Effective Procurement Could Help Prevent a “Twindemic”

Coming up to the UK’s third Winter with Covid-19, how do things stand? Cases are lower than the beginning of the pandemic, with more and more people vaccinated, but are starting to increase as flu season hits. Yet, a recent UK Government decision has reduced testing in healthcare settings; it is now no longer available for individuals who are not symptomatic. Cases of Covid-19 are predicted to increase, but so are viral infections, as they tend to do over the colder months. So what exactly is the UK healthcare system facing and how can it best prepare, to avoid being overwhelmed in this coming “twindemic”.

Current Cases in the UK

Officials have warned that the UK is likely to face spikes in COVID-19 and influenza over the coming months. In September, the figures for positive tests were as follows:

• Wales: 62,900 positive tests; 1/50 of the population
• England: 857,400 positive tests; 1/65 of the population
• Northern Ireland: 23,100 positive tests, 1/80 of the population
• Scotland: 117,100 positive tests, 1/45 of the population

While these numbers are part of an overall downward trend, reflected globally (WHO), this is not to say that there will not be an increase, as is typical, during winter. Interestingly, the majority of infections in the UK were of the Omicron variants, BA.4 (12.2% of infections) and BA.5 (86.3% of infections).

Since September, however, COVID-19 cases have increased. Most recently, the figure for positive tests in England was up to 1.1 million, compared to 857,400 in September. For Northern Ireland, the September figure has almost doubled and is now 46,100. Although Scotland’s figures have stayed relatively similar, Wales has also increased to 63,400.

Previous Covid-19 Strategies

So, with that knowledge, and the likelihood of an upward trend for positive COVID-19 tests, what should the NHS be doing to prepare? First, let’s look at what was done before and what some of the previous set-backs have been, in order to avoid them again. In summary, they were underprepared, underfunded and under equipped for a pandemic of this scale. At some points, this led to unsafe circumstances for healthcare workers and their patients. The NHS simply did not have enough PPE to go around and the sourcing was not done effectively. While we now know far more about the virus, and the best way to protect the public and most vulnerable, the NHS must ensure they do not get caught out again in medical shortages.

Once enough PPE was sourced, the NHS had a far better chance of protecting the public and key workers. There was, however, another issue which caused many preventable deaths. Testing, as it became available, was not widespread enough. Those who had been in hospitals and were being discharged to care homes did not receive COVID-19 testing and many of them brought the virus into care homes full of vulnerable people. Once testing was ramped up and readily available to the public, greater caution could be exercised.

The most effective way to unlock the UK was to vaccinate the people. When these were authorized and deployed, the NHS utilized an effective system to get as many people vaccinated as possible – starting with those most at risk. Since the initial shots, much of the UK has been fully vaccinated, in fact 40,373,987 people have received two doses and last winter’s booster.

Current UK Strategy, Vaccines

Speaking with our contacts at the NHS, we learned that hospitals are currently preparing for the upcoming flu and COVID-19 season in three main ways:

1. Promoting immunization
2. Staff awareness of following hygiene protocols
3. Time discharge of patients to create bed space.

Using these methods, they hope to avoid becoming overwhelmed in the winter months. Part of this strategy, immunization, is already underway with the autumn booster programme. The NHS is urging those who are eligible to get it. The booster is for people who are: over 65, pregnant, at high risk, live with someone who has a weakened immune system, over 16 and a carer, living or working in a care home for older people and frontline health and social care workers. Some people offered the booster are also offered the annual flu vaccine at the same time, combatting both winter threats.

This strategy is indeed worthwhile, but the NHS must be prepared for other variants of the virus that may require alternate or adjusted vaccinations. We are already seeing that the majority of infections in the UK are with the Omicron variant. Coronavirus Disease is likely to continue to mutate given how widespread it is. When these mutations occur, if they are not responsive to our current vaccines, new versions will need to be developed. To be able to acquire these, if they become necessary, the NHS must make sure that they have an effective sourcing system in place.

Current UK Strategy, Testing

Unlike boosters, testing is slowing down and being paused for some circumstances. Since April, the UK government has stopped free at-home testing for the public. Now, it has paused routine, asymptomatic testing in care homes, the NHS, hospices, parts of prisons, domestic abuse refuge centers and homelessness settings. Unlike, however, the start of the pandemic, those discharged from hospital and going into care homes and hospices will receive a COVID-19 test. The government has said that it expects vaccines, boosters and antivirals to provide the majority of protection for people. 

Demand for testing generally has reduced. This is reflected by the FDA, who have removed their EUA route for test manufacturers. Now, tests for COVID-19 will not be able to receive emergency approval from the FDA. The system, however, will remain in place for diagnostics that use new technologies and tests for new variants.

Despite this, the move from the UK government comes as slightly controversial. Dr Susan Hopkins, the UK Health Security Agency’s Chief Medical Adviser, says that ‘vaccines remain our best form of defense’. Secondary lines of defense include antibiotics and antivirals, symptom dependent. The Royal College of Nursing, however, is worried about the pause in testing. They say that continued vigilance is vital, so that both patients and staff are not put at risk. However, a contrary view is that testing costs money and if there are no symptoms, there is no point. Notably, testing advice in Scotland, Wales and Northern Ireland differs from England’s.

Options to Consider, EU Advice

Are there other steps that the UK health system should be considering? Samantha Field, Public Health Registrar and Martin McKee, Professor of European Public Health think so. They advise that the UK follows the plan of the EU, more closely. This plan centers vaccines and pharmaceuticals, like the UK, but it has a strong emphasis on procurement. Taking into account that a new COVID-19 variant may be resistant to existing vaccines and antivirals, the EU is prioritizing virus (coronavirus and influenza) surveillance, coordinated cross-border responses and procurement methods. 

With joint procurement measures, they say they have a vast purchasing power. Using this, they can source from favorable vaccine manufacturers and suppliers, as well as access new versions quickly. Also in this international plan, is the consideration of the supply chain. The EU wants to ensure they identify bottlenecks and work around blocks – to avoid shortages. As the UK is much smaller, it has less market power. Additionally, Brexit has provided trade complications. While the NHS currently has ample supplies and support, the EU is advising that the UK follow its lead and stay on top of the supply chain.

Procurement Solutions

All that being said, a reliable procurement method appears the most important component that the UK can add to their strategy for dealing with COVID-19 in the winter, alongside flu season. This would best prepare the NHS, in terms of having enough and a steady supply of medical equipment, as well as current vaccines and new ones as they emerge. But what is the best way for the NHS to go about this?

Well, there are steps that the healthcare organization can take and Vamstar’s services are definitely one. Access to our AI-powered marketplace provides invaluable insight into multiple, reliable suppliers, avoiding the pitfalls of using only one or two. We ensure that the most suitable suppliers fulfill tenders and provide greater tender visibility. Our product also considers value-based procurement, where buyers can purchase goods that may not be the cheapest, but provide the most valuable outcomes. For instance, the most effective antivirals will increase the likelihood of getting a patient discharged from hospital quickly – the best outcome for them, thus freeing staff time and hospital resources. If you would like to find out more, visit our website: http://www.idlewolf.com/about-us/.

Medical Technology | COVID-19 Pandemic | Hospitals | Healthcare Data | Machine Learning | Market Intelligence | Clinical Data | Flu | Public Procurement | Patient Care | Artificial Intelligence | NHS | Supply Chain | European Market | Vaccines