COVID’s second year and counting witnessed the emergence of vaccination roll out strategies to safeguard populations against the virus. Throughout January and March, we reported on how COVID-19 vaccines became one of the most precious medications in the world and the challenge healthcare systems around the world faced in securing and distributing supplies to the population.

As the healthcare landscape evolved globally, the UAE and the wider GCC region also experienced a drastic change due to COVID-19.  The need for investment and further development of digital infrastructure and telehealth solutions, to facilitate the shift of primary care delivery away from hospitals was emphasised.

Related: COVID-19 vaccines: The most precious medications in the world?

Government-led digital health initiatives drove adoption of telehealth in UAE and KSA. Frost & Sullivan’s analysis, Strategic Public-Private Partnerships Transforming the Telehealth Market in the KSA and the UAE, 2020–2025, found that telehealth is a promising model for healthcare services in the Kingdom of Saudi Arabia (KSA) and the United Arab Emirates (UAE) and both governments are developing robust digital health infrastructure to support telehealth services

Health insurance organisations were quick to offer telehealth services to ensure, UAE members had uninterrupted access to sound medical advice. The advancements in medical innovations such as telemedicine, wearables, precision medicine, artificial intelligence (AI) plus online prescriptions and delivery, led to a more efficient and effective way of delivering healthcare outcomes in 2021.

Related: 2022 trends: Digital Healthcare and Innovation

Throughout May, COVID-19 continued to wreak havoc in India. According to a World Health Organization (WHO) report, hospitals in India were fighting for beds and oxygen in response to the deadly surge in infections and the country was accounting for nearly half the coronavirus cases reported worldwide and a quarter of the deaths.

Meanwhile in June, the possibility of Sinovac and health passes to restore travel to the Southeast Asian nation, was revealed by Dr. Kuljit Singh, President, Association of Private Hospitals of Malaysia.

Pfizer raced to develop a COVID-19 vaccine in record time in the previous year, and these were instrumental in saving many lives. The company also rolled out the vaccine for 12-to-15-year old's marking a significant step in the fight against the pandemic in July.

In August we reported on how vaccine tourism became popular with individuals travelling to countries to get quick access and make an appointment to get a vaccine shot. Jonathan Edelheit, CEO of the Medical Tourism Association commented that, one of the biggest challenges with the COVID-19 vaccine was that it was not available everywhere in the world. Also, many people were looking to get a specific vaccine with demand for Pfizer and Moderna vaccines.

Sotrovimab, an anti-viral treatment for COVID-19, became available for early treatment of certain categories of COVID-19 patients in the UAE following an agreement between the Abu Dhabi Department of Health, the group purchasing organisation (GPO) Rafed, and biopharmaceutical company GlaxoSmithKline (GSK). As a result, Abu Dhabi was the first location globally to receive this drug, we reported in September.

Over the next 10 years, digital infrastructure virtual care, remote patient monitoring, and AI will account for 30 per cent of hospital investments in GCC, predicted Ricky Shah, Consulting Editor, OCO Global. Arab Health and Medlab Middle East was also confirmed for 24-27 January 2022 in September, with technology taking centre stage. Digitalisation, blockchain and Big Data are growing in prominence, and according to the Voice of the Healthcare Industry Market Outlook 2021 report produced by Omnia Health Insights, AI is the second most impactful area of tech overall, followed by robotics. 23 per cent of those surveyed from the GCC placed a much higher priority for investment in this area of new technology.

In October, WHO approved first malaria vaccine after trials in Africa. Hailed a breakthrough, it marked the beginning of striving to eradicate and eliminate malaria. The first vaccine against a parasitic disease and was five decades in the making. Dr. Alex Coutinho, former Executive Director for Partners in Health in Rwanda commented during Africa health that there is “still have a long way to go” as the first steps are to manufacture the vaccine and make it affordable. Also, as part of the United Nations General Assembly, Facebook hosted a virtual session on ‘Using Social Media to Build Confidence in Vaccines’. The session provided information on vaccine availability and how communicating about vaccines is critical to increasing their uptake worldwide.

