Potential solutions to the challenges identified during the first meeting of the “Health” group

1. Access to health care for the treatment of COVID-19 and other conditions.

The access to health and treatment for COVID-19 differs in particular countries depending on their socioeconomic level, prevalence of the infection cases, resources and organization of health care systems.

Improved access may be obtained by;

1. Paying special attention to the needs of high risk groups, namely; those with disability, the elderly and those living in poverty. Private institutions providing health care should support the public system.
2. Distributing the first available ethical vaccine to high-risk groups, including health care workers. Tax-paying citizens with a moral objection to unethically-produced vaccines, especially those derived from aborted human foetal cell lines, have the right to receive medical products and care consistent with their moral values.
3. Addressing the lack of medical personnel in resource-poor countries by governments facilitating the bureaucratic process of engaging appropriately skilled COVID-19 health care workers, and ensuring safe working conditions (including Personal Protective Equipment), and fair remuneration.
4. Optimising hospital bed availability for COVID-19 cases by facilitating timely discharge of recovering patients to home, and engaging social workers to address domestic issues preventing the completion of convalescence at home.
5. Diminishing fear, anxiety and mistrust in the health care system in the population at large, resulting from alarmist media reporting, through public information policies which ensure accurate reporting of the COVID-19 situation, educate about the need for ongoing treatment of chronic health conditions (comorbidities) so as to reduce the morbidity and mortality of an infection and, when available, encourage participation in early detection programmes for malignancy; for example, breast, bowel and cervical screening. Catholic NGOs have an invaluable role to play in counteracting the negative impact of inaccurate media reporting by presenting accurate and balanced information which gives hope.
6. Providing outpatient care through an appropriate combination of face-to-face and telephone/telemedicine consultations, balancing the risks and benefits of each method for staff and patients, and avoiding the temptation to rely on virtual consults as the mainstay of outpatient care.

1. The problem of heightened emotional stress levels should be considered part and parcel of the mental health burden of the COVID-19 era. Lockdown, with its loss of family income, the need for homeschooling, and tension arising from living in closed quarters, has been associated with more substance abuse and aggressive behaviour both inside and outside the home. The mainstream media narrative misleadingly links the words “violence” and “family”, implying family violence is endemic when, in reality, it’s uncommon and violence has been seen more often on the streets of various capital cities in the form of protests. The mass media has a crucial role in lowering individual and societal levels of anxiety and aggression. Another measure which ought to achieve the same effect is the engagement of young people as volunteers helping those in need, especially the elderly who, when hospitalised, may feel lonely, abandoned, depressed and fearful of dying alone and without the sacraments. These feelings may be exacerbated by family members who stay away for fear of contracting COVID-19.
2. Families should be allowed to visit members who are hospitalised or in a care facility, and both solidarity and fraternity should be encouraged.
3. The pandemic must not be allowed to promote dehumanization. Every church should be open for prayer, Mass and reconciliation. When a church must be locked for security, a view of the vestibule and Tabernacle should be assured for example, through a grate. As Maria Jose Vilaca has said, “Everybody should get their peace of mind and a reason to live”. We all need more support..

1. Social protection and economic support is a duty of government rather than non-government organisations. That said, NGOs have an important role in advocacy and coordinating with national Caritas offices in collecting donations of money and necessary items.

1. We, as Catholic-inspired NGOs, should recommend that all providers of maternal and child health care withdraw new maternity hospital regulations which separate mothers and newborns from fathers and other family members. Family-oriented perinatal care, which was introduced decades ago, should be maintained with appropriate viral precautions to permit family interaction in the delivery and postpartum rooms.

The first case report of an uncomplicated vaginal birth in a COVID positive mother, in which there was no separation of the infant from its COVID positive parents, was published in June 2020.1Published series thus far indicate that pregnant women are probably not at increased risk of severe COVID-19 infection.1 Similarly, there is no evidence to date of vertical transmission of coronavirus (mother to baby in-utero).1 The largest obstetric experience of coronavirus is from China where almost all mothers have been delivered by Caesarean section, they are separated from their newborns for at least 14 days, and not allowed breastfeeding or rooming in.1 Recent RCOG (UK) guidelines for COVID positive mothers suggest that delayed cord clamping, breastfeeding and rooming in are possible if strict viral precautions are observed (mask wearing and hand washing).1 WHO guidelines strongly support breast feeding for these mothers.1

Hence, the recommendation to perform Caesarean delivery for every COVID infected mother may be unnecessary, and every case should be assessed on its own merits, factoring in the known disadvantages of Caesarean section.

