Remote Access Urgent for Respiratory Care in Rural Asia

ABM Respiratory Care CEO Vinay Joshi says supporting the growth and access of remote healthcare services is critical to helping people living with respiratory diseases in rural areas.

By Vinay Joshi

One year on, COVID-19’s effects are far and wide, with the pandemic deepening the existing divide between richer and developing countries.  If advanced economies reserve essential medical supplies for their own citizens and cut, rather than expand, aid and other concessional financial support, developing countries will bear heavy costs, on a human and economic level.

With recent advancements in vaccine development and rollouts, the world may be one step closer to having a panacea for COVID-19. However, for Asia’s rural populations, vaccines as a solution seems unlikely.

In rural areas with poor infrastructure, there are challenges to conquer for COVID-19 vaccines, such as driving awareness, and ensuring acceptance, accessibility and availability. There is also a lack of healthcare workers to facilitate the vaccination rollouts. The world’s poorest populations are located mainly in Southeast Asia, which also has the largest shortfall of healthcare workers.

The Economist Intelligence Unit predicts that the richer, geographically smaller economies including Singapore, Hong Kong and Taiwan will have more than 60% of its population vaccinated by the end of 2021. The rest of the region, dispersed across cities, forests and islands, lack resources and face transport and regulatory issues. Poorer countries, including Laos and Myanmar, may only vaccinate 60% of its populations in 2025 and beyond.

In 2020, rural Sarawak (Malaysia), India, Indonesia and Myanmar reported ventilator shortages. In March, the global demand for ventilators was at least 10 times what was available. The market for ventilators is expected to continue increasing to USD 1843.1 million, driven by the pandemic and the rising incidence of respiratory illnesses.

Worldwide, demand for healthcare workers is predicted to increase to 80 million, with only 65 million supplied, amounting to a shortage of some 15 million workers. WHO’s Southeast Asia region needs to increase nurses and midwives by 1.9 million to achieve health for all by 2030. The lack of healthcare workers in Southeast Asia is compounded by migration of healthcare workers to richer areas. According to the World Bank, at least 65.6% of the population in South Asia and 40.1% of the population in East Asia and the Pacific are living in rural areas. Considering the poor healthcare infrastructure in these areas, the depth and impact of ventilator shortages may be unreported.

The combination of ventilator shortages, lack of healthcare workers, and the challenges of rural area vaccination highlight the importance of remote respiratory care as a current solution in rural areas. Fewer healthcare workers and fewer bedside visits are required to manage tele-ventilators, thereby also reducing infection risk. While the recent developments for vaccine distribution may reduce the strain on the healthcare industry, the rollout will take time and the long-term efficacy is still unknown.

With vaccination challenges in rural areas, the importance of remote healthcare cannot be overlooked. Remote healthcare enables an ongoing connectivity or patients outside of physical clinics and hospitals, which means patients can still be cared for or monitored continuously. This avoids unnecessary hospital trips and prevents exposure to the coronavirus.

Some respiratory care start-ups have been doing great work in this space. For example, Resmetrix is developing a wearable sensor to detect respiratory inconsistencies. The wearable sensor is wirelessly connected to a smartphone app, providing real-time access to respiratory and vital signs for the patient and clinicians, enabling health systems to monitor quarantined or mildly ill COVID-19 patients. Apps like these enable patients to receive medical examinations at home, eliminating the risk of spreading the virus in overcrowded hospitals.

Another great innovation to address the shortage of ventilators is the use of tele-ventilators, which can be accessed remotely anywhere in the world. This eases the burden of staff running to every ventilator when alarms go off and helps healthcare professionals manage numerous patients. For example, my company, ABM Respiratory Care, partnered with Advanced MedTech and Temasek Review to develop the world’s first tele-ventilator, the Alpha ventilator, to support respiratory care at a time of great need and severe shortage.

It is important for healthcare products to be made accessible, practical, and affordable for hospitals or care centres to implement in rural areas, especially during a crisis. For instance, the Alpha tele-ventilator weighs four kilograms, making it a portable and convenient solution for rural areas. For areas with limited infrastructure, the tele-ventilators can be installed at home as well, enabling patients who are unable to travel or obtain bed space at hospitals to be treated at home.

When set up in rural areas with a lack of healthcare workers, the tele-ventilators reduce the strain on the healthcare system, as they require less healthcare professionals to operate. Additionally, tele-ventilators will reduce bedside visits and infection risk, reducing the potential spread of COVID-19. This innovation has huge potential to save many lives in rural areas, where the limited number of hospitals can be overburdened with a shortage of staff and lack of resources.

Remote access to respiratory data is crucial in rural areas as it provides healthcare workers with quick access to critical data, especially in large regions with limited resources. The data helps healthcare workers better understand complex cases and supports them in decision-making processes.

To understand how increased access to data benefits healthcare practitioners, Ventura County Medical Center Director of Pediatrics Dr Chris Landon discusses the potential of tele-ventilators –

“As a clinician, with more patients requiring mechanical ventilation, it’s never been more critical to have access to information you need to make necessary interventions to support adequate respiratory function. In the face of complex cases we need solutions that allow multiple caregivers access to consult and coordinate care. During this difficult time, having remote access to your most critical patients’ data, while helping reduce your team’s risk of infection, is essential,” says Dr Landon.

While governments are working to roll out COVID-19 vaccinations in rural areas, remote respiratory healthcare

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