Addressing a special session on “The role of artificial intelligence and machine learning in Patient Safety” at the three-day Patient Safety Virtual 2021 conference in November, Dr Samer Ellahham, Medical Director of Continuous Improvement, Director of Accreditation, Cleveland Clinic Caregiver, Senior Cardiovascular Consultant, Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, UAE said that if integrated into health systems properly, Artificial Intelligence (AI) will give healthcare workers more chance to show care and empathy.

Last year, seasonal influenza infections were at a minimal rate due to COVID-19, however the climate’s influence on viruses was discussed to be significant as most diseases have a seasonal variation, with respiratory illnesses occurring typically during the winter months. Omicron’s first cases have coincided with the flu season, with the variant being the most dominant strain in the US , accounting for over 73 per cent of new coronavirus cases less than three weeks after the first case was detected.

Rising infectious disease rates will continue to drive ME&A clinical laboratory services, according to latest research, says Medlab Middle East. The Middle East and Africa laboratory services market is expected to grow to a market value reaching US$ 7.5 billion. the next edition of Medlab Middle East which takes place at the Dubai World Trade Centre from 24-27 January 2022.

To sign off, practitioners predict that digital healthcare is here to stay and will grow exponentially within the next few years, “we have witnessed in the past years, technological innovations, particularly Artificial Intelligence (AI) will continue to influence procedures and solutions in the health sector. The sector has made advancements in robotic surgery, and this will remain one of the trends to look forward to in the coming year,” said Dr. Zbiggy Brodzinsky, Consultant Orthopedic Spine Surgeon at Valiant Clinic Hospital.

According to estimates released by the US Centers for Disease Control and Prevention, the Omicron Covid-19 variant is now the most dominant strain in the US, accounting for over 73 per cent of new coronavirus cases less than three weeks after the first case was detected.

Omicron accounted for 73.2 per cent of cases during the week ending December 18, while Delta accounted for 26.6 per cent. Omicron was just 12.6 per cent of the circulating virus the week before, ending December 11, and accounted for roughly 1 per cent of new cases in the first week of December.

Related: Lessons learnt from the COVID-19 pandemic towards universal healthcare in South Africa

In an interview with Dr. Andrew Badley, head of Mayo Clinic’s COVID Task Force and infectious disease researcher, we deep dive into what the spread of the new variant means for the healthcare and wider community.

WHO has warned that Omicron is the fastest spreading variant yet, already found in 77 countries less than a month after being officially reported. What does this mean for the healthcare community, especially as the world was adapting to COVID by implementing preventative measures such as the vaccine? 

Unfortunately, that means we are going to see many many more infections, and although the Omicron variant may cause less severe disease, just through the sheer number of cases it is likely that we will see many more hospitalisations and deaths. It also means that we as healthcare providers need to advocate for what we know works to reduce infection rates and reduce disease severity, which are promoting universal vaccination and boosters. Also, universal masking in public places, social distancing and frequent handwashing, and when you have been in contact with a case or have symptoms, to get tested and if need be treated quickly.

Omicron’s high number of mutations based on protein spike have reportedly made it one of the most transmissible variants. How will this affect vaccine protection, as there is discussion on the effectiveness. 

Related: Robotic surgery gains momentum during COVID-19

Vaccine effectiveness is not all or none, it is a matter of degrees. So far, the current data suggests that the available vaccines have a slight reduction in protection against Omicron compared to other variants, but the degree of protection is still high. Consequently, there is no need at present, and likely will not be a need to create new vaccines for the Omicron variant. Boosting can also help in two ways; first boosting increases the quantity of antibody which is helpful, but more importantly boosting can improve the quality of antibody responses through a process known as affinity maturation. Also Boosting enhanced T cell responses to Omicron, which adds a third level of added protection.

Mutation of viruses is a common phenomenon, how has technology aided in the in early detection and prevention of new strains? 

The widespread ability of labs across the world to detect the virus through techniques such ads PCR, and to sequence the virus allows scientists to see near real time, when there is conserved mutation I viral isolates.

Is there a probability of the new strain being less severe if the population is already vaccinated or in patients who had already contracted COVID before? Are vaccine boosters necessary measures in safeguarding the population? 

