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News | Friday, 29 May 2020

Coronavirus: National Academy Leopoldina presents fourth ad-hoc-statement

Coronavirus: National Academy Leopoldina presents fourth ad-hoc-statement

Picture: Pixabay / iXimus

The German National Academy of Sciences Leopoldina has issued a fourth ad-hoc-statement on the coronavirus pandemic. It is dedicated to the topic: "Medical Care and Patient-Oriented Research in an Adaptive Healthcare System". The paper focuses on short- and medium-term aspects of medical and care services under the conditions of a sustained pandemic and identifies long-term measures that lead to a more resilient and adaptive healthcare system.

The authors recommend a needs-based system focusing on patient well-being and quality assurance, rather than a primarily profit-oriented approach. It should appreciate all employees and integrate innovations as well as digital solutions. The aim is an adaptive healthcare system where the public health service and the ambulatory and stationary sectors work together well, and research results are promptly integrated into clinical practice.

In the past weeks, the coronavirus pandemic has posed extraordinary challenges to the German healthcare system. According to the ad-hoc-statement, the confrontation with a new viral disease has shown the great importance of a publicly funded healthcare system and of an interconnected and research-based healthcare. Due to precautionary measures against infection with the largely unknown SARS-CoV-2 virus as well as the rearrangement of the system to be able to handle a potentially large number of severely ill COVID-19 patients, ambulatory and stationary care for patients with other illnesses has, however, faded into the background. Even important preventive measures and research activities had to be interrupted. Now, needs-based preventive, diagnostic and therapeutic measures for all patients need to be resumed promptly and, whenever possible, to their full extent.

The authors consider the following short- and medium-term framework conditions necessary to ensure healthcare for all patients in times of an ongoing pandemic threat:

  • provision of sufficient stationary, ambulatory, and post-stationary capacities and securing personnel, rooms and technical reserves for the treatment of COVID-19 patients when required
  • establishment of a regional and in-hospital early warning system for SARS-CoV-2 infections
  • implementation of science-based targeted testing strategies
  • strengthening public confidence in a safe and patient-oriented medical treatment
  • high-quality care and health services for all patients by promptly integrating new research developments

It is the responsibility of the state to ensure healthcare in times of crisis and a quality-assured and science-based medical treatment for the population. The working group of the German National Academy of Sciences Leopoldina recommends taking the following general aspects into account for the long-term development of the healthcare system:

  • ensuring high-quality, science-based and ethically responsible care for all patients
  • determining defined and differentiated areas of responsibility for each healthcare provider in a region according to the level of care expertise with a special function for university medicine
  • providing adequate numbers of qualified medical and care staff
  • guaranteeing comprehensive digitisation and structured cross-sectoral connectivity of all hospitals and of ambulatory care
  • ensuring the realisation of healthcare tasks, for example by supplementing the current diagnosis related groups (DRG) reimbursement with structural components while avoiding false incentives
  • social appreciation, appropriate remuneration, attractive and needs-based training as well as favourable working conditions for medical and non-medical personnel

With this statement, the German National Academy of Sciences Leopoldina publishes the fourth ad-hoc-statement on the coronavirus pandemic in Germany. The first three statements focused on acute healthcare policy measures in dealing with the pandemic, and on psychological, social, legal, educational, and economic measures that may contribute to a gradual return to societal normality.

The detailed fourth ad-hoc-statement “Coronavirus Pandemic: Medical Care and Patient-Oriented Research in an Adaptive Healthcare System” may be downloaded here.

13 April 2020 – German National Academy of Sciences Leopoldina presents third ad-hoc-statement

The German National Academy of Sciences Leopoldina has published a third ad-hoc-statement on the COVID-19 pandemic. The paper entitled “Coronavirus Pandemic – Sustainable Ways to Overcome the Crisis” deals with the psychological, social, legal, educational, and economic aspects of the pandemic and describes strategies that may contribute to a gradual return to normality. The authors of the statement emphasise that, in light of the psychological, social, economic, civil society, and political problems caused by the coronavirus pandemic, curbing its spread must be given the highest priority. Although the pandemic will continue to define economic and societal life for months to come, criteria and policies have to be developed that go beyond the acute limitation of fundamental rights such as the freedom of movement to ensure a gradual return to normality. According to the statement, such a gradual relaxation of regulations requires consistently low infection rates to prevent the healthcare system from being overloaded, increasing identification of infected persons, and disciplined compliance with protective measures (hygiene, the wearing of mouth and nose protection, physical distancing).