1. For various reasons, access to spiritual care has fallen short of actual need in a number of hospitals and aged care facilities. The reasons for the shortfall include a shortage of chaplains, the prevailing practice of requesting chaplaincy assistance on an “as needed” basis, and that sick patients may be unaware that their poor condition warrants the Holy Sacraments. Isolated patients are afraid of dying alone, and for the faithful the notion of dying without receiving the greatly desired Sacraments increases their distress. Hospital chapels, and spiritual care in general, should be accessible to health care professionals as well.

The Polish Institute of Legal Culture, “Ordo Iuris,” recently received reports from numerous Polish hospitals and aged care facilities, that senior management had forbidden entry to chaplains, and, instead, advised patients to view Holy Mass on TV. This contravenes Polish law which states that patients have the right to receive spiritual support through the religious service of his/her own faith. Ordo Iuris has intervened in such cases, frequently with success. The Patient Rights officer also investigates every case in which a patient’s freedom of conscience may have been breached.

There are instances in which the Catholic Church has created its own sanitary rules. It is our view that the Church should not take on this role but, rather, continue to focus on it’s principal duty of leading souls to Heaven. After all, is not the spiritual health of one’s soul no less important than the health of the body?

1. During the COVID-19 pandemic, many governments around the world enacted Emergency Management legislation which classified elective surgical abortion as a category 1 procedure, on par with urgent procedures for gynaecological cancer and precancer, ovarian cyst complications, etc. In South Australia, there was also a push by certain politicians, and others, to make Early Medication Abortion (EMA) available via telehealth (tele-abortion).2

Elective surgical abortion consumes significant medical resources, including emergency operating theatre staff and time, and Personal Protective Equipment (PPE).4 Complications from medication and surgical abortion generate additional Accident and Emergency attendances, and emergency surgery4. In addition, compared with early surgical abortion, EMA has up to 11 times higher death rate 3, a higher overall complication rate (20% vs 5.6%) 4,6 and is at least 6 times more likely to require surgical evacuation (6% vs 0.9%).4,6 Furthermore, providing medication abortion via telemedicine to women who cannot access all the recommended pre- and post-abortion care, and for remote/rural women in particular, heightens the risk of women becoming casualties of home abortions.5

Hence, numerous states in the USA classified elective abortion as a non-essential procedure, and several state governors and Chief Medical Officers explicitly banned elective abortion.

In summary, elective surgical and medication abortion should NOT be considered an essential procedure under Emergency Management legislation. Action opposing this trend should be organised.

1. Abortion, the intentional killing of an unborn child, is not part of authentic healthcare. A physician’s vocation is to be the guardian of life and health. We are not to sit in judgement, deciding who is to live or die, nor act as an executioner. The surveillance and reporting of hospitals and aged care facilities for cases of physician-assisted suicide (euthanasia) is an important priority. The pandemic should not be used to justify the expansion of abortion or euthanasia.

1. There is a danger that “pandemia” may be a vehicle for contempt and negligence toward human life. We, as Catholic NGOs, should be unfailingly vigilant to maintain the utmost respect for human life, whatever the challenge might be, as stated by Mrs Marion for Femina Europe.

1. It is our duty, as Catholic NGOs operating during the pandemic, to pray.

References:

1. Lowe B, and Bopp B. COVID-19 vaginal delivery. Short Communication. Aust N Z J Obstet Gynaecol 2020;465-466.
2. https://www.news.com.au/national/breaking-news/better-abortion-care-needed-during-virus/news-story/1b0da3ee3afb32d17f196f38da0603ba
3. Green M. Fatal Infections Associated with Mifepristone-induced Abortion. NEJOM. 2005;353:2317-2318
4. Pregnancy Outcome in South Australia 2016 https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/resources/pregnancy+outcome+in+south+australia+2016
5. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2014-PI-01965-1&d=202004151016933 pg19
6. Niinimäki M1, Pouta A, Bloigu A, Gissler M, Hemminki E, Suhonen S, Heikinheimo O:. Immediate complications after medical compared with surgical termination of pregnancy’ https://www.ncbi.nlm.nih.gov/pubmed/19888037