New strains of any virus can be more severe, or less severe of not alter disease severity in any way. Whether to vaccinated is not impacted by the presence or absence of new strain. We know without any doubt that vaccination against SARS-CoV2 reduces ones likelihood of becoming infected, or becoming sick if infected, of developing severe disease if sick, or ultimately dying from infection. The protection is not absolute, but there is a many fold risk reduction from vaccination, especially with a booster. 

The origins of the Omicron variant is inconclusively being linked to being discovered in AIDS patients, placing HIV under the microscope, with possible reasons being an uncontrollable case of HIV and COVID resulting in the new strain. What are your thoughts? 

We do know that as long as a virus continues to replicate and spread within a society, we will keep seeing new mutations, so we will see more variants in the future. The existence of omicron is not due to a single case. 

Robotic surgery is accelerating in the UAE, even post COVID-19. There are other trends to look forward to in medicine and diagnostics, but robotic surgeries seem to have a prevalence as it supports surgeons in delivering improved and more efficient outcomes for patients.

“Decades ago, this procedure seemed unimaginable, but it became a reality and kept on evolving. Traditionally, spine surgeons must insert instruments into your spine, relying on their knowledge of anatomy and with the help of X-rays. Due to the procedure's sensitivity, it usually takes long hours, which can exhaust doctors and tire them,” said Dr. Zbiggy Brodzinsky, Consultant Orthopedic Spine Surgeon at Valiant Clinic & Hospital.

Related: Robotic heart surgery lends a healing hand

Data by Verified Market Research shows that the global robotic surgery market size was valued at $6.1 billion in 2020, it is expected to reach $22.27 billion by 2028. The company said that medical robots have become “high in demand since the onset of the COVID -19 pandemic.”

Robots can move freely around patients and operating theatres; nonetheless, they can also be used as a disinfectant with the virus- and bacteria-killing ultraviolet light.

Related: Growing number of patients benefit from robotic-assisted surgery in UAE

“The more light the robot exposes to a surface, the more harmful microorganisms are eliminated. 99.99 per cent of all germs and bacteria are removed within 10 minutes in a standard patient room,” wrote Verified Market Research.

Dr. Brodzinsky is one of the doctors conducting robotic surgeries in the UAE. Robotic Surgeries are advanced and minimally invasive. Surgeons use small instruments that are connected to robotic arms. Robotic surgeries are not meant to replace surgeons, the robots are operated by the surgeons.

Those surgeries intend to have less physical contact with the patient, and rather have the ability to help patients spend less time in the hospital and more time at home. So far, robotic surgery has an almost close to zero complication rate, minimum surgical trauma, and high efficacy according to Dr. Brodzinsky. These, and more, are what make robotic surgery an ideal option.

“Today, robots assist surgeons with precision and accuracy even with repetitive tasks. Robots can perform repetitive tasks with virtually unlimited endurance and without decreased performance, minimising the chances of fatigue-related errors and potentially resulting in more consistent outcomes for patients. Further, robotic guidance instead of image guidance minimises radiation exposure for the patient, surgeon, and other operating room staff,” he said.

Mediclinic City Hospital, a private hospital in the UAE, is one of the pioneers in robotic surgical systems. The healthcare provider put together an experienced team of surgeons with the most advanced robotic surgical system available, The da Vinci Xi.

This system acts as an extension of the surgeon’s eyes and hands, therefore, gives the surgeon magnified vision and 360 degree dexterity of four arms. Hence, surgeons can perform some of the most complex procedures using this system. The number of surgeries that have been operated by da Vinci Xi worldwide has surpassed 10 million worldwide.

In October of this year, The Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) and Mediclinic Middle East announced that they have successfully carried out the country’s first robotic kidney donor surgery on two male patients at Mediclinic City Hospital.

“We have seen an increase in robotic surgeries performed in the country post-Covid. We attribute this growth to various factors; particularly how efficient and seamless the procedure is,” said Dr. Brodzinsky.

Not only private hospitals but the trend is also increasing in the public hospitals. The Emirates Health Services (EHS) said that Al Qassimi Hospital for Women & Children has used surgical robots to perform 12 surgeries to treat pelvic diseases within five days. This increases the hospital’s record to 151 robotic surgeries since February 2019. EHS developed robotic surgeries in Gynecology to promote artificial intelligence into the practice.

The trend of using robots in healthcare is on the rise, as more providers learn that these automated applications can be used in conjunction with the healthcare staff and not as a replacement for them.

