurement and the right side of the face was depressed.

“Rasha Mohammad was taken for surgery where the tumor was removed along with the jawbone and chin. Bone from the right illiac crest was removed, shaped and auto-transplanted to form the right jaw and chin. The blood supply to the new jaw was augmented by bringing in sternocleidomastoid muscle flap to cover the bone,” said Dr. Mandeep S Malhotra, Head- Breast, Head & Neck Oncology Surgery, Fortis Hospital Vasant Kunj.

“The entire surgery took seven hours. We have been able to achieve more than expected. The tumor has been removed and the patient’s face looks normal. Additionally, she can bite properly and ear normal food,” added Dr. Malhotra.

Source : Economic Times

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Uzbek Kid Regains Voice After 10 Years Following Surgery in India

A 12-year-old boy named Khusanbek Ozotilla from Uzbekistan regained his voice after undergoing surgery in Indraprastha Apollo Hospital, New Delhi. The boy lost his ability to speak after undergoing a tracheostomy at the age of two in his home country.

The boy fell from the terrace of his house suffering head injuries for which he underwent lifesaving surgical procedure tracheostomy in his country. In this procedure, an opening is created in the neck to place a tube into the windpipe.

“The boy had to live with a hole in his neck due to which he lost his speaking ability,” said Dr. Suresh Naruka, consultant in the ENT department at Indraprastha Apollo Hospitals.

The child was admitted to the hospital and surgery was planned to be done in two stages.

“In the first stage, the boy underwent an endoscopic examination where it was found that he was suffering from subglottic stenosis. A T-tube was placed in his trachea,” said Dr. Ameet Kishore, senior consultant at the Indraprastha Apollo Hospitals.

“After one week, the second stage of the surgery was performed. A reconstruction of his windpipe was conducted using a part of his rib as a graft. The stage closed the opening on the neck,” added Dr. Kishore.

The child was kept in the pediatric ICU for a day and the next day he was taken off the ventilator. He has now returned to his home country and doing fine.

Source : Economic Times

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Doctors Treat Rare Case of Blurred Vision due to Heart Infection

A 23-year-old doctor named Lokendranath from the Hyderabad city developed a rare condition of blurred vision due to valve infection which was spreading in his heart. 

He was advised to meet a cardiologist and an abnormality of heart valve known as the bicuspid aortic valve was discovered after a series of tests. In Bicuspid Aortic Valve (BAV), two of the leaflets of the aortic valve fuse during the early weeks of pregnancy. In this case, the aortic valve was swollen up and had infected the surrounding valve tissue as well.

“In valve infection, the patient shows symptoms such as tiredness, consistent fever and more. In Lokendranath’s case, the infected material must have reached his eye due to which he suffered from an unusual symptom that is blur-vision,” said Dr. Ramakanta Panda, a cardiovascular thoracic surgeon at Asian Heart Institute.

“Valve infection is a deadly condition and patients with valve defects are more vulnerable to infection. The common source of infection is nose, teeth, urine or sputum. This is why people should have proper dental hygiene,” Dr. Panda added.

Source : Economic Times

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