On December 31, 2019, the World Health Organization learned about a number of cases of pneumonia of unknown origin in Wuhan City, China. On January 7, Chinese authorities identified the cause as a novel coronavirus (2019-nCoV), a member of the coronavirus family that had never been encountered before. And the rest is history… the world changed forever. But in December 2020, we are still not over the worst.
So, how has medical travel changed in 2020?
Before the pandemic, the main barrier to medical travel was safety. Many patients certainly consider travelling abroad for treatments that they need or want. They research destinations, providers and prices. They submit enquiries about the treatment options. But then, they fail to follow through with a booking. In essence, the high dropout rate of potential medical travellers is down to concerns about safety. Can I trust this doctor/hospital/clinic? What are the chances of something going wrong? What happens if I have a complication? Covid-19 means that patients’ concerns are now even greater. Is this destination “Covid safe”? What happens if I catch Covid-19 when I’m there?
The response from providers and destinations has been mixed. We’ve seen the appearance of ‘Covid-safe’ certification for hospitals and clinics to build confidence with prospective patients about an individual treatment centre.
More widely, international organisations, regions and destinations have created their own protocols to encourage safe travel and tourism and which may support the recovery of medical travel, including:
- The World Travel & Tourism Council has introduced global Safe Travels protocols for use by the travel and tourism sector as best practice guidelines to help restart and speed up the recovery of the sector in the wake of Covid-19. The Safe Travels stamp has already been adopted by many countries.
- The Caribbean Public Health Agency’s new Health Assurance stamp for Healthier Safer Tourism is an initiative set up to protect the region’s tourism sector and safeguard public health.
- In Turkey, the Culture and Tourism Ministry has launched a healthy tourism certification programme to ensure high health and hygiene standards at airlines, airports, other transportation facilities, accommodation and food venues.
- The Airports Council International has established an Airport Health Accreditation programme to provide airports with an assessment of how aligned their health measures are with the ACI Aviation Business Restart and Recovery guidelines.
So, travel and tourism organisations have been busy trying to “protect” their destinations. But what about travellers, medical or otherwise, who are concerned about the risk and potential cost of contracting Covid-19 while they are away? There have also been developments to counter those concerns:
- HL Assurance and Changi Travel Services have launched a new Covid-19 insurance policy for short-term visitors to Singapore. The policy offers up to S$100,000 of hospitalisation cover in the event the insured is infected with Covid-19 while staying in Singapore.
- Emirates Airlines is offering anyone who books a flight free global cover for any Covid‑19 health expenses and quarantine costs that a passenger may incur.
Long term, despite the development of a vaccine, the fear of Covid‑19 will continue to threaten the recovery of medical travel.
The new world of telehealth
If the patient can’t travel to the hospital, can the hospital come to the patient? With restrictions on travel likely to continue for some time, the growth of teleconsultation and telemedicine has continued apace. The Future Health Index 2019 report showed that telehealth had yet to become a common part of healthcare professionals’ day-to-day work, with 39% saying they did not currently use telehealth in their practice or hospital. The 2020 report will have halved that response, if not more so.
Covid-19 has resulted in an acceleration of the adoption of technology in all walks of life. What was once a nice to have has now become an essential component of the healthcare offering for every business and hospital serving international patients. If a hospital or clinic hasn’t invested in a dedicated teleconsultation facility, then it is no longer in the medical travel business.
Survive or thrive?
In an October 2020 IMTJ article, Paul McTaggart, CEO of Dental Departures, summed up the challenge for medical travel providers and hospitals serving international patients. 2020 has been a case of survival of the fittest. The barriers to travel have meant the disappearance of many small-scale agencies and facilitators who had neither the resources nor the finance to endure the loss of business.
For many hospitals where international patient business represents only a small proportion of their revenue, their biggest challenge has been managing the influx of domestic Covid-19 patients; attracting international patients has been the last thing on their agenda. For those hospitals with dedicated international patient departments and significant throughput, furloughing and laying off or repurposing staff has been the short-term solution. However, the short-term fix is becoming a much longer term decision. Do we stay in the international patient business or is it time to exit?
A backlog of demand for treatment
Hospitals in many developed countries have had just one thing on their mind – the virus. It’s meant the cessation or severe restriction of planned elective surgery in many hospitals. The result is a build-up of pent-up demand for knee and hip replacements, cataract operations and other non-life threatening procedures. In the UK, the number of NHS patients waiting for more than a year for surgery has gone from 1,032 to 83,203 in 12 months. The number waiting for more than 19 weeks has gone from 620,454 to 2,151,443.
There’s a similar picture of pent-up demand for IVF treatment. Infertility clinics have been closed. Infertility travel has come to a stop. According to the UK’s Guardian newspaper this week, “Many women fear their last chance to have a child may have disappeared”.
Health systems across the globe will take a long time to reduce the backlog. Seeking treatment abroad may be the only option for many patients. The medical travel survivors of COVID-19 will be the ones that benefit.