Wound infections are the most common postoperative complication, particularly in developing and low-income countries. Surgeons are recommended by WHO and the UK’s National Institute of Health Research guidelines to use alcoholic chlorhexidine skin preparation and triclosan coated sutures to prevent Surgical Site Infection (SSI).

However, findings from the FALCON trial, carried out in Benin, Ghana, India, Mexico, Nigeria, Rwanda, and South Africa, did not demonstrate superiority of these interventions over lower-cost alternatives.

Researchers who participated in the trial are advocating for the revision of global guidelines. Aneel Bhangu, co-author from the University of Birmingham, commented that SSI is a major burden for both patients and health systems. “We have delivered the biggest trial of its kind, where we could not demonstrate the superiority of these interventions over cheaper alternatives,” he said.

Patients who develop SSI experience pain, disability, poor healing with risk of wound breakdown, prolonged recovery times, and psychological challenges. Co-author Professor Adesoji Ademuyiwa, from the University of Lagos, commented: “The overall SSI rate was very high at 22 per cent, it is clear that small randomised trials should now be avoided and should be replaced with larger trials that can provide more robust evidence on the incidence of SSI, ultimately leading to more effective measures to help tack this global healthcare challenge.”

In an interview, Aneel further explained how these findings are immensely vital for a wide range of care providers in LMICs. “Following existing WHO and NICE guidelines, have significant cost implications for organisations which have limited resources.”

Can you tell us more about the genesis of the study, and why was it crucial to be carried out?

The interventions we tested within the study are included in clinical guidelines from the World Health Organisation. Before technologies, devices and drugs are placed in clinical practice, they need robust testing within a trial. Over 24 months, this trial was conducted and evidence toward the benefits and the risks were outlined. Cost is an important factor, in some parts of the world, especially in low- and middle-income countries, patients often pay for everything that is used during treatment. I believe the patient should only be paying if the treatment will work and there is proof of benefit.

We need to be researching and innovating more for the future. One of the risks of COVID moving forward is that we only provide basic health care, without the layers of innovation and research which we need. For example, keyhole surgery is an innovation that has proven benefits, and unless we continue to innovate, devices and techniques will not progress.

Continuing high-quality research is key in the present and post COVID era as it will guide improvements in treatment areas for our patients over the next decade.

How will findings from the study help steer future solutions in the right direction?

We are already conducting our next set of trials on this topic; the CHEETAH trial has recruited 9000 out of 12,800 patients. Changing instruments such as gloves before stitching up the wound will help determine if there is a decrease in infection rates. Therefore, we are testing more complicated behavioural and team-based approaches. By evaluating more complex areas, we will be able to prove or disprove benefits.

Can you tell us about the consequences of SSI?

Wound infection is the most common complication following an operation and they range from very minor to major complications. Wound breakdowns prolong for months, and this may affect a member of the household who is the breadwinner, which in turn can cause financial strain for the family and by large the community through living costs. Catastrophic expenditure is when a household spends 10 or 20 per cent of their annual income on their health care. Wound infections are a source of catastrophic expenditure, and once the family is plunged in, it can take years to recover.

Catastrophic expenditure can be worsened by a patient paying for treatments of no benefit to them. The most effective way to understand successful treatments is through evidence accumulated from a series of randomised trials and surgery. There are two aspects to this, the first is what is the cost of the wound infection? The cost of living varies in different societies.

The very first study we will produce is on what is the cost of wound infection in these countries. This is crucial, because if we can make the argument that reducing one wound infection will save the hospital $8,000 a year and save the patient $3,000 a year, then it becomes far easier to get policymakers and governments to make positive recommendations for this specific trial when we'll do a health economic analysis.

However, if the trial did not show a benefit then there is no cost-benefit. Nevertheless, it is still vital that we prove that some of these measures are either more cost-effective or expensive as we need to link the research to policymakers. Currently, there is a gap between the research paper and the policymaker, and we are working very hard to close that gap.  

The study also touched upon a formal health economic analysis in a future paper, which will describe the global costs and potential savings based on FALCON results – can you elaborate on this?

