Introduction
Saudi Arabia is the Arabian Peninsula’s largest nation and is responsible for the well-being of a high number of citizens and residents. Saudi Arabia’s healthcare system took vital steps to address the COVID-19 pandemic. The Minister of health chaired a national emergency response committee that actively monitored trends both locally and internationally. Some of the initiatives the committee undertook included the management of identified cases, the repatriation of citizens, and the supply of necessary resources to the health sector. Despite having a robust healthcare system, Saudi Arabia faced significant challenges occasioned by the increased demand for acute care services precipitated by the COVID-19 pandemic.
Background
Saudi Arabia is one of the world’s most important religious and business hubs. The country is the largest in the region and has a population size of 34 million, with 21 million Saudi nationals and 13 million non-nationals (Alessy et al., 2020). The nation’s healthcare system is robust and provides free care to all the people in its 494 hospitals, which offer 22.5 beds per 10,000 people and employs an estimated 113,000 physicians (Khan et al., 2021). The COVID-19 pandemic affected the lives of people all over the globe. The highly contagious virus caused an unprecedented level of morbidity and mortality, prompting the government to implement adverse measures in an attempt to stop the spread of the disease (Alonazi & Altuwaijri, 2021). It is vital to note that the application of risk assessment tools developed by the Global Center for Mass Gatherings was prioritized (Khan et al., 2021). Rapid response teams were deployed to address emergent issues and limit disease spread in the population.
The healthcare system experienced a significant degree of pressure during the pandemic. The facilities were prepared to admit a large number of patients, and the General Directorate of Hospitals assessed organizational readiness and coordinated the distribution and admission of confirmed COVID-19 cases (Khan et al., 2021). The institution also assessed the need for respirators, personnel, and rapid ambulance teams. Saudi Arabia’s strategic response to the pandemic ensured that the people were protected from the pandemic’s ill effects and that containment measures limited the spread of disease.
Impact on Training
Health professionals are a key component of any nation’s healthcare system. Saudi Arabia’s residency and fellowship training programs were adversely affected by the COVID-19 pandemic. The cancellation of in-person sessions has significantly affected learning in healthcare institutions. Recommendations by the United States Surgeon General for the delay of elective and non-essential medical interventions to preserve medical supplies and limit the spread of disease affected numerous individuals in healthcare contexts (Balhareth et al., 2020). As a result, trainees have had limited exposure to diagnostic activities and outpatient clinics, which is vital for learning. A study by Balhareth et al. (2020) demonstrated that 97% of respondents experienced limited surgical exposure as a result of the pandemic. While the attempt to address the deficits using telemedicine and conferencing technology should be lauded, it is vital to note that most are not as effective, given the fact that the systems are new.
Impact on Service Delivery
A variety of healthcare services were affected by the pandemic. Healthcare service utilization declined due to limited availability, fear of contracting the virus, and constrained access (Rabbani et al., 2021). It is vital to note that a significant portion of healthcare resources was diverted to address the pandemic, which inadvertently led to the disruption of core services. The continuum of care was, therefore, negatively impacted due to disturbances in follow-up visits and medication supply.
The increased demand for medical services far outweighed the available resources, prompting the re-organization of the medical landscape. The suspension of chronic and non-urgent care in favor of emergency care adversely affected the healthcare system’s capacity to address the population’s needs. For instance, a study by Alsuhaibani and Alaqeel (2020) showed that childhood immunization was adversely affected in the Qassim region due to COVID-19. Routine vaccinations were delayed in babies younger than one month, with the fear of contracting the virus being the most common cause of delay (Alsuhaibani & Alaqeel, 2020). The ambiguity of the initial stay-at-home orders and vaccination procedures outlined by the health ministry also contributed to the limited access to vaccinations.
In responding to the COVID-19 pandemic, the ministry of health prioritized the establishment of isolation and treatment centers. It was necessary to transform existing facilities to address the needs of individuals diagnosed with the virus. Staff shortages prompted the closure of some primary care centers, which had to cancel and divert appointments to other institutions (Rabbani et al., 2021). A study by Rabbani et al. (2021) demonstrated that 25% of the women interviewed reported missing clinic appointments as a result of COVID-19 policies. The researchers also note that primary healthcare facilities that had to manage diverted patients were overwhelmed by high numbers (Rabbani et al., 2021). There was notable fragmentation in the delivery of care as many patients missed their appointments.
Family medicine practices were significantly affected by the COVID-19 pandemic. Shatla et al. (2021) conducted a study in which s significant number of patients experienced cancellations in physical examination procedures. The researchers note that 94.7% of the study participants had their routine health check visits canceled, 50.3% experienced delays in consultations, and 84.3% faced disruptions in chronic care visits (Shatla et al., 2021). A further 55.5% were unable to access acute care services, and 90.5% faced challenges accessing preventive care services (Shatla et al., 2021). The transfer of healthcare workers to other health facilities and the increased incidence of the virus among healthcare practitioners contributed to staff shortages. It should be noted, however, that there were no reported shortages in medication reported in the country. It is vital to point out that 36.4% of the study respondents reported shortages in personal protective equipment at the pandemic’s peak (Shatla et al., 2021). The aforementioned challenges adversely affected the quality of services offered to Saudi Arabia’s population.
