Telemedicine at the heart of management of the COVID-19 crisis

During the COVID-19 crisis, telemedicine was at the center of the health management systems in the canton of Geneva. Telemedicine contributed to the triage and follow-up of patients with a suspected or confirmed diagnosis of COVID-19, as well as to the coordination of different healthcare actors in the patient’s trajectory. New partnerships and reinforcement of coordination in the Geneva healthcare and social care networks with an unprecedented use of telemedicine tools were able to ensure patient care while preserving frontline healthcare providers. Telemedicine has benefited during this time from a temporary relaxation of measures and regulations governing its practice, encouraging its deployment in a crisis situation. However, for these tools to be effective, they need to become an integral part of our healthcare systems.

Out-of-hospital cardiac arrest: Choosing wisely whom to resuscitate

Restrictions on the management of out-of-hospital cardiac arrest during the COVID-19 pandemic have challenged the previous << more care is better care >> approach. By promoting both the reduction of no-flow delay and implementation of quality chest compressions, resuscitation guidelines have evolved in order to prevent neurological injury. At the same time, mechanical chest compression devices and extracorporeal membrane oxygenation (ECMO) have emerged, allowing for prolonged resuscitation. These new possibilities have made decision making more complex, while decision support tools have not evolved much. At each decision point, the futility of the measures envisaged must be considered. Better resuscitation for a better life means above all << choosing wisely >> whom to resuscitate.

[Vulnerable populations and COVID-19 : need for innovation and cooperation to address health and social needs]

The COVID-19 crisis has rapidly increased the vulnerability of groups of population already facing precarious living conditions. The emergence of food and housing insecurity have forced health and social actors along with the local authorities to implement innovative responses in order to respond to these unmet needs. This article presents some of these responses, such as an interdisciplinary mobile COVID-19 screening team, an emergency housing program and a large-scale food assistance program. These examples highlight the need for an intersectoral, coordinated and collaborative response simultaneously targeting different domains of insecurity in parallel to actions on the underpinning social and political determinants of these vulnerabilities.