Moving forward in COVID, we need to ensure that our systems are strengthened, research and testing of innovations should be of high quality along, with observations made smaller and more controllable. Keyhole techniques reduce costs, with reduced wound infections and hernias. However, surgery is best when it's put into a pathway for the patient. Presently, it's seen as via the end of that past pathway, as an expensive luxury or as a damage control procedure. What we want is to see surgery shifted right to the start of that pathway. For example, if you have bad appendicitis or cancer that ruptures in the abdomen, you will require major surgery, this can be avoided if a patient is diagnosed earlier and undergoes a less complex surgery with lower costs. Recovery is easier; therefore, surgery should be isolated but should be seen as an integrated pathway that can support whole communities.

The impact on patients and communities is significant, as surgery is expensive for hospitals and patients. Research is key in making surgery as effective and affordable as possible, some countries around the world, especially in low-income settings have low rates of surgery. Boosting the rate of surgery is important as it can limit the impact of diseases such as cancer.  This needs to be done with safety and cost in mind to ensure that families live without the consequences of lifelong costs or infections.

Practitioners predict that digital healthcare is here to stay and will grow exponentially within the next few years. The transition in adopting new methods has been challenging, however, innovation has followed suit, “we have witnessed in the past years, technological innovations, particularly Artificial Intelligence (AI) will continue to influence procedures and solutions in the health sector. The sector has made advancements in robotic surgery, and this will remain one of the trends to look forward to in the coming year,” said Dr. Zbiggy Brodzinsky, Consultant Orthopedic Spine Surgeon at Valiant Clinic Hospital.

Bold plays in digital can help health systems solve a range of clinical and operational challenges and unwrap opportunities to move them along the path to the Future of Health, according to Deloitte’s global healthcare outlook report for 2022.

Related: Pivoting to telehealth – Opportunities and challenges

The report further comments that for healthcare to improve digitally, existing resources should be used, additional resources bought, or partnerships made to source what is needed. Practitioners have also recommended automating routine processes as it provides cost-efficient scalability for the future. “For instance, health systems can move non-core functions— training databases, testing environments, and disaster recovery backups—to the cloud; this helps in learning how to work with the capability, and, over time, migrate mission-critical systems.”

Digital healthcare can provide essential data to clinicians and patients, maximising the quality of care and efficiency of care delivery. In the UAE, for example, the Dubai Health Authority launched Doctor for Every Citizen telemedicine service which has provided 83,000 telemedicine consultations during the period from January 2020 to January 2021.

Related: Looking beyond the pandemic: Why telemedicine is here to stay

During the ongoing pandemic, several healthcare providers have integrated telemedicine to continue to safely care for their patients remotely. “Video consultation is a small fragment of digital transformation. The future is based on automation of data collection, documentation and coding; remote patient monitoring to better understand patient status, adherence, and crisis prevention,” said Michele Tarnow. President and CEO at the Alliance Care Technologies International.

Another example of creating databases, in the UAE is Riayati, a digital healthcare platform for the National Unified Medical Record (NUMR) program. Riayati aims to transform the current UAE healthcare landscape through the centralisation of medical records and the delivery of an innovative, fully integrated, digitised clinical information system.

A KPMG study, 'Who cares, Wins' predicted that by the year 2030 the world would be short 80 million physicians and nurses which means the healthcare system must innovate to ensure that they can work effectively.

“In the areas of diagnostics, leveraging AI and machine learning to provide decision support tools can be key in speeding up and improving the accuracy of diagnosis,” said Tarnow. She added, “leveraging data from wearables, implanted devices, and bidirectional communication between patients and providers will empower patients to take control of their health engagement while being monitored by their providers.”

Tarnow explains that all the technology required to accelerate digital transformation in healthcare is in place. The key to success lies in building solutions that seamlessly integrate into hospital systems, improving provider workflow efficiency and increasing capacity.

An expert in healthcare data and the leader of medical interoperability, Enovacom, the Orange Business Services healthcare subsidiary, has supported healthcare establishments with the digital transformation of their information systems since 2018.

Enovacom's new patient-centered solution, centralises and leverages healthcare data securely in a single application. Enovacom Patient Link facilitates administrative formalities, the digital relationship with patients and can be used to manage all care pathways. Interoperable by nature, it enables the various healthcare establishments to securely share patient healthcare data before, during and after their admission.

