The effects of the COVID-19 pandemic on health care have been very wide-ranging. The pandemic has burdened healthcare with COVID patients, especially in intensive and inpatient care. On the other hand, the pandemic and societal restrictions have changed people’s behaviour in health services. Furthermore, hospital functions such as elective surgeries have been suspended in order to reallocate resources.
The TULES Research Unit at Tampere University Hospital has carried out extensive research on the effects of the COVID-19 pandemic in healthcare. The research has been led by Professor Ville Mattila. Alongside him, the main researchers have been Ville Ponkilainen and Mikko Uimonen from Hospital Nova of Central Finland and Ilari Kuitunen from Mikkeli Central Hospital. In addition there has been broad research collaboration with a range of specialists from different hospital districts.
Professor Ville Mattila, how did this pandemic research originate in the first place? What observations prompted closer inquiry? – I was on duty at Accident and Emergency Department Acuta on 22 March, 2020, astonished by the low number of patients. The pandemic had just hit. I thought that our high-quality registers would yield unique information on changes in morbidity and in the use of resources in exceptional situations.
What concrete lessons has the pandemic research provided in terms of use of hospital resources? – First aid and emergency surgery resources must be maintained in all circumstances. Although milder illnesses disappear momentarily from the emergency room, the incidence of severe injuries, fractures, and illnesses requiring urgent care does not change, even during exceptional times.
Ilari Kuitunen, what has been the most surprising finding in your research so far? – In my opinion, the most surprising finding thus far has been how little the exceptional circumstances ultimately affected adults’ specialized care emergency visits in Finland compared to what has been internationally reported and to what media has reported about, for instance, the incidence of coronary diseases and traumas. It was also particularly surprising that the visits of the oldest old patients increased in number, even though infections did not spread in usual fashion. The cancellation of nonacute appointments and visits in the spring of 2020 led to an increase in emergency visits and hospitalization among older patients, even if infections that year were more infrequent than normally. Finland has also done well when it comes to surgery, as the hospitals partaking in the study managed to reduce their surgery backlogs to pre-pandemic levels already during the autumn of 2020. Also, oncological surgery rate did not decrease that year.
What else has the pandemic taught? – Results from international research were not directly applicable to Finland, and it was important to have this research made here. In future, we know that even strict restrictions without curfew do not reduce injuries and severe illnesses, and resources for their care must be secured. Furthermore, this taught that under the current Act on the Secondary Use of Health and Social Data such quick and unique multi-centre projects, which produce enormous amounts of data within a year, will not succeed anymore. This should be brought into broader public debate.
Text by Aleksi Reito