The paper addresses questions of data- and model-based decision support and perspectives concerning the evaluation of legal rights. It also proposes recommendations for buffering psychological and social impacts. Besides, measures for the economic and financial sector, as well as the area of education, are illustrated. The statement identifies the following principles as a general framework: the protection of every individual human being and the facilitation of a dignified life, as well as the gradual restoration of the citizens' social, economic, political, and cultural capacity for action. The concepts of sustainability and resilience should guide all measures.

The third statement supplements the two previous ad-hoc-statements on health policy issues in dealing with the pandemic issued on April 3 and March 21. These recommendations continue to apply. In particular, the current focus on caring for COVID-19 patients must not lead to a shortfall in the care of others. Sufficient capacities in intensive care units and stocks of protective equipment should be held in reserve for new outbreaks of the pandemic. The healthcare system should be analysed and adjusted accordingly. Furthermore, every effort has to be made to expedite the research into effective medications and the development of quickly and widely available vaccines. The German National Academy of Sciences Leopoldina will closely monitor and support this process.

The detailed third ad-hoc-statement “Coronavirus Pandemic – Sustainable Ways to Overcome the Crisis” may be downloaded here.

8 April 2020 – German National Academy of Sciences Leopoldina presents second ad-hoc-statement

The German National Academy of Sciences Leopoldina has published a second ad-hoc-statement entitled “Coronavirus Pandemic – Measures Relevant to Health”. The paper focuses on measures relevant to health, which can contribute to a gradual normalisation of public life. Three measures are particularly important: (1) general use of mouth and nose protection, (2) short-term use of mobile phone data and (3) increase in testing capacities.

This statement complements the first ad-hoc-statement “Coronavirus Pandemic in Germany: Challenges and Options for Intervention” of the interdisciplinary working group dated March 21, 2020, in which the participating scientists described measures to contain the pandemic, protect vulnerable population groups, and to increase the capacity of the public healthcare system and the public supply of critical goods and services. These recommendations remain valid and are herewith supplemented in light of recent developments.

At present, measures relevant to health are particularly important. In addition, immediate and long-term social and economic consequences must be taken into account for future decisions. The Leopoldina is currently working on further statements with recommendations for a sustainable “restart” of public life and the economy.

The detailed second ad-hoc-statement “Coronavirus Pandemic – Measures Relevant to Health” may be downloaded here.

27 March 2020 – German National Academy of Sciences Leopoldina advises on coronavirus pandemic

The worldwide spread of the coronavirus SARS-CoV-2 and its associated respiratory disease COVID-19 proceeds at a highly dynamic pace. The Leopoldina has published a first ad-hoc-statement on possible health policy options to counter the further spread of the virus. The associated working group will support and accompany the readjustment and implementation of any measures with additional publications. An additional working group has been established to address the legal, economic, social and psychological aspects of the pandemic.

21 March 2020 – German National Academy of Sciences Leopoldina presents ad-hoc-statement

An interdisciplinary working group of the Leopoldina has been working on medical perspectives of the pandemic. The resulting ad-hoc-statement “Coronavirus Pandemic in Germany: Challenges and Options for Intervention” discusses potential health policy options to counter the further spread of coronavirus in Germany.

Measures taken by the German Federal Government and the German Federal States (Länder) to curb the ongoing coronavirus pandemic are urgently required at present and correspond to the  threat  posed by  the  pandemic.  They  consist  of  three  elements:  (1)  containment  of  the  epidemic, (2) protection of vulnerable population groups, and (3) capacity increase in the public healthcare system and  in  the  public  supply  of critical  goods  and  services. There  is  scientific  evidence for the effectiveness and necessity of selected measures, while others are proposed on  the  basis  of  projections  and  political  considerations.  Top  priority  must  be  given  to  the  development of drugs and vaccines. With this, medical ethics must be considered.

From a  scientific  point  of  view,  a  Germany-wide  temporary  shutdown  (of approx. 3  weeks)  with  consistent physical distancing seems advisable at this time. Necessary and health-preserving activities must remain possible. All efforts in the next weeks and months should be directed towards making pharmaceutical interventions and protective measures available for the public, and towards assuring testing capacities for cases suspected of infection and for those persons entering the country. During the  shutdown  period,  preparations  must  be  made  for  the  controlled  and  selective  restart  of  publicand economic life.

By means of a temporary “shutdown”, the working group discussed a stringent nationwide curfew until at least after the Easter holidays. At that point, the situation would have to be re-evaluated. This would not imply a work prohibition, a ban on purchasing food or even a ban on going for walks with the family. The goal is to make consistent use of home office, if possible. A disciplined spatial distance of 2 meters between people is also crucial, especially if they do not live in the same household.

The detailed ad-hoc-statement “Coronavirus Pandemic in Germany: Challenges and Options for Intervention”  may be downloaded here.


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