With vaccination campaigns stepping up across the globe, the end of coronavirus is in sight for some nations. However, challenges remain with the spread of the Delta variant, ever-changing travel restrictions and evidence of another wave appearing, according to former UK chief scientific adviser, Sir David King. Experts discussed the viable routes to recovery through data and scientific advances, during the opening keynote session, 'Moving Beyond COVID-19 – Creating a Roadmap out of a Crisis', held at the HIMSS21 European Health Conference on 7 June.

The global experts included: Prof Sharon Peacock FMedSci CBE, executive director and chair at COVID-19 Genomics UK (COG-UK) Consortium and Professor of Public Health & Microbiology, University of Cambridge, UK, Dr Hans Kluge, regional director for Europe at World Health Organisation (WHO) Denmark, Prof Ran Balicer, Clalit Research Institute, Israel, Hal Wolf, president and CEO at HIMSS, US, Joaquim Cunha, executive director at Health Cluster Portugal and Andrew Miles, head of EMEA, healthcare and life sciences at Google Cloud UK.

Harnessing digital as part of the roadmap

The discussion started by looking at global efforts made since the last HIMSS Europe Digital event in September 2020. At the time, more than 20 million people had been stricken by COVID-19, with more than 800,000 people were reported to have died.

"Today we're struggling to contain a fourth wave that has raged across India and South America, and given new cases to a daily average of more than 800,000. Total global cases have increased eightfold since August of 2020, and deaths have quadrupled," said Wolf.

Currently, over one billion vaccines have been administered. In countries like the US, Israel, and the UK, there has been an adequate supply of vaccines, making the promise of a "new normal" seem achievable, explained Wolf.

"Today, it is more clear than ever, that the digital health solutions including telehealth applications, electronic medical records, digital devices, as well as information tools, such as population health databases, and analytic tools, are essential to our ability to treat, detect and manage the disease.

"We now have the opportunity to build on all the digital health solutions that have been adopted out in necessity during COVID-19 emergency and use them in a way to improve health and wellness, achieve greater health equity, and prevent and respond more quickly to the spread of the next highly contagious disease," conceded Wolf. 

Reinforcing this hopeful sentiment, Kluge said: "I think we need to realise we're not out of the woods yet. But we do have some hopeful stories […] collectively we still need to adhere to the public health and social measures. Genomic sequencing of variants is an area of concern because that is what can catch us by surprise."

Vaccine hesitancy as an area of focus

Kluge also explained why nations need to look beyond access to vaccines and focus also on vaccine hesitancy. "In the European region where I'm sitting, for example, there is some hesitancy once you hit a certain percentage. Above all, I believe what Europe needs is leaders who transmit hope and optimism. People are tired and frustrated here. We need to stand with the people, tell the truth, but also tell them there is light at the end of the tunnel."

In December 2020, Israel acted as a 'global model state' for starting a rapid national campaign to vaccinate its entire population. Israel committed to sending Pfizer statistical data in exchange for COVID-19 vaccine doses.

Highlighting the robust digital health infrastructure that spearheaded and transformed the campaign, Balicer said: "I think that one of our lessons learned from these events have been that pandemics are a stress test. They are a stress test to societies and they are a stress test to health systems. Health systems that are able to mitigate such an event and remain intact, are those that have those capacities in normal times, you cannot just conjure it out of the blue in a crisis.

"It is the basic attributes of universal health care, of strong primary care, and strong digital health infrastructure that help you both in normal times, as well as such crisis. In Israel, the digital health infrastructure helps us do some really important steps in the early waves and in the vaccination campaigns," continued Balicer.

In March 2020, at the beginning of the pandemic, Israel created a predictive model to understand which patients are at the highest risk of having a severe illness.

"When there were very few patients in Israel and you could use our class models for influenza and couple them with information from China and Italy, that came in. With that we created a predictive model, put it into practice, identified the highest risk patients and coded each and every one of them," explained Balicer.

"The highest sphere of 200,000 patients, each one got a phone call from a physician telling him whatever you need, we'll get it to you at home or with telecare."

Managing emerging variants

Meanwhile, in the UK, the government has expressed that it is 'open' to delaying England's lockdown end date if necessary. The spread of the Delta variant remains a major source of concern as it becomes dominant in the UK, with another 5,341 infections recorded on 6 June, according to official figures.

Discussing the management of emerging variants, Professor Peacock, said: "Now, certainly various concerns could potentially be a cause for the derailment of our efforts. But I don't think it's at the top of our list. I believe that we can manage variants with changes in vaccination strategy. I think the real risk of derailment lies with our slow pace of vaccine rollout to the world. I believe that to be a major risk for derailment in the future.

"Looking ahead, the importance of sequencing for future pandemic control really revolves around using this to provide actionable information. That means detecting variants of concern and variants of high consequence as soon as possible.

"We need to do this to keep diagnostics, vaccines and therapeutics working. We can change vaccines, we can tweak them over time to new variants, and that is what is being done against the variant from South Africa at the moment. We also need to use sequencing to understand the geographic distribution of variants of concern and high consequence so that we can match our vaccine efforts to that distribution."

Access the 'Moving Beyond COVID-19 – Creating a Roadmap out of a Crisis' session from the HIMSS European Digital Conference 2021 ‘On Demand’ here.

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