The solution is now available in France and will be launched in additional countries in 2022.

An innovative digital solution for patient care

Healthcare establishments have an overall view of their activity, a 360° view of the patient, contextualised information, assistance with identity monitoring, and process automation in a user-friendly and secure solution.

The Enovacom Patient Link solution is based on the Enovacom healthcare data warehouse that structures and capitalises on healthcare data for future use.

This new initiative strengthens Orange Business Services' strategic position as a trusted partner in the digital transformation of e-healthcare.

"As a leading player in e-healthcare, we believe that the patient-healthcare provider relationship should be digitalised in a considered and fair manner. The aim is to have a positive impact both on the daily lives of medical staff and on the healthcare experience for patients, while leveraging data. For Enovacom Patient Link, our teams worked with all healthcare players to design an innovative and secure solution that best meets their uses," said Laurent Frigara, Deputy CEO of Enovacom.

Managing the rise of infectious diseases and how they are contributing towards driving the Middle East & Africa clinical laboratory services market, will be just one of the hot topics on the agenda, as participants gather for the next edition of Medlab Middle East which takes place at the Dubai World Trade Centre from 24-27 January 2022.

The growth of the Middle East and Africa region’s clinical laboratory services highlights a marked increase in the cases of infectious diseases, combined with increasing demand for timely and accurate diagnosis, which is stimulating innovative methods of clinical diagnostics.

According to analysis carried out by research consultancy Data Bridge Market Research, over the next seven years, rising rates of infectious diseases and advances in clinical diagnostic methods will expand the Middle East and Africa’s clinical laboratory services market by a Compound Annual Growth Rate (CAGR) of 4.7% over the period 2021 to 2028, culminating in a market value exceeding $7.5 billion.

Rejoy Penacerrada, Conference Director for Informa Markets, said: “The study expects that another key factor contributing towards market growth, will be the accelerating adoption of digital pathology platforms and a preference for comprehensive health checkups offered by clinical laboratories.”

Supporting that analysis, another report by market research, business intelligence and consulting firm, Market Data Forecast, has estimated that the infectious disease therapeutic market in the Middle East and Africa is currently worth more than $9 billion and estimates that it will rise to $13.2 billion by 2026 a CAGR of 7.8%.

“The research attributes the rise in infections to a proliferation of certain microorganisms such as bacteria, fungi, viruses and parasites that are causing infections such as malaria, HIV, tuberculosis and influenza,” added Penacerrada.          

These and other opportunities and challenges will also be discussed across nine CME accredited multi-disciplinary conferences, including lab management, histopathology, clinical chemistry, microbiology, molecular & genomic diagnostics, haematology and blood transfusion in addition to a special track dedicated to COVID-19 and an online-only conference, Future of Lab.

As part of the Clinical Microbiology conference, the topic Infectious diseases in the region will be discussed, which will be led by industry expert, Prof Ziad Memish, Senior Infectious Disease Consultant, Director, Research & Innovation Centre, King Saud Medical City, College of Medicine, Alfaisal University, Riyadh.

Widely recognised as a pioneer in Mass Gathering Medicine and Infection Control, Prof. Ziad established the WHO collaborating centre for mass gathering medicine in the Ministry of Health and WHO Collaborating Center for IC in Saudi National Guard Health Affairs.

He said: “The twenty-first century has witnessed a wave of severe infectious disease outbreaks, not least the COVID-19 pandemic, which has had a devastating impact on lives and livelihoods around the globe. Early detection is the key to the prevention and control of any communicable diseases.”

“Clinical microbiology laboratories have had a pivotal role during the COVID-19 pandemic and will remain front and centre as new variants are identified. We are delighted to be hosting renowned specialists in this field such as Dr Ziad, who will be able to provide expert analysis on topics such as the immunology of SARS-CoV-2 and how laboratory tests are improving to support the clinicians and their diagnosis,” concluded Penacerrada.

As part of Informa's commitment to providing the highest hygiene and safety levels, the event will again take place under the protocols introduced via the company’s Informa AllSecure health and safety mandate. The enhanced measures include 35 guidelines covering all aspects of cleaning and hygiene, social distancing measures, and the use of PPE, screening, and a track and trace in conjunction with local authorities.