Communication is a vital aspect of service delivery in healthcare contexts. The ability to communicate with patients was adversely affected, with 64.4% of the respondents in the study by Shatla et al. (2021) indicating that they faced difficulties exchanging information with their clients during health status checks. The use of telephone services introduced a variety of issues. For instance, users lost the ability to communicate non-verbally, address cultural variances and deal with language problems. Shatla et al. (2021) note that the inability to access comprehensive information made decision-making challenging, given the fact that clinicians had to rely on patient symptoms and self-assessment findings.
Cancer care was negatively affected by the outbreak of COVID-19 in Saudi Arabia. Twenty three governmental centers offer cancer management services in the Saudi Kingdom (Alessy et al., 2020). In a bid to control the rates of infection, hospital access was limited to a single entry point, and screening teams were placed at all access points in radiotherapy facilities and outpatient treatment centers. Virtual meetings were instituted for non-urgent cancer treatment, including surgery and clinic visits, and virtual platforms were used to provide cancer support services, and mail delivery was the primary means used to supply medications (Alessy et al., 2020). Individuals diagnosed with the virus were forced to delay cancer treatment until they recovered fully to limit transmission and the occurrence of complications.
The complexity of cancer care meant that oncologists faced numerous challenges when attending to patients using virtual platforms. For instance, the lack of physical examination and limited access by patients to the technological services required to receive care led to gaps in the delivery of care (Alessy et al., 2020). The level of trust among residents in Saudi Arabia in the ability of government cancer screening facilities to prevent COVID-19 transmission has declined significantly. Alessy et al. (2020) posit that the decline in confidence is likely to precipitate an increased incidence of late-stage cancer diagnoses in the kingdom. In addition, it is expected that the number of patients seeking cancer treatment services is likely to decline due to the fear of contracting the virus. Such outcomes are likely to undo the progress made in cancer treatment in Saudi Arabia.
Impact on Healthcare Practitioners’ Mental Health
The Covid-19 pandemic had a significant impact on the mental health of Saudi Arabia’s healthcare workers. In a study to evaluate the pandemic’s impact on psychological well-being, Arafa et al. (2021) found that 69% of health practitioners in Egypt and Saudi Arabia experienced depression, 58.9% were diagnosed with anxiety, and 37.3% faced sleeping difficulties. The researchers also noted that the female gender was a significant risk factor for the development of adverse mental health conditions as a result of managing patients diagnosed with the virus. The extensive media coverage of the crisis served to aggravate psychological distress. It was estimated that watching the news for more than twelve hours a day was associated with an increased risk of developing mental distress (Arafa et al., 2021). The elevated degree of misinformation from social media platforms further aggravated the condition.
Conclusion
Even though Saudi Arabia has one of the world’s most advanced healthcare systems, it was not immune to the effects of the COVID-19 pandemic. The cancellation of in-person sessions has significantly affected learning in healthcare institutions. There was a decline in healthcare service utilization as a result of limited availability, fear of contracting the virus, and constrained access. In addition, staff shortages caused by transfers and transmission among personnel prompted the closure of some primary care centers, which had to cancel and divert appointments to other institutions. The use of telephone services introduced a variety of issues, such as a limited ability to communicate non-verbally, address cultural variances and deal with language problems. Therefore, health practitioners experienced difficulties making decisions on account of limited information. Finally, the pandemic had a significant impact on the mental health of healthcare workers in the country, which negatively impacted their efficiency. The aforementioned challenges notwithstanding, Saudi Arabia has taken vital steps to learn from its experiences and ensure that the healthcare system is prepared to address its population’s needs in crisis situations.
References
Alessy, S. A., Davies, E. A., & Jazieh, A. R. (2020). Cancer care during the COVID-19 pandemic: A perspective from Saudi Arabia. Ecancer Medical Science, 14, 1–6.
Alonazi, W. B., & Altuwaijri, E. A. (2021). Health policy development during COVID-19 in Saudi Arabia: Mixed methods analysis. Frontiers in Public Health, 9, 1–8.
Alsuhaibani, M., & Alaqeel, A. (2020). Impact of the COVID-19 pandemic on routine childhood immunization in Saudi Arabia. Vaccines , 8(4), 1–10.
Arafa, A., Mohammed, Z., Mahmoud, O., Elshazley, M., & Ewis, A. (2021). Depressed, anxious, and stressed: What have healthcare workers on the frontlines in Egypt and Saudi Arabia experienced during the COVID-19 pandemic? Journal of Affective Disorders, 278, 365–371.
Balhareth, A., AlDuhileb, M. A., Aldulaijan, F. A., & Aldossary, M. Y. (2020). Impact of COVID-19 pandemic on residency and fellowship training programs in Saudi Arabia: A nationwide cross-sectional study. Annals of Medicine and Surgery, 57, 127–132.
Khan, A., Alsofayan, Y., Alahmari, A., Alowais, J., Algwizani, A., Alserehi, H., Assiri, A., & Jokhdar, H. (2021). COVID-19 in Saudi Arabia: The national health response. Eastern Mediterranean Health Journal, 27(11), 1114–1124.
Rabbani, U., Saigul, A. A., Sulaiman, A., & Ibrahim, T. H. (2021). Impact of COVID-19 on antenatal care utilization among pregnant women in Qassim, Saudi Arabia. Cureus, 13(11), 1–13.
Shatla, M., Alharthi, B. T., Alharbi, A. G., Khan, Z. A., Althaqfi, A. A., Babkoor, A. A., & Almalki, A. A. (2021). The Impact of the COVID-19 pandemic on family medicine practices in Saudi Arabia. Cureus, 13(